Under the Illinois Workers’ Compensation Act, the insurance company for your employer has to pay for all “reasonable and related” medical care as a result of your injury. So if you lift a box at work and feel a pop in your back, it’s reasonable for you to go to the doctor, get physical therapy, have a MRI, etc. It wouldn’t be reasonable to go and get some experimental treatment that is not recognized by the majority of the medical community.
For most injured workers the issue is either getting traditional treatment approved or once you’ve had the treatment, getting the bills paid.
Insurance companies in Illinois work comp cases will sometimes act like they can take forever to make a decision or just blow off your claim all together. The reality is that once a medical provider sends a bill to the insurance company, they have 30 days by law to make payment. The only way they can get out of it is if the bill is too vague or they have a good faith reason for denying your claim or the bill.
It’s often a legal strategy for insurance companies to delay, delay, delay in hopes that you’ll use your personal insurance or just go away. Sadly it often works.
The way to counter it is to be aggressive. When they won’t respond to you or don’t pay a bill without reason you should file a 19(b) petition for immediate hearing before an Arbitrator which is an emergency hearing and puts pressure on the insurance company to do the right thing.
Of late we have seen a lot of insurance companies accept a case, pay you for your time off of work, but not pay any of the medical bills because that is the big cost. They are just playing a game and hoping to get a discount or get someone else to pay it. In some cases they rush to settle without you knowing the bills aren’t paid and you don’t discover it until you get a collection letter six months later.
The best advice I can give you is to stay on top of the bills. Every time you go to the doctor ask for an itemized copy of any outstanding charges. When you are discharged from care, follow up 45 days later to check on the bill. And never ever settle your case until every medical provider has been called and you’ve verified that no bills are unpaid.
And as always, if you have any questions get in touch with us for a free consultation.