Legal Question in Workers Comp in Illinois

Re: Do I follow my doc or the I.M.E?

If your IME doc says you can go back to work with restrictions, you must do that or get a second opinion from another doctor to see whether he agrees with the IME.

You would be better off having an attorney on your side to make sure that things that are being asked of you are within reason and that your interests are protected.

The insurance adjusters and their "IME" are there to protect the interest of the insurance company. You should have someone who is on your side in all this.

I hope this helps,

Taradji Law Offices

Re: Do I follow my doc or the I.M.E?

Dear Sirs:

There are ways to defeat the recommendation of an IME doctor, though none of them are guaranteed.

Please call to discuss.

Many thanks,

John C. Wunsch

[email protected]

Re: Do I follow my doc or the I.M.E?

QUESTION:

I fell off a ladder at work 2 months ago and injured my lower back including nerve damage. I have been treating with a doctor who took me off work until further notice. I received injection as well as pt 3x a week. My company sent me to a doctor for an I.M.E. He says I can go back with only a weight lifting restriction. What happens if I go back and can't do the job? Will I lose my ttd? Do they still pay my doctors visits and can they fire me? Also they put me back on the schedule for only 12 hours when I normally get 40.

ANSWER:

You should follow YOUR doctor's directions, with the following caveats:

a. Your doctor needs to be as qualified as the IME doctor.

(For example, your doctor should be a neurosurgeon or an orthopedist (who does spine surgery) as I am sure that the IME doctor is specialized.)

b. You need to understand that if you do not have a skilled attorney, you may go several weeks to several months without a TTD check.

c. If your IME doctor is Dr. Zelby, or another insurance company doctor whose reputation and credibility is compromised, then you will have a better chance of quick resolution.

d. The more labor intensive your job and the more traumatic the accident then the better the chance your chance of prevailing.

If you do not have an attorney and you do not return to work, you will most likely be terminated from TTD benefits but that does not mean that your case is lost - just that the claim for lost wages during that time is forfeited.

If they put you on the schedule for 12 hours instead of 40 hours then you are entitled to TPD payments - which is roughly 2/3rds of the amount you were making prior to the accident minus the NET that you take home for those 12 hours.

It is difficult to contemplate all situations, so it is best to call for an appointment with several lawyers and hire the one that you feels best serves your needs.

Good luck,

Matt Belcher

Re: Do I follow my doc or the I.M.E?

Your case involves some complex issues and I would definitely recommend you hire an attorney to help you through these land mines.

In general, you have the choice of following the IME physician or your own physician. The IME's physician's opinion that you can return to work was made becuase he is being paid by the insurance company. If your own doctor opines otherwise, you can abide by his recommendations. However, doing so may mean you'll have to fight the insurance company in court.

You are entitled to follow your doctors recommendation and receive payment for your time off work and medical treatment. To do so, I would file an emergency motion for you called a 19(b) petition. These motions allow us to get the issues before an Arbitrator(judge) within about 45 days. However, during this time, you could go without pay as the insurance company may fight you.

Alternatively, should you choose to abide by their docotors opinion and return to work at a 12 hour job, the insurance company would be required to pay you the difference between 40 hours and 12 hours - this is called TPD. If they do not, I would again file an emergency motion to get in front of the Abritrator as soon as possible.

I hope this answers some of your questions. Ultimately, there are many things to consider. The employer cannot fire you for your injuries if you have filed a claim with the Industrial Commission. Therefore, I would recommend you hire an attorney who can file a claim for you very quickly as this protects your right to a wrongful termination claim, should your employer choose to fire you for your injuries.

I have handled many such cases before and I am happy to even speak to you further at no fee should you have more questions or need more advice. Good luck.