Illinois workers' compensation is a program that allows employees who have been injured while on the job to receive compensation from their employer while they recover. Under the current Illinois workers' compensation program, an employer is also required to provide medical care and pay for all necessary visits to a physician. But in a normal work injury and Illinois workers' compensation case, there may be some disagreement as to how much medical care is actually necessary, and how much medical care an employer must pay for.
It can be frustrating when someone who has been injured while at work doesn't receive the medical care that they think they deserve under Illinois workers' compensation and the care they think they need to recover and become a healthy and reliable worker. And there are some things you can do to pursue the proper amount of medical treatment, even if you find the initial medical care more than a bit lacking.
A good first step in the quest to receiving proper medical care guaranteed under the Illinois workers' compensation law is to meet with at least one trusted physician. Under the Illinois Workers' Compensation Act, an employee has the right to receive medical treatment from two physicians of his or her choice. In addition, those two physicians are able to refer the employee to any other specialists or doctors they feel are necessary. This is called the 'chain of referral' and every physician in a chain counts as only one of the two physicians that an employee is allowed under the Illinois Workers' Compensation Act to see at the employer's expense.
Some employers and insurers may do everything they can to try to retain control of the injury case. They may tell you that a certain doctor is not authorized or that the doctor is not in their network. If you hear these statements, or similar ones, you should consider yourself in a delicate and possibly precarious situation and it's highly recommended that you see a lawyer about your situation, in order to make sure you are able to connect with a doctor or physician that you trust and are guaranteed under the Illinois Workers' Compensation Act.
Under the Illinois Workers' Compensation Act, your employer has no right to authorize a physician and has no right to refuse any licensed physician. But it's also important to know that, under the Illinois Worker's Compensation Act, your employer or employer's insurance company is not explicitly required to provide authorization for a payment. Yes, this is a bit confusing. But that usually only turns into a problem when a physician refuses to provide treatment for any reason. This isn't a very common situation, but if it does occur in your case, once again, it's highly recommended that you see a lawyer.
In some cases, employers have entered into an agreement with workers' unions that only allow an injured employee to select from a list, or panel, of physicians provided by the employer.
If your employer is one that offers a panel, you will be able to schedule an appointment with one of the doctors on the panel, with the employer or insurer footing the bill. It may happen that the employer will try to convince you to select a particular physician, one that the employer has a relationship with. There may be several reasons why an employer would do such a thing, and many of them may be benign. But injured employees should always remember that, under the Illinois Workers' Compensation Act, they are in no way required to see the physician that their employer would like them to see. Just remember that while it's not always the case, there is a chance that a doctor who's favored by your employer may not have your best interests at heart. You should see who you are comfortable with seeing.
It's probably best to select a doctor on the list, or the panel, who's different from the one that your employer suggests. You should still call the doctor's office before the appointment just to verify that your employer will, in fact, be paying for the appointment. Some employers may wrongly think that they do not have to pay for a physician's appointment if it's not from their preferred physician on the list. This may either be a genuine mistake, or an intentional attempt to force you to see their preferred physician. Either way, it's important to be vigilant and make sure that you are granted all the rights granted to you under the Illinois Workers' Compensation Act.
Peter Drummond is a social security disability and workers compensation attorney licensed to practice law in Illinois and Missouri, and owns a law firm called Drummond Law with offices throughout Illinois and Missouri.
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