IMEs in Illinois Workers’ Compensation: What Injured Workers Need to Know
An Independent Medical Examination (IME)—also called a Section 12 exam—is a mandatory medical evaluation in Illinois workers’ compensation cases requested by the employer or insurance company, not your treating doctor. The IME is used to assess whether your injury is work-related, what treatment is necessary, whether you can return to work, and whether workers’ compensation benefits should continue. Although labeled “independent,” the IME doctor is selected and paid by the insurer, and the report is often relied on to deny, reduce, or terminate benefits.
What Is an IME (Section 12 Exam) in Illinois Workers’ Compensation?
An Independent Medical Examination (IME) is a one-time medical evaluation performed by a physician selected by the employer or its insurance carrier under Section 12 of the Illinois Workers’ Compensation Act.
The IME doctor is not your treating physician and does not provide medical care. Their role is limited to examining you and issuing a report for the insurance company’s use in your workers’ compensation claim.
Why Do Insurance Companies Request IMEs?
Insurance companies commonly request IMEs to:
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Determine whether the injury is work-related
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Question the severity of the condition
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Dispute the need for surgery or continued treatment
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Claim the worker can return to work full duty or light duty
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Argue the worker has reached Maximum Medical Improvement (MMI)
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Justify suspending or terminating benefits
IMEs are often requested after a treating doctor recommends surgery, extended time off work, or permanent work restrictions. Note, this is a good time to consider hiring a workers’ comp attorney. The insurance company is saying “Can I stop paying now?”
Is an IME Mandatory in Illinois?
Yes.
Under Illinois law, an injured worker is generally required to attend an IME if it is properly requested. Failing to attend without good cause can result in a suspension of workers’ compensation benefits.
That said, IME requests must be reasonable in time, location, and scope. Repeated, excessive, or abusive IME requests may be challenged before the Illinois Workers’ Compensation Commission.
Who Pays for an IME?
The employer or insurance company must pay for:
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The cost of the IME
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Reasonable travel expenses, including mileage
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In some cases, transportation such as taxi or rideshare
An injured worker should not be billed for attending an IME.
What Happens During an IME?
An IME is usually shorter than a regular medical appointment. During the exam, the doctor may:
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Review selected medical records
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Ask how the injury occurred
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Perform a physical examination
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Ask about pain levels and limitations
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Evaluate the worker’s ability to return to work
The IME doctor does not treat you, prescribe medication, or offer medical advice.
How Long Does an IME Take?
Most IMEs last 15 to 30 minutes, though some may take longer depending on the type of injury. Many injured workers are surprised by how brief the examination is.
What Happens After an IME?
After the examination:
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The IME doctor prepares a written report
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The report is sent to the insurance company
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The insurer may rely on the report to continue, reduce, or stop benefits
In most cases, the injured worker does not receive a copy of the report directly, but an attorney can obtain and review it.
How IMEs Are Used to Deny Workers’ Compensation Benefits
IME reports are frequently used by insurance companies to argue that:
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The injury is no longer work-related
- The injury is pre-existing or degenerative
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The worker is exaggerating symptoms
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Additional treatment is unnecessary
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The worker can return to work without restrictions
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The worker has reached MMI
Importantly, IME opinions are not binding on the Illinois Workers’ Compensation Commission and can be challenged with medical evidence and testimony.
What Should You Do Before an IME?
To protect your workers’ compensation claim:
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Be honest and accurate
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Answer questions briefly and directly
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Do not exaggerate or minimize symptoms
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Do not volunteer unnecessary information
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Do not argue with the doctor
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Write down what occurred immediately after the exam
Everything you say or do during the IME may appear in the doctor’s report.
Can an IME Be Challenged in an Illinois Workers’ Comp Case?
Yes. An IME can be challenged by:
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Presenting testimony from treating physicians
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Cross-examining the IME doctor
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Pointing out inconsistencies or factual errors
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Showing bias or lack of familiarity with the worker’s condition
The Commission often gives greater weight to treating doctors who have followed the worker over time.
Do You Need a Lawyer for an IME?
While a lawyer is not required, many injured workers seek legal guidance because IMEs are one of the most common tools used to deny or terminate benefits. An experienced Illinois workers’ compensation attorney can help prepare for the exam and respond if benefits are unfairly cut off afterward.
FAQ — Independent Medical Examinations (IME) in Illinois Workers’ Compensation
Q: What is an IME in Illinois workers’ comp?
A: An IME, or Section 12 exam, is a mandatory medical evaluation by a doctor chosen by the insurer to assess your work-related injury, its treatment needs, and your ability to work.
Q: Do I have to attend an IME?
A: Yes — if properly requested under Illinois law, attendance is required or your workers’ compensation benefits could be suspended.
Q: Who pays for the IME?
A: The employer or insurance company covers the cost of the exam and reasonable travel expenses.
Q: How long does an IME take?
A: Most IMEs last 15–30 minutes, though the duration depends on your injury.
Q: Can I challenge the IME report?
A: Yes. IME reports can be challenged with evidence from your treating physicians or by pointing out inconsistencies.
