A nice man called us recently after hurting his shoulder on the job while working up in Highland Park. He called his family physician who told him that he doesn’t accept workers’ compensation cases. Apparently he had some hassles dealing with an insurance company once and prefers to focus on patients with regular insurance. Kind of a shame, but it’s his prerogative.
So the caller wanted to know where he should go for medical treatment. As a general rule we don’t tell clients who their doctor should be because if it ever comes out on a witness stand, it could look bad. We will, however, tell them the names of doctors that we think do a good job and leave it up to them as to who they want to see.
In the bigger picture though, it’s important to see a physician that has relevant credentials for your injury. Under Section 16 of the Illinois Workers’ Compensation Act, the employer (or really their insurance company) has to pay for all medical treatment that is reasonable and related to your accident. The key thing to focus on is reasonable. In general, lots of chiropractic care isn’t seen as reasonable by Illinois Arbitrators. Neither is experimental medicine.
The best way to handle this is to seek a referral to a specialist. Your family doctor is fine for a first point of contact, but usually an orthopedic or neurological type doc will need to be seen, especially if you have a lingering injury. It’s almost impossible to dispute the care being recommended by a reputable surgeon.
If there is out of the box type care you want such as naturopathic care, you are best served by getting the insurance company to agree to that treatment before it takes place. Often they will agree because a lot of that care is cheaper than having a surgery, but you don’t want your claim being held up over $5,000 in medical bills that are deemed unreasonable. You may win that argument in the end, but you’d have to go to trial to do so.
Above all else, make sure to look out for your health. Tell the doctor truly how you are feeling. Don’t exaggerate your symptoms, but don’t under-report it either. Many an injured worker has created problems for themselves because they were too proud to tell their treater what was really going on.
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.
