What Are My Treatment Options?
The following information is specific to the state of Illinois. Your state may have different guidelines regarding workers’ compensation treatment options.
Attorney Serving Belleville, Illinois: Workers’ Compensation Treatment Options
The Illinois Workers’ Compensation Act was amended in 2011. This amendment may affect your treatment options if your employer has what is called a preferred provider plan (“PPP”). If you are unsure if your employer has a PPP or you do not know what options you have if he or she does, contact us for a free consultation.
If your employer does not have a PPP, then you are entitled to exercise the same treatment options you would have otherwise had before the amendment.
East St. Louis Job Injury Claim Lawyer
If you have been injured in a workplace accident, getting proper treatment is probably your top concern. However, the workers’ compensation process is a complex and sometimes confusing system. Knowing the facts can help you navigate the system more effectively and protect your rights.
Following are some frequently asked questions and information regarding your workers’ compensation treatment options:
- Can I treat with my own doctor?
- How much does workers’ compensation cover for my treatment?
- How long can I be treated for my injury?
- Can an employer request medical records?
- What is nurse case management?
- Can I perform light duty?
To discuss your job injury claim with an experienced attorney, contact Glass & Korein, LLC, today for a free initial consultation. Our East St. Louis workers’ compensation treatment options lawyers can help make sure you get the medical care you need.
Can I Treat With My Own Doctor?
The answer depends on whether you were injured before or after the amendment to the act and whether your employer has a PPP. If your injury took place before the amendment or your employer does not have PPP, Illinois allows injured workers to choose two doctors or specialists independent of the doctors chosen by their employer. As an injured worker, you can be treated by any number of medical providers after that, provided they were referred by, or can be traced back within the line of referrals to, either of the original two doctors. In addition, you can choose to treat with chiropractors and other nonmedical personnel. However, such alternative providers should be recommended by a medical doctor to minimize conflict with the insurance company.
Employers do have the right to send workers for exams by doctors of their choosing to serve as their witnesses. They cannot require you to accept treatment from those doctors, rather than your own. It is important to note that these doctors may not necessarily have your best interests in mind. Be careful in dealing with such doctors since they are not seeing you to offer a treatment plan. You can still see two doctors of your own choosing, even if you initially receive treatment from an employer-referred doctor.
If your injury took place after the amendment date and your employer has a PPP (notice of which he or she must post at your workplace), then you are limited to one doctor from within the pool of approved providers and then only one independent choice, plus all referrals as referenced above. Many specialists are preferred providers within many of the plans. This may include the doctor you wanted in the first place.
How Much Does Workers’ Compensation Cover for Treatment?
Workers’ compensation pays for reasonable and necessary medical treatment, including medications, doctor visits and rehabilitation therapy in accordance with the state’s medical fee schedule or any negotiated contract with the specific provider. If there is a dispute and your workers’ compensation treatment is denied, you can seek treatment under your group insurance plan or Medicaid, if applicable. The workers’ compensation carrier may have to reimburse other insurers and you for payments if the dispute is resolved in your favor. If bills are paid in accordance with the Fee Schedule or a negotiated contract, the medical provider cannot come after you for the balance.
Note: Your provider cannot report unpaid deductibles or bills to credit agencies if it knows your workers’ comp claim is disputed. Be sure to inform your provider of the situation.
Workers’ compensation benefits will also pay an injured worker for travel expenses to an employer-referred doctor and treatment. The laws frequently change regarding travel expense benefits for treatment, so it is important you talk to a lawyer who can inform you of your rights.
How Long Can I Be Treated for My Injury?
Illinois law does not specify a time limit for how long a worker can be treated for an on-the-job injury if the treatment is reasonable and necessary. However, it does have a clause called “maximum medical improvement.” This states that workers’ compensation benefits should end when an injured worker has reached maximum improvement and no further treatment will improve the condition.
There is no firm definition for maximum medical improvement. Contacting an Illinois workers’ compensation attorney can help you maximize your workers’ compensation treatment entitlements.
Can an Employer Request Medical Records?
In Illinois, employers have the right to request reasonable information from doctors while treatment for a work injury is ongoing. They can only access existing records in order to ensure the treatment is related to the accident. If your employer requests authorization to access medical records, make sure that you sign an authorization to obtain records from your doctor only, and only for information related to the workers’ compensation case.
They do not have the right to talk with your doctors when you are not present. Do not give them permission (written or otherwise) to do that, since problems can result from misinformation, misunderstandings, or attempts by employers to influence treatment and work status decisions.
What Is Nurse Case Management?
In some states, nurses go along to treatment and advise the employer on the current treatment status. This is called nurse case management. Sometimes this is helpful because a nurse can make sure the treatment is appropriate. However, nurses may try to influence the treatment, advising the doctor to refer the injured worker to a specialist of the nurse’s choosing, which favors the employer.
In Illinois, employees have the right to protect themselves against intrusive nurses. Nurse case management is not automatic, but rather dependent on whether the injured employee and his or her attorney agree to it. We secure agreement to appropriate limits on nurse involvement for our clients’ protection before allowing “case nurses” to participate.
Can I Perform Light Duty?
At some point in an injured worker’s treatment, a doctor may determine the worker is capable of light duty for a time, until the next appointment, for example. Employers may accommodate this light duty in order to help the worker integrate back into the work environment. Many employers create make-work jobs for this purpose, even if no actual light-duty positions exist there.
If your doctor approved light duty, make sure he or she specifies clearly what this means. Have your doctor lay out the specifics of what you can or cannot do, how many hours of the day you can work and other relevant restrictions. Make several copies of this light duty slip to give to your employer, to keep with you at all times on the job and to show your lawyer.
Contact an Illinois Job Injury Claim Lawyer
Weekend and evening appointments are available. We serve our clients on a contingency fee basis; you won’t pay us unless we have done our job and collected money for you.