Spinal Cord Stimulator Trial Approved After an IME Dispute: Illinois Workers’ Comp Win

By Matthew C. Jones, Illinois Workers’ Compensation Attorney | Last reviewed August 2026

The worker’s identity, employer, case number, hearing location, doctors’ names, and other identifying facts have been omitted. The purpose of this case study is to explain how a serious treatment dispute can be proven – not to publish a client’s private medical history.

The case was tried by Brenton M. Schmitz, a partner at McHargue & Jones with more than 15 years of Illinois workers’ compensation experience. The decision is a strong example of what can happen when an insurer relies on an IME to dispute chronic pain, medical causation, work ability, and an expensive treatment recommendation.

What Did the Arbitrator Order?

The hearing was brought under Section 19(b) of the Illinois Workers’ Compensation Act. That type of hearing can address disputed medical care, temporary disability benefits, unpaid bills, and related issues while the claim remains open.

After considering the worker’s testimony, treatment records, diagnostic studies, medical bills, and two doctors’ evidence depositions, the arbitrator:

• found the worker’s continuing orthopedic and neurologic conditions causally related to the work injury despite a disputed intervening-causation argument;
• authorized a spinal cord stimulator trial as prospective medical care;
• ordered payment of substantial disputed medical bills;
• awarded TTD through the hearing date, subject to the employer’s credit for TTD already paid; and
• left later medical and disability issues open for future determination.

This was not a final permanency award, and it was not an order automatically approving a permanent SCS implant. The first step is the temporary trial. If the trial is medically successful, the treating physician may then request permanent implantation.

For a plain-English explanation of the hearing process, read our Illinois workers’ comp hearing and trial guide. For the wage-benefit rules, see how much workers’ comp pays in Illinois for TTD, TPD, maintenance, and AWW. Our separate overview explains the types of Illinois workers’ compensation benefits that may be involved from treatment through permanency.

Why the Treating Doctor Recommended a Spinal Cord Stimulator Trial

The worker had a long treatment history involving orthopedic injuries and chronic lumbar and leg symptoms. Treatment included surgery, physical therapy, diagnostic imaging, electrodiagnostic testing, injections, and interventional pain-management procedures. Some procedures produced temporary relief, but the low-back and leg symptoms returned.

The treating spine specialist concluded that another traditional operation was not the best answer. He described the pain as regional and recommended an SCS trial because stimulation could address multiple areas of pain rather than target a single structure with another surgery.

That distinction matters. A spinal cord stimulator is often considered when a worker has persistent neuropathic pain but no clear, correctable surgical target remains. The question is not simply whether a new MRI shows something that can be cut out, decompressed, or fused. The physician must explain why the pain pattern is medically credible, why conservative care failed, and why neuromodulation is reasonable.

Our full guide explains when Illinois workers’ comp may pay for a spinal cord stimulator, including psychological screening, the temporary trial, permanent implantation, and future medical issues.

The Insurance IME Said the Pain Was Not Supported by the Testing

The employer sent the worker to a Section 12 examination, commonly called an independent medical examination or IME. The IME examiner characterized the symptoms as non-physiologic and raised allegations of symptom magnification, malingering, or a possible somatic explanation. He did not believe the SCS would help because he did not see a sufficient structural explanation on the MRI.

The treating spine specialist disagreed. He had examined the worker repeatedly, reviewed the treatment course and testing, and testified that he saw no symptom magnification. His examinations included negative Waddell findings. He connected the condition to the work injury based on the history, physical examinations, imaging, and EMG studies.

This is the classic dispute we discuss in IME doctor versus treating doctor: who does Illinois workers’ comp believe? An IME report does not automatically control the case. The arbitrator weighs both opinions against the complete medical timeline, diagnostic evidence, examination findings, and testimony.

Why the Arbitrator Found the Treating Doctors More Persuasive

The result did not turn on one magic test. Several pieces of evidence reinforced one another.

1. The arbitrator found the worker credible

Chronic-pain cases often depend heavily on credibility because pain cannot be reduced to a single MRI image or laboratory result. The arbitrator observed the worker testify, compared that testimony with the records, and found no material contradiction that made the worker unreliable.

2. The treating specialist had a longer clinical history

The treating specialist saw the worker over time and could evaluate the response to therapy, injections, and other treatment. The IME examiner evaluated the worker once. A treating relationship does not guarantee that the treating doctor wins, but repeated examinations can provide a more complete basis for the opinion.

3. Other doctors did not corroborate the IME’s accusations

The decision noted that other physicians – including another examiner selected by the employer earlier in the claim – did not document malingering or symptom magnification. That made the one-time IME examiner’s accusations less persuasive.

4. The defense position contained a practical inconsistency

The IME examiner minimized the condition while still accepting significant restrictions from an earlier functional capacity evaluation. The arbitrator considered whether that position fit the overall record.

5. There was no utilization-review report in evidence

The decision specifically noted that the record did not include a utilization-review report criticizing the SCS recommendation or another treatment modality. The employer still had the IME opinion, but there was no separate utilization-review analysis for the arbitrator to weigh.

6. The treatment recommendation offered a path forward

The treating specialist did not promise a cure. He recommended a trial that could test whether stimulation reduced pain and improved function before a permanent device was considered. The arbitrator found that approach more persuasive than ending care with significant restrictions and no further attempt to improve function.

Why This Decision Matters Beyond One SCS Case

Serious chronic-pain claims are frequently disputed because the worker’s symptoms may be more extensive than the current MRI or EMG appears to explain. That does not mean every SCS recommendation is reasonable or that every chronic-pain claim will succeed. It means the case must be evaluated on the complete record.

In a well-developed case, important evidence may include:

• a consistent history from the accident forward;
• documentation of failed conservative care;
• pain-management and specialist records;
• physical examination findings and functional observations;
• the worker’s response to injections, therapy, and prior procedures;
• psychological screening and a defined SCS trial plan;
• the treating doctor’s deposition testimony;
• cross-examination of the IME examiner; and
• credible testimony about symptoms, limits, and work ability.

If the condition results in lasting work limits, our guides explain what happens after permanent restrictions and what affects the value of an Illinois back-injury claim.

What Happens If the Employer Seeks Review?

An Illinois workers’ compensation arbitration decision can be reviewed by the Commission. A party generally must file a Petition for Review within 30 days after receiving the decision and complete the review process required by the Act and Commission rules.

A Commission review is not a brand-new trial with new witnesses. The record built at arbitration – including the worker’s testimony, medical exhibits, and doctor depositions – is therefore extremely important. We expect that review may be sought in a case of this significance, but no review result should be reported unless and until one exists.

This page will be updated if a later Commission or court decision changes the result.

Regional Pain Is Not Automatically CRPS

The arbitration decision described a regional pain disorder. It did not expressly diagnose complex regional pain syndrome. Those terms should not be treated as interchangeable.

CRPS has specific clinical diagnostic criteria and is frequently disputed in its own right. For that separate issue, read our guide to CRPS, RSD, treatment, benefits, and case value in Illinois workers’ compensation.

Frequently Asked Questions About SCS Workers’ Comp Trials

Can an Illinois workers’ comp arbitrator order an SCS trial?

Yes. If the worker proves that the treatment is reasonably required to cure or relieve the effects of the work injury and that the condition is causally connected to work, an arbitrator may award prospective medical care under Section 8(a). The evidence needed depends on the facts and medical record.

Does the insurance company’s IME doctor decide whether treatment is approved?

No. The insurer may rely on the IME to deny or delay treatment, but an arbitrator can find the treating doctor more persuasive. Medical records, testing, treatment response, deposition testimony, and the worker’s credibility all matter.

Does approval of the SCS trial mean a permanent device must be implanted?

No. A temporary trial is used to evaluate whether stimulation provides meaningful relief and functional benefit. A permanent implant is considered only if the treating team finds the trial successful and the next stage is medically appropriate.

Is this arbitration result final?

Not necessarily. A party may seek Commission review within the applicable deadline. This article accurately describes the arbitration-level result as of publication.

Can TTD continue while an SCS dispute is being litigated?

It can, depending on the medical restrictions, work status, maximum-medical-improvement dispute, and other evidence. Learn how Illinois calculates TTD and other wage-replacement benefits. If checks were cut off after an IME, read what to do when workers’ comp stops paying checks in Illinois.

Sources

• Recent Illinois Workers’ Compensation Commission arbitration decision and firm case record. Identifying client details intentionally omitted.
• 820 ILCS 305/8(a) – Illinois medical-benefit statute.
• 820 ILCS 305/12 – employer-requested medical examinations.
• IWCC Petition for Review of Arbitration Decision.