Can workers’ comp force you to see their doctor?

Workers Compensation - May 6, 2025

Navigating a workers’ compensation claim can be overwhelming and very complicated. Though it can be a huge relief to know you have access to the medical treatment you need for your work-related injuries, it can also be frustrating to hear that you need to see providers other than those already established.

If you are worried about how insurance companies are handling your claim or that you aren’t getting the benefits you are entitled to receive, contact a Chicago workers’ compensation attorney at Horwitz, Horwitz & Associates.

How do you find a medical provider through workers’ compensation?

Many of us have a physician or practice we prefer to see for treatment. According to the Illinois Workers’ Compensation Act, the state follows a “two doctor” rule as long as the provider is part of the Preferred Provider Program (PPP) offered by your employer. You may be able to continue care with your provider if they are included in the PPP network.

Some situations may allow you to choose a provider outside of a preferred provider program. This may be because your employer does not provide a list, or the approved physician makes a specialist referral outside of the network. It may also happen when you are transported to an emergency room for life-threatening injuries.

What is the two-doctor rule?

According to Illinois law, workers’ compensation insurance allows you to choose two doctors from the list of approved providers to treat your workplace injuries. For example, you can see one doctor on the list, and if you are unsatisfied, you can seek another for a second opinion or to transfer care altogether.

When might a PPP physician be required?

Your employer or the WC insurance provider may require you to see an approved provider for evaluation or assessment. These situations may include an initial evaluation to create a treatment plan or recommendations for your personal injury.

You may also see a PPP physician for a Functional Capacity Evaluation to establish when you may return to work. The insurance company may also require an Independent Medical Examination (IME) to continue benefits.

Can you opt out of the preferred provider program?

If you are already established with a treating physician, you may prefer to see them for your care, even if they are not in the preferred provider program. If this is the case, you may opt out of the program, though this may be considered your first choice, meaning you can only see your one chosen out-of-network physician.

The Illinois Workers’ Compensation Commission (IWCC) PPP advisory notice form available for download explains that the IWCC may not consider your decision to utilize your own out-of-network provider under two circumstances:

• You are unable to seek treatment from the provided list of physicians, and you follow all preauthorization requirements.
• The Department of IWCC determines that the care you have received from a PPP provider is inadequate or inappropriate

To opt out of the program and see your own physician for your medical care, you must do so in writing to your employer. While this may allow you to receive ongoing treatment from your provider.

What are my options for a medical provider in a workers’ compensation claim?

If you have been injured on the job, you are entitled to workers’ compensation benefits while seeing your own provider. Workers’ comp insurance cannot directly control the physician you see for treatment. However, you may need to follow your employer’s policy to see someone who is not part of the preferred provider program.

Where can you learn more about your workers’ comp claim in Illinois?

If you have concerns about how your workers’ compensation claim is handled, it may be pertinent to contact a Chicago workers’ compensation lawyer. At Horwitz, Horwitz & Associates, we have an experienced team dedicated to protecting your rights to receive the workers’ compensation you are entitled to according to Illinois law.

Call us today at (800) 985-1819 to schedule a free case consultation and discuss your legal options.