Illinois workers’ compensation law says that an employee injured in the course of their employment is entitled to 100% coverage of reasonable medical expenses related to their work injury. Sounds simple enough, but once you are in the system, you’re bound to have questions about your specific situation. Here are a few things to keep in mind about how it all works:

  There should be no out-of-pocket costs, not even co-pays, for your work injury treatment. This includes surgery, medications, emergency room visits, check-ups, chiropractic services, physical therapy, etc.

 – Your employer most likely has workers’ compensation insurance, which means that the insurance company pays your benefits and is the one you’ll be dealing with. They aren’t going to bend over backwards to cover more medical bills than what they feel they have to pay. Their goal is to pay the minimum.

 – If you are seeking alternative medical procedures, you might get met with resistance from the insurance company. It generally depends on the treatment and how non-traditional it is.

 – You get to pick your own doctor, but there is a limit on how many doctors you can see. You are entitled to two chains of referral. This basically means you can get a second opinion, but not a third. If the doctors, specialists and therapists are all in one line of referrals, there is no limit on the number of practitioners you can see within that chain.

– Your employer may require you to choose a doctor from their preferred network. If you opt out, you lose one of your two chains of referral, leaving you with just one.

 If the insurance company or your employer is telling you that your treatment isn’t covered, if you feel like you are being forced into a certain type of treatment, including surgery, or if you’re confused about what your rights under Illinois law, talk to a lawyer who is experienced with and committed to helping injured workers get the benefits they’re entitled to.

By Michael Helfand