MEDICAL BENEFITS

If you sustain an injury that is covered under the Illinois Workers' Compensation Act, your employer is obligated to pay for any and all medical treatment that is reasonably necessary to treat your work-related injury(s).  In other words, if the treatment recommended by your doctor(s) is related to the specific condition(s) that you develop as a result of the work accident, and it is also the type of treatment that most doctors would find to be medically necessary in order to treat that specific condition(s), then your employer or its workers' compensation insurance carrier must pay for 100% of that treatment, and you would not be responsible for any co-pays or out-of-pocket expenses of any kind.

 

Examples of medical care covered under Workers' Compensation:

 

  • First Aid / Ambulance service
  • Emergency Room visits and treatment
  • Diagnostic testing (X-rays, MRI's, CT scans, etc.)
  • Hospital stays
  • Doctor visits
  • Physical therapy
  • Pain Management
  • Surgery
  • Prescription medication
  • Prosthetic devices
  • Medical appliances and/or in-home medical care

 

Following a work injury, you can generally select up to two (2) physicians of your own choice to see for medical treatment for which your employer is obligated to pay, in addition to any referrals from those two providers.  First aid, emergency care and non-emergency care obtained before the injury is reported to your employer do not count as one of the two choices.

 

However, if your employer has a Preferred Provider Program (PPP) in place at the time of the accident, then your choice of provider will be limited to a choice of two physicians selected from a network of providers within the PPP.  If your employer does have an established PPP, it must inform you about it in writing on a special form created by the Illinois Workers' Compensation Commission (IWCC).

 

Lastly, your employer has a right to send you to a doctor of its own choice for an Independent Medical Exam (IME) which is paid for by the employer regardless of that doctor's findings. 

 

If you have questions regarding your medical care following a work injury, call ROBIN LAW OFFICE today at 312-771-1100.