In Wisconsin an independent medical examination of the injured worker can be requested by an employer or its workers compensation insurance company after the employee makes a workers compensation claim. There can be more than one exam but generally only once IME doctor for each claimed body part injured. Wis. Stat. Sec. 102.13(1). The travel to an IME appointment is usually limited to 100 miles and the insurance company must provide transportation or reimburse for mileage. Wis. Stat. Sec. 102.13(4). They must also pay TTD for any lost wages as a result of the IME appointment. The injured worker and his or her attorney should view IME appointments carefully. Insurance companies do have the injured claimants followed to and from the appointment to record on video how the injured worker is moving around and to verify that they can sit in a car for certain lengths of time, especially if the treating doctor has limited sitting or driving restrictions in place.
The notice of the IME must state its date, time, and place of the exam and the procedure for rescheduling, as well as the IME doctor’s area of specialty. The notice must also explain the employee’s rights to have a personal physician present at the exam, but this is almost never done due to the cost in paying your own doctor to go to such an appointment. The injured worker is entitled to a copy of the IME report immediately upon receipt by the employer or insurance company of the report. Note, insurers regularly fail to send the injured worker a copy of the IME report, so be sure to request it if you do not receive it within 30 days of the appointment.
If the injured worker refuses to be examined, his right to workers comp benefits and medical treatment may be stopped. Refusing an IME appointment is a tenuous step which should be made only with proper legal advice through your lawyer who is representing you. An attorney who is not representing a person generally does not have the necessary facts in order to base proper advice on. Second or follow up IME appointments are within the workers compensation Department’s discretion.
Once an injured worker presents a prima facie case, a treating doctor gives a diagnosis and causation opinion that it is work-related, then the employer or workers compensation insurer must rebut. Generally this is done through the independent medical examination. However, courts in Wisconsin have held that the defense can rebut the injured workers case with factual evidence that the accident never happened or that the treating doctor was provided with a wrong or incomplete factual basis.
McCormick Law Office in Milwaukee, Wisconsin.
