Illinois is one of the better states to be in when it comes to workers’ compensation benefits. The law provides injured workers with payment for wage loss if they can’t work, coverage of medical bills and other benefits.

Medical coverage is 100% for all medical treatment that is reasonable and related to your condition. The key words are “reasonable” and “related.” Here is a bit more about what each of these means when it comes to workers’ compensation:

“Reasonable” medical care is something that is prescribed by a doctor and generally accepted as an appropriate treatment by other doctors. So mainstream treatment is usually considered reasonable without much argument. On the other hand, a special pillow that makes it easier to sleep at night after a neck injury could go either way. If your doctor prescribes it, that will help, and you would be more likely to get reimbursed for the cost. Same goes for a gym membership. If your doctor prescribes exercise, then a gym membership is arguably reasonable.

“Related” means that the treatment has to be related to your work injury. This can be an issue if your doctor sees you for other things in addition to your work injury. If you are seeing your doctor for high blood pressure, and then also for a back injury you suffered on the job, you’ll only get reimbursed for the part of the bill that represents your back treatment.

The good news is that if your treatment is reasonable and related to your injury, then the bills should be covered 100%. There shouldn’t be any co-pays or out of pocket expenses. If you have paid for anything out of pocket, then you should get reimbursed. Make sure to keep all of your receipts.

When there is a dispute about covered medical treatment and costs, it can help to talk to a workers’ compensation attorney who works through these issues with Illinois workers every day. They’ll have the experience to help you understand what’s covered and what’s not, and the ability to get you reimbursed or covered as soon as possible.

By Michael Helfand