For most injured Illinois workers, you get to choose your own physician if you get hurt on the job. If you don’t like that one you have a right to a second opinion. The work comp insurance company has to pay for both of these medical providers as long as the treatment is reasonable and related to your job injury. If you seek out a third opinion without approval or a referral from one of the first two doctors, you have to pay for that.
A few years back the law was amended to allow an employer to create a preferred provider program. Basically this states employers can create an exclusive list of medical providers if their program is approved by the Illinois Department of Insurance. An injured worker can choose to treat with a medical provider who is not on the list. But doing this constitutes one of the two choices of medical providers. Their doctor is essentially your second opinion. There aren’t too many companies who have created a preferred provider program in Illinois, but they are out there.
But even before that, a law was passed that until recently hadn’t been used and presents a warning for Jewel workers in Illinois. The Illinois Workers’ Compensation Act has a big exception to workers choosing their own doctor in the “Panel of Physicians” provision. If a “panel of physicians” is in place by an employer, workers hurt on the job only treat with medical providers from this list, unless there are extenuating circumstances or a panel physician makes a referral to a provider not on the list.
The good news is that these panels can only be created if there is an agreement by the representative of the employees (e.g. a union) and it’s approved by the Illinois Workers’ Compensation Commission.
Why the Jewel union agreed to this is beyond me. It really is not in the best interests of their workers. That said, it’s there. There are two major problems with it in my opinion:
- It can take away your choice as to which doctor you are treating with. You might have an established relationship with a physician you think is great and know cares about you. If they aren’t on that list, you can’t see them.
- If you don’t know about this agreement and get medical care outside this panel, you will get stuck with the bills even if your injury is work related.
Imagine if you hurt your right knee a year ago in a car accident and had surgery. The surgeon did an amazing job and you made a quick and complete recovery. They checked up on you, got you the best room at the hospital, gave you their cell phone number for emergencies and were available for any questions. If you then hurt your leg again at work, doesn’t it make sense that you’d want to see this doctor and they’d be the best choice for you? Of course. But if they aren’t a part of this panel, the only way you can see them is if a panel doctor turns down your business and gives you a referral.
Not all the doctors on this list are bad, but it doesn’t change the fact that you should have a choice over who cares for your injury. So if you are a Jewel worker, be careful. You don’t want to be hurt and stuck with a bill. This agreement certainly puts you at risk.
If you have any questions about this or anything else related to Illinois work comp law, please contact us any time for free at 312-346-5578.
