Edwardsville, IL patients get work injury and accident care at our clinic beside St. Louis Lambert International Airport. It is about thirty-five to forty minutes away via I-55/70 and I-270 west. Illinois lets you choose your treating physician, two of them plus their referrals. That choice comes before any exam an insurer sets up.
Edwardsville is the Madison County seat, so a good deal of the paperwork side of a claim is run from here. The part that decides most outcomes, though, happens in an exam room.
We are a medical practice, not a law firm. The statutory position here is summarized from the Illinois Workers’ Compensation Commission; your particular claim belongs with your attorney.
What is the purpose of an IME in workers’ comp?
There is the doctor you choose to treat you. And there is the doctor an insurer sends you to. They are not doing the same job. Mixing them up costs people.
Your treating doctor is building a medical record and a treatment plan. The insurer’s examiner is writing a report for the side that hired them. It usually covers cause, maximum medical improvement and whether you can work. What an IME involves is worth reading before you go to one.
Which is why the first choice is yours
This is why the Illinois rule matters. The treating physician is yours to choose — two of them, plus their referrals — while in Missouri the employer selects and your own doctor comes at your own expense. Set out in full here.
What makes a report hard to dismiss
Pain you report in your own words is the easiest thing in a file to brush off. Everyone in the process knows it. What holds up is measurement. That means imaging checked against the exam, nerve conduction tests when needed, and function measured in numbers, not just described.
The functional capacity evaluation covers how capacity is measured, and the subjectivity problem covers why it is needed.
What should you say, and not say, during an IME?
Go, be accurate, and do not put on a show. An experienced examiner is looking for one thing above all: exaggeration. A gap between what you show and what you say is the finding that ends claims.
Just as much, do not play it down. People routinely describe a good day because they were raised to tough it out. That becomes the baseline on record. Describe a typical day, including what you have stopped doing.
Bring a list of what you cannot do, not a story about pain. Function is what counts: how capacity is measured.
Why capacity findings get challenged
A functional capacity evaluation gives numbers, which makes it feel final. It is not. The usual challenge is that you did not give full effort. Most tests have built-in checks made to catch exactly that.
Knowing that changes how you take the test. Steady, honest effort across repeated tries is what makes the result hold up. Trying to look worse than you are makes it worthless. The same logic runs through avoiding the malingering label.
After maximum medical improvement
Being declared at maximum medical improvement does not mean treatment stops. It means the condition is not expected to get much better with more care. That is a prediction, and predictions can be wrong. This is especially true when they are made before the interventional options were fully tried.
It has effects. Temporary benefits typically end. A permanency assessment follows. The file starts moving toward closure. So ask whether the decision came too soon at the time, not afterward.
The honest test is this: has anything with a fair chance of improving your function gone untried? Maybe the diagnosis was never confirmed — nobody found which part makes the pain. Then the treatment was aimed at a guess. Stalling on a guessed treatment is not the same as the condition itself stalling. Alternatives to back surgery and interventional pain care covers what a confirmed diagnosis opens up.
A second opinion at this point is not stalling. It is the last moment when a missed diagnosis can still change the path. The records that support it are the same ones your claim already relies on: objective evidence and how it is read.
Bring the record you already have
The most useful thing you can bring is the past imaging itself, not the report. Reports are summaries written to answer the referring doctor’s question. A scan read to rule out a fracture is read differently from the same scan checked for a disc or a partial tendon tear.
Also useful: the date the injury was reported and to whom, any written work limits already given, and the list of what you have stopped doing. That last one does more in an exam than a pain score, because it is specific and testable. And it is what a capacity test is trying to measure in the end.
Spending your second choice
Illinois gives you two providers. People often use up the second one on a whim after a bad visit. Take your time, because there is no third.
A referral made by a provider you chose does not count against the two. So a doctor who will refer you on for care outside their field stretches your choices instead of using them up. Know that before you decide to start over somewhere else.
Related reading: work injury care for Glen Carbon, IL patients and work injury care for Maryville, IL patients.
Illinois patients can join our physician-directed physiotherapy program in St. Louis: a plan built around the injury, ordered and supervised by a physician, with every visit fully documented.
Frequently asked questions
How far is the clinic from Edwardsville?
About thirty-five to forty minutes via I-55/70 to I-270 west, to 4477 Woodson Rd, Suite 202 beside Lambert Airport.
Is an IME a second opinion?
Not in the usual sense. It is an examination arranged by the insurer to produce a report for the insurer: what an IME actually is.
How is my capacity to work decided?
Ideally by measurement, not by someone’s say-so. That is what a functional capacity evaluation is for: the FCE explained.
Can I change doctors if I am unhappy?
Illinois gives you two choices of provider, and referrals from those do not count against the two. Think hard before you use the second one.
What happens after maximum medical improvement?
Treatment does not stop on its own. Maximum medical improvement means the condition is not expected to get much better with more care. That is a prediction. Temporary benefits typically end. A permanency assessment follows. The file moves toward closure. If nobody confirmed which part makes the pain, the decision may be too early. A second opinion at that point is not stalling.
Where we are
Accident and Injury Experts
4477 Woodson Rd, Suite 202, St. Louis, MO 63134
Next to St. Louis Lambert International Airport, with parking at the door.
Call (314) 887-5866 · info@injuryexperts.us