Well, no one except you and a trusted doctor. Don’t let the insurance company or your employer force you to see the doctor of their choice. The insurance company wants to spend as little money as possible on your claim. Your priorities are different. You need to look out for you, and it’s usually in your best interest to see a doctor you already know and trust.
In Illinois, injured workers get to pick their own doctor for treatment of their work injury. Prior to 2011, that freedom of choice was even broader, but it’s still better than many states. You essentially get two separate choices of doctors. Included in each choice is any specialist or other doctor to whom you are referred. Put another way, you get two chains of referrals. All treatment that is reasonable and related to your work injury should be covered 100%. You should not have any co-pays or out-of-pocket expenses.
Under recent changes in the law, employers in Illinois are allowed to set up preferred provider networks, which is a list of doctors you have to pick from. You are allowed to opt out, however. Also, while they can’t force you to be treated by their doctors, your employer and the insurance company can request that you undergo an Independent Medical Exam or IME with their doctor. This is usually a one-time exam and usually happens because the insurer is disputing your doctor’s opinion.
Not only should your employer and insurer not dictate your medical treatment, they should stay out of your appointments with your doctor. Some insurers try to send “nurse case managers” to injured workers’ appointments. They’re not allowed to come unless you consent, and we suggest that you don’t consent. They’re just looking for ways to save money on your claim.
It helps to have a lawyer you can trust, as well. Your attorney should not ask for any money up front. They should not force you to see a specific doctor (it’s a sign that they have an agreement with a certain doctor, which doesn’t make you look good), and they shouldn’t hesitate to get your case into court – including going to trial – if it’s in your best interest.
