The Governor has signed into law HB 5228 as of 8/7/26, which has some important ramifications on Independent Medical Exams (IMEs) and other benefits in Illinois workers’ compensation.
Some of the new requirements for IMEs are, if challenging the reasonableness/necessity of recommended medical treatment:
- Respondent must obtain an IME report and provide it to Petitioner’s counsel within 90 days of receiving records from the treater recommending the additional treatment; and
- Respondent must obtain an IME who is board-certified in the same specialty as the treater.
Failure to comply with these new IME requirements exposes the Respondent to penalties and attorneys’ fees under Sections 16 and 19(l) of the Act by creating a rebuttable presumption of unreasonable/vexatious delay in authorizing medical treatment.
Other changes included in the newly-enacted legislation are:
- Burial expense benefits are increased to $10,000.00 from $8,000.00;
- Utilization Review (UR) doctors must practice in the same or comparable specialty as the treater and must have experience treating patients with the condition at issue;
- UR determinations are only valid for 3 months and when UR certifies a recommended surgery, 3 months of post-operative treatment is automatically certified as well.
If you have any questions, please contact AJ Sheehan or your current MVP Law Illinois attorney.
