What Doctors Can I Go To Under the Workers’ Compensation Act in Illinois?
Workers Compensation - September 10, 2015
If you were injured at work, you should always ask, “What doctor can I go to under workers’ compensation in Illinois?”
Below, we cover some of the key things you need to know before making your way to a doctor for your work-related injury. It is always a good idea to consult with an experienced attorney so that you can be fully aware of your rights.
The attorneys at Horwitz, Horwitz & Associates have been trusted advocates of Illinois workers in workers’ compensation cases for three generations. Call (800) 985-1819 to schedule your free consultation today.
Every state has its own workers’ compensation laws. About half of the states permit employees to choose their own doctors for treatment for a work injury. Other states allow the employer to choose the doctor who will treat the injured worker.
In Illinois, you have a right to choose your own treating doctors. It is strongly recommended that you do so.
You are allowed to select two doctors whose treatment will be covered under the Workers’ Compensation Act, so long as the treatment is reasonable, necessary, and related to the injury.
It’s important to remember that attending a mandated medical examination by a physician chosen by the employer does NOT count toward one of your two doctor choices.
The so-called “Two Doctor Rule” applies only to physicians chosen by the injured worker. The details of the “Two Doctor Rule” are covered below.
Can I choose my own doctors?
If you have been injured, you have the right to receive medical treatment. The “Two Doctor Rule” includes not only two physicians of your choice, but all medical providers and specialists to whom those two chosen doctors have referred you.
If you see another doctor outside the referral chains of your first two chosen doctors, their bills in most cases will not be covered by workers’ compensation.
It is important to note that emergency care and first aid will not count as a “choice” of doctor. However, if you continue to receive treatment from the emergency medical provider after the condition ceases to be emergent, it could be construed as a choice of doctor.
If your employer transports you for treatment to a company doctor, it should not count as your first choice of doctor. However, factual disputes can arise as to who actually chose the doctor in such cases.
Because the “Two Doctor Rule” limits the employee’s number of physician choices, it is important to always obtain a written referral if you wish to see another medical provider. In that way, you can avoid disputes as to whether the new provider is within the referral chain of one of the first two chosen doctors.
A good first doctor choice might be your family doctor, primary care physician or general practitioner. In that way, you will be free to return to your personal physician for referrals to specialists, if needed.
Some people may wish to see a chiropractor as one of their first two choices. While chiropractors are permitted to treat work injuries in Illinois, the opinions of chiropractors sometimes carry less weight with the Illinois Workers’ Compensation Commission – the court that hears workers’ compensation cases — than those of a medical doctor who is licensed to practice medicine in all of its branches.
Similarly, the opinions of doctors who specialize in particular medical conditions or body parts will sometimes carry greater weight than those of a general practitioner. Of course the relative weight to be given to the opinions of various medical providers will always depend on the particular facts and circumstances of each case.
Preferred Provider Programs
A 2011 amendment to the Workers’ Compensation Act allows the employer to establish or join a Preferred Provider Program (“PPP”). If your employer does not have a PPP, you may still choose up to two doctors for treatment, plus any additional medical provider within their referral chains.
If your employer does have a PPP, you may receive treatment from doctors within the PPP. If you choose not to receive treatment from doctors within the PPP, you will be considered to have used up your first choice of doctor. In that case, you will have only one physician choice remaining under the “Two Doctor Rule.” Of course, that physician may still refer you to other medical providers for further treatment at the employer’s expense, as outlined above.
Employer-Chosen Treating Physicians
In some cases, injured workers may receive treatment from medical providers chosen by the employer, such as a plant physician, company clinic, or occupational medicine facility. You are permitted to receive treatment from employer-referred doctors, but you are not required to do so. If you receive your initial treatment from an employer-referred doctor, you are at liberty to switch your care to a doctor of your own choice.
The employer-referred physician does not count as your choice of doctor under the “Two Doctor Rule.”
Employer-Chosen Examining Physicians
From time to time, your employer has a right to schedule you for a medical examination with a doctor of its choice. The examining doctor does not count as a choice of doctor under the “Two Doctor Rule.”
While you are required to submit to the examination, you are not required to submit to any treatment by the examining doctor. The examination must be at a reasonable time and place. The employer is required to reimburse you for the reasonable cost of travel to and from the examination, as well as lost wages if you are required to miss work, and the cost of necessary meals.
The employer is required to provide you or your attorney with a copy of the examining doctor’s report. If you fail to attend the examination after receiving timely notice and payment of travel expenses, you may lose your right to receive further compensation benefits for the time period after which you failed to attend the examination.
View changes to the “Two Doctor Rule” here.
Questions? Call Us.
If you have more questions regarding the Illinois Workers’ Compensation Act, or if you are still wondering what doctor you may see under workers’ compensation in Illinois, our workers’ compensation attorneys can help.
Horwitz, Horwitz & Associates invites you for a free telephone or in-person consultation to discuss your injury and any questions you may have. Call (800) 985-1819 to schedule your free consultation with a workers’ compensation attorney today.