For the most part, the Illinois workers’ compensation system is really worker friendly. There are rules to follow as not everything is in your favor, but if you do things the right way, you shouldn’t have too much trouble.
One area where we see injured workers causing themselves problems (before they see us or any other attorney) is in jumping from doctor to doctor without a referral. Under Illinois law, you can see two chains of physicians. In other words, if the ER sends you to your primary doctor who refers you on to an orthopedic doctor who then sends you out for physical therapy, that is one chain of referrals. You can seek a second opinion without a referral – although we think you should still get one – and anything beyond that would be considered beyond the two chains of referrals.
A potential client recently came to us with this problem. She was so rushed to get treatment, which is understandable, that she never got a referral to see the 3rd opinion doctor. This doctor wants to perform a surgery and she wants him to do it. On top of that, the IME doctor the insurance company sent her to agrees that the surgery is needed and said that this particular doctor would be a great choice to perform the procedure.
The problem is that the insurance company doesn’t have to pay for this treatment since it’s outside the two chains of medical referrals allowed. They could care less about this worker, her pain and who she thinks is the best doctor for her issue. But unfortunately there isn’t anything that can be done other than try to reason with them that the worker will get better if she has the surgery. That strategy is a long shot.
So while I encourage you to be anxious about getting better, don’t be so hurried that you cause yourself problems. Take some time to learn what the law is and what you can and can’t do.
The flipside to this are the people that allow the insurance company to call all of the shots and end up with a hack doctor or a nurse case manager that interferes with your treatment. Education is so key, even if you wish this would all go away. Feel free to trust an insurance company, but always verify. They make money by minimizing what they pay and the truth is that most don’t look at you as a human being, but instead as a file number. Look out for yourself.
We are workers’ compensation attorneys who 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.
