I’ve written a lot before that when it comes to your Illinois workers’ compensation claim, credibility is key. You need to be credible which means don’t embellish your injuries or change your story.  Tell the truth about how you got hurt even if it doesn’t seem like a perfect story.  Don’t get caught on surveillance video doing things that you told your doctor you can’t do. Basically don’t lie.  That’s simple enough, right?

The credibility of your lawyer also matters.  If they are known for filing bogus claims, you may be looked at as a faker too even if your claim is legit. Your are guilty by association.

You also need to have a credible doctor in your corner.  In most cases you need a medical doctor to state what your injuries are and how they are related to your job duties.  The insurance company will surely hire their own doctor to state that you either aren’t injured or weren’t hurt at work. If you don’t have a good doctor in your corner you could lose your case.

I mention this because a high volume medical provider, Marque Medicos of Chicago and other locations, was just accused of billing fraud in a lawsuit by Liberty Mutual insurance company.  See: http://cookcountyrecord.com/stories/510997776-liberty-mutual-accuses-back-clinic-marque-medicos-of-workers-comp-insurance-fraud-demands-17-million#.V7tVCtIIQsU.email.

This is an outfit known for treating a large amount of patients and in my opinion doesn’t have the best reputation.  This lawsuit kind of backs up my feelings as they are accused of billing for work not performed and other allegedly fraudulent billing practices.

Whether they are guilty of this or not, this suit will not help their reputation in the legal community and with Illinois Workers’ Compensation Commission Arbitrators.  Fair or not, it’s possible that some patients who have legitimate injuries and are getting real care from them will have their treatment looked at more closely and in a skeptical way as compared to patients getting treatment from clinics that don’t have these allegations.

There are plenty of other facilities that have a bad reputation too although this is the first time I can recall one of them getting sued. You can bet that if the lawsuit is successful, more claims will follow, especially if Liberty Mutual gets anywhere near the $17 million that they are asking for.

My advice to you as a patient of any doctor is to make sure that once a month you are getting a copy of your bill.  You want to make sure that it’s getting paid and if it isn’t you want to find out why not and/or have your attorney do what is necessary to get the bill paid so those treatments don’t come out of your pocket.  You should also, as this case shows, make sure that you are being charged for the treatment that you are actually receiving.  If a medical provider is doing one thing and then billing the insurance company for something else then it can be a sign that they aren’t the right facility for you.  If they get caught it can hurt them, but it can also hurt you.  And you have to look out for you.

If you have any questions about anything related to Illinois work comp law, call us at (312) 346-5578 or fill out the form to the right and we’ll call you ASAP.