Imagine you are up on a scaffold at work and doing some painting when suddenly the scaffold collapses and your ankle gets crushed. It’s witnessed and your employer and the insurance company agree that your injuries are work related and the insurance company says they will pay for all of your medical care. So how can they get away without having to pay all of your doctors?
The answer is, they can screw you if you screw up. Let me explain.
Under Illinois law, when you are hurt on the job you are entitled to see a doctor of your choice. If you don’t like what that doctor recommends or has to say you can see a second doctor. Any referral you get from either of these physicians is considered part of their treatment. So if the first doctor order a MRI and then some physical therapy and then suggests a surgeon, that’s all part of your first opinion.
The problem develops when you don’t get a referral to a new doctor. Once you are on your third choice, you have to pay for that treatment out of pocket, no matter what.
The insurance company isn’t going to warn you about this. They aren’t going to tell you to get a referral to make it happen. And if you don’t, you will get screwed over, especially if you like this third doctor and want them to take care of you.
It can get even trickier because for accidents after September 1, 2011, the insurance company can pick one of your doctors for you. You don’t have to see them, but if you don’t it will really limit your options.
So the bottom line is to make sure that you always get a referral. If you don’t it could cost you a ton of money. And there won’t be anything you or the best lawyer in the world can do about it.
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Imagine you are up on a scaffold at work and doing some painting when suddenly the scaffold collapses and your ankle gets crushed. It’s witnessed and your employer and the insurance company agree that your injuries are work related and the insurance company says they will pay for all of your medical care. So how can they get away without having to pay all of your doctors?
The answer is, they can screw you if you screw up. Let me explain.
Under Illinois law, when you are hurt on the job you are entitled to see a doctor of your choice. If you don’t like what that doctor recommends or has to say you can see a second doctor. Any referral you get from either of these physicians is considered part of their treatment. So if the first doctor order a MRI and then some physical therapy and then suggests a surgeon, that’s all part of your first opinion.
The problem develops when you don’t get a referral to a new doctor. Once you are on your third choice, you have to pay for that treatment out of pocket, no matter what.
The insurance company isn’t going to warn you about this. They aren’t going to tell you to get a referral to make it happen. And if you don’t, you will get screwed over, especially if you like this third doctor and want them to take care of you.
It can get even trickier because for accidents after September 1, 2011, the insurance company can pick one of your doctors for you. You don’t have to see them, but if you don’t it will really limit your options.
So the bottom line is to make sure that you always get a referral. If you don’t it could cost you a ton of money. And there won’t be anything you or the best lawyer in the world can do about it.
