The insurance company can't talk to your doctor. Period.
Reason #4,826 to not go at it alone.
My surgeon canceled my laminectomy and said that he talked to the nurse case manager for the insurance company who convinced him to do three more months of physical therapy. I've already have three months of PT, two epidural injections and NO RELIEF. Why does she get to do that? Also, is she allowed to schedule my appointments and attend?
This from a struggling injured worker in downstate Illinois that contacted us. There is a law in Illinois that in plain English says that your employer or the insurance company are not allowed to talk to your doctor without your permission. Of course they don't tell you that. Quite often when you first get hurt the insurance company will act as nice as can be because they want to take advantage of you this way. Why do they do it? As shown above, in some cases they can get doctors who are push-overs to change their medical opinion. They hope to frustrate you and save money.
Not only are they not supposed to talk to your doctors (other than to ask for copies of medical records and bills) they aren't allowed to schedule your appointments or attend any of your exams. We can't guarantee any of our clients a result, but we do guarantee that if we are representing you that this non-sense will end. We gladly communicate with the insurance adjusters, but we make sure that medical decisions are actually made by your doctor.
There is even a case that created a rule called the Petrillo Doctrine. In plain English that means that if the insurance company or one of their representatives talks to your physician without permission, anything that doctor says is not admissible as evidence. In other words, if your doctor says that your injury is work related, but then the nurse manager talks to him and gets him to change his opinion, that change of opinion will get tossed out of court. This law was created to protect innocent workers.
It's an un-even playing field when you aren't represented. If you are going to choose to go at it alone you are playing with fire.
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.
