When an injured worker calls our office to discuss a case, one of the first things we try to figure out is if a case is accepted or denied. Accepted means that they are paying your medical bills and/or TTD benefits. Denied means that they aren’t paying one or both of those benefits. It’s usually a good idea to get a lawyer no matter if it’s accepted or denied, but knowing which it is helps us give you free advice.
There’s a third category that is more and more common these days. We get a lot of calls from injured Illinois workers who say something like:
I was hurt at work. My case was accepted and I’ve been seeing a doctor. But the insurance company is really slow to approve authorization for tests and treatment.
In other words, the insurance company doesn’t have a basis for denying your case, but they aren’t giving providers confirmation that they will pay for things like physical therapy, MRI’s, steroid injections, etc. So what ends up happening is that your care gets delayed and you get frustrated.
This also plays out with TTD checks. Whether they usually come weekly or bi-weekly, you begin to notice that they are a few days or weeks late. That of course can cause a financial hardship on you and your family.
None of this is unintentional. The insurance company wants to limit what they pay out on your case. If they don’t approve physical therapy for a month, maybe you’ll get better without it (highly unlikely), use your personal insurance or just give up. If your TTD check is late, maybe you’ll return to work against the advice of your doctor.
All of these actions by the insurance company put your health at risk. A delay in medical care can make many injuries substantially worse and in some cases, permanent. They also violate the Illinois Workers’ Compensation Act. Sadly, insurance companies do this because it works often enough that it saves them a lot of money.
There is only one solution. You have to officially file a case with the Illinois Workers’ Compensation Commission so you have leverage to act in response to their bad behavior. We fortunately find that doing this and having an attorney on the case stops a lot of the games, especially the delays in getting medical care. It shouldn’t come to that, but to them it’s just business.
Their goal is to frustrate you and they are usually successful. Just know that you can push back so you can focus on your health, listen to your doctor and make a great recovery. If you’d like our help, we are happy to talk to you any time for free and in confidence.