How Long Do They Have To Turn Over The IME Report?

A way too patient injured worker contacted me recently.  They wanted to know how long the insurance company had to turn over the report from the independent medical examination (IME) doctor.  Here’s what they had to say:

I hurt my shoulder at work. Five months ago my work comp benefits were suspended pending an IME report. I’ve heard nothing from them other than they’ll get it to me when they can. Meanwhile I can’t get physical therapy and I’ve been without pay. How long do they have to turn this over? I heard California is 30 days. Is it the same in Illinois?

Oh man, is this injured worker way too patient. There is no law in Illinois that says an IME has to be turned over at a certain time or even at all. In many cases, if the doctor finds in a way that the insurance company won’t like, they’ll call the adjuster and give a verbal report, but never issue a written report.

While there isn’t a set period of time for it to be turned over, you certainly know when it’s been too long. One month is too long. Five months is insane. I would bet my very last dollar that the doctor found against the insurance company and since this worker isn’t yet represented, the insurance company is just jerking them around.  I assure you that if the report was in their favor, the insurance company would have sent it off right away.

So if there isn’t a time limit, what can you do? There are two things that are very effective:

1. You can subpoena the IME doctor for a copy of the report and their file related to the exam. While you can’t see the letter the insurance company or the attorney wrote to the doctor about the exam,  you can absolutely get the report if there is one and a copy of their notes.
2. You can go to arbitration. At trial, you would testify that you went to an IME and that no report was ever turned over to you.  When this happens, it creates a presumption that the report was against the insurance company and in your favor. So all things being equal, if your doctor is credible, you should win. It’s almost the same thing as getting a report that goes in your favor.

What you can’t do is wait and wait and wait. This is your case and your life, so you have to go on the offensive. In my opinion, 30 days is the maximum you should wait, and quite honestly, after three weeks you’d be justified in filing a trial motion.  In a case of a five-month delay, filing for penalties and fees would be appropriate because they’ve essentially ignored the law and denied benefits without any justification.

The bottom line is the insurance company has a right to send you for an IME, but they don’t have a right to delay your benefits indefinitely without any evidence that justifies their behavior.  The only way they get away with it is if you let them.

By Mike Helfand

Courtesy of Illinois Workers Compensation Law Blog

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