Medical care in Illinois work injury cases: choosing your own doctors
After a work-related injury, it is comforting to know that you can still have some choice as to which doctors you see, even while receiving workers’ compensation benefits. But, like anything in life, there are limits to this freedom of choice.
Illinois Workers’ Compensation law allows an injured worker to receive benefits for the medical services of two physicians of choice, in addition to emergency and first aid treatment. This means that the insurance company should pay for the visits to a doctor you choose, and also for others to which that doctor may refer you, in the same chain of referral. You are then able to pick another doctor, who can also refer you to others.
Once, however, you have had your two picks, you are not able to receive benefits for a physician of your choosing, unless the insurance company agrees to your selection.
There are some gray areas, though where it may seem as if it is the employee’s choice of doctor, but the employer actually has a hand in it. In these cases, often it can be held that the employer’s involvement made it their choice, and preserved one of the two choice options for the employee.
Recently, the Illinois Workers’ Compensation Commission looked at such a situation, and found that the employer had intervened in the choice. The employee had gone to see his doctor, and was referred to another for further examination. After that, the employer’s nurse case manager recommended another doctor, who the employee saw voluntarily. When the employee later saw another doctor that he chose himself, there was a dispute about whether that was a third choice that the employer would not be responsible for.
In fact, according to the Illinois Commission, the involvement of the nurse case manager in scheduling and going along on the appointment, kept it from being counted as one of the employee’s two choices. Also of note to the Commission, was the fact that the employee was not represented by an attorney at the time of this physician referral and visit.
Seeking treatment for your work injuries in a proper and timely manner can be critical both to your medical treatment and to your ability to recover the medical expenses. Being able to choose your own physicians, within the scope of the Illinois law, can help that process along while also helping your comfort level.
We are workers' compensation attorneys that help people with Illinois work injuries anywhere in IL via our statewide network of attorneys. Contact us and we will answer your questions or find the right lawyer for your situation.
