Chicago Medical Benefits Attorneys
Workers’ Compensation Medical Benefits in Illinois
If you are an employee who has sustained a work-related injury, you are likely entitled to medical benefits through the Illinois workers’ compensation system. These benefits are designed to pay for most—if not all—your medical expenses after a workplace accident or job-related injury.
If you are having trouble recovering workers’ compensation medical benefits, or if your employer or their insurance provider has denied your claim, reach out to our team at Anesi Ozmon. Based in Chicago, our medical benefits attorneys represent clients throughout Illinois in a variety of workers’ compensation-related matters. We have been fighting for the rights of hard-working people across the state since 1955 and are prepared to stand up for you.
What to Do After a Work-Related Injury
If you were injured at work or suffered an injury or illness related to your working conditions, you should insist on immediate medical attention. In Illinois, you do not have to see a doctor selected by your employer. Instead, you are entitled to see a doctor of your choosing. In fact, you can see two doctors of your choice. However, if your employer has an established Preferred Provider Program (PPP), this will count as one of your two choices, even if you decide not to use the PPP. Additionally, your initial doctor may refer you to a specialist if necessary, and this does not count as a “second choice.”
You should not have to pay for medical treatment on your own, nor should you use any personal insurance or union insurance plan. This includes both emergency treatment and non-emergency treatment, which are treated separately under Illinois’ workers’ compensation laws. If you pay for the services of a medical provider with cash or a personal check, your employer or the workers’ compensation insurance carrier should reimburse you.
After seeking medical attention, including calling 911 if necessary, make sure you report your work-related injury or illness to your employer within 45 days. If you fail to report your injury within this timeframe, you could lose your right to recover workers’ compensation benefits, including medical benefits.
What Medical Benefits Are Available Through Workers’ Compensation?
In Illinois, workers’ compensation pays for all “reasonable and necessary” medical expenses related to a qualifying work injury or illness. This includes initial medical treatment, as well as ongoing care, rehabilitation, and therapy.
Workers’ compensation medical benefits in Illinois include compensation for the following:
- Ambulance fees
- Surgery and other treatments
- Physical rehabilitation therapy
- Prescription and over-the-counter medications
- Medical devices/equipment
- Mileage reimbursement for travel to and from medical appointments
Although you are not required to treat with the company doctor, your employer does have the right to have you examined by a physician of its choice to determine if you are entitled to continuing weekly benefits or to determine the extent of your permanent disability. This is often referred to as an Independent Medical Examination (IME) or a Section 12 examination.
How to Recover Workers’ Compensation Medical Benefits
To recover medical benefits through the Illinois workers’ compensation system, you must file an Application for Adjustment of Claim with the Illinois Workers’ Compensation Commission within three years of the date of your injury. If you did not discover your work-related injury or illness right away, the three-year deadline may be deferred from the date on which you discovered your injury/illness or the date on which your injury/illness was reasonably discovered. In any case, if you do not file your claim within the designated timeline, you will lose your right to recover workers’ compensation benefits.
Your rights to medical benefits may vary even after you properly file your claim. If your claim is settled, you will likely be required to give up all future medical rights in exchange for that lump-sum settlement. You will not be able to claim any future medical expenses against your employer if your medical rights are terminated in a settlement contract. There may be situations in which a settlement can provide for an extension of your medical rights, but it is very important you consult with an attorney regarding these special situations.
Can an Employer Request an Injured Employee’s Medical Records?
Yes. The Workers’ Compensation Act gives employers the right to obtain medical records from injured employees’ treating doctors. Upon written request, the treating doctor must provide full and complete reports to the employer.
These reports are important because they inform the employer that the employee is unable to return to work. The employer may need these reports in order to authorize payment of weekly temporary total disability benefits, as well as to authorize medical treatment.
What to Do If Your Employer Refuses to Pay Your Medical Bills
If an employee informs a medical provider that a claim is on file at the Illinois Workers’ Compensation Commission, the provider must cease all efforts to collect payment from the employee. While the claim is pending, the provider is allowed to send the employee reminders that the employee will be responsible for payment of the bill when the provider is able to resume collection efforts.
The provider may also request information about the status of the claim, and if the employee fails to respond, the provider can resume collection efforts. An attorney can make sure that your bills are not placed in collections while your claim is pending. Reach out to our Chicago medical benefits attorneys at Anesi Ozmon to learn how we can protect your rights.