Medical Benefits

When you are injured in a work-related accident, workers compensation requires your employer or your employer’s workers comp insurance policy to cover all of the medical care that you reasonably need to recover from your injury. Among the types of treatment that may be covered are:

  • Emergency room visits
  • Doctor’s office visits
  • Hospitalization
  • Surgery
  • Physical therapy
  • Chiropractic care
  • Prescription drugs
  • Prosthetics
  • Medical appliances such as wheelchairs or crutches

When you get treatment, you’re generally allowed your choice of medical provider. If your employer has a provider network, you may have to choose from the list of medical providers who participate in the network. You get to choose two, and anyone who gave you first aid or who treated you in an emergency room doesn’t count toward your two. It also doesn’t count if the doctor you pick refers you to a specialist. If your employer doesn’t have a provider network, then you can pick any two medical providers you want.

How Do Medical Benefits Work?

There are a couple of different scenarios for getting your medical bills paid when you make a workers compensation claim. The first is fairly straightforward. You make a claim to your employer or your employer’s workers comp insurance policy, and your employer or the insurance company pays the bills directly.

The second scenario — when there’s a dispute over your workers comp claim — can be a little more complicated. When your employer or the insurance company denies your claim or disputes your injuries, you can make a claim to the Illinois Workers Compensation Commission. Obviously, when this happens your medical bills are not being paid by your employer or the insurance company while the claim with the IWCC is pending.

However, workers compensation law says that the doctor, hospital, or other medical provider also can’t try to collect payment from you while your IWCC claim is in process. To get this protection, you have to notify the medical provider that you filed a claim with IWCC. The medical provider is allowed to send you notices about the bill and to seek status updates on your IWCC claim, but not to actually try to collect.

Employee Responsibilities

There are several things you’re responsible to do regarding medical care for your work-related injury. Those include:

  • Seek medical care as soon as you are injured or as soon as you start to experience symptoms
  • Follow doctors’ advice so that you can recover and go back to work if not permanently disabled
  • Notify your medical providers that they’re treating you for a work-related injury so they can bill your employer
  • Provide your employer with the name and contact information for your medical providers, and notify your employer if you change doctors
  • Provide your employer enough information about your injury and treatment so your employer can make a decision whether to accept your claim

If you don’t follow your medical providers advice or behave in a way that delays or impedes your recovery, you may not be able to get medical benefits. Likewise, if you don’t give your employer the necessary medical information to support your claim, you may not be able to get medical benefits.

How a Lawyer Can Help

If you have questions about how your workers comp medical benefits should work, or if you think your employer is wrongly denying your medical benefits, a qualified Chicago workers comp lawyer can help. An attorney can guide you through the system and advocate on your behalf to make sure you get the treatment you need and that your bills get paid.