What Treatment is Covered Under Workers Compensation in Illinois?
Workers Compensation - September 10, 2015
What Treatment is Covered in Illinois Under the Workers’ Compensation Act?
Under Illinois law, employers are required to provide workers’ compensation insurance for almost all employees – exceptions being sole proprietors, business partners, corporate officers and some members of limited liability companies have the option of exempting themselves.
According to Horwitz, Horwitz & Associates workers’ compensation attorney Mark Weissburg, “Through the workers’ compensation insurance, your employer is required to pay for all necessary first aid, medical and surgical services, and all necessary medical, surgical and hospital services… limited, however, to that which is reasonably required to cure or relieve from the effects of the accidental injury.” Weissburg went on to say, “What you’ve just experienced (aside from a bit of vertigo) was part of Section 8(a) of the Workers’ Compensation Act.”
Illinois Workers’ Compensation Act – Section 8(a)
Section 8(a) of the Workers’ Compensation Act states, “The employer shall provide and pay the negotiated rate, if applicable, or the lesser of the health care provider’s actual charges or according to a fee schedule, subject to Section 8.2, in effect at the time the service was rendered for all the necessary first aid, medical and surgical services, and all necessary medical, surgical and hospital services thereafter incurred, limited, however, to that which is reasonably required to cure or relieve from the effects of the accidental injury. If the employer does not dispute payment of first aid, medical, surgical, and hospital services, the employer shall make such payment to the provider on behalf of the employee.”
That is quite a lot to take in and understand, so let’s see if we can take this legal mumbo-jumbo and put it into words that make sense. Weissburg says, “Basically, you have the right to all prescribed medical treatment if it helps you get better, or at least your doctor thinks it might.”
As always, there are some issues that may arise. When a doctor takes the Hippocratic Oath to practice medicine honestly, among other points you would expect that your doctor is prescribing treatment that will or at least that they think will help you get better. Well, the insurance company needs to make sure this is the case, so they may hire a doctor from their own network to make sure that the treatment you doctor is prescribing is “reasonable and necessary.” The insurance company does this through Independent Medical Exams, medical record reviews, or submission of a claim for “utilization review.” At the heart of it, these are all ways the insurance company is attempting to dispute the bills.
Chicago Workers Compensation Attorneys
Chicago Workers’ Comp attorney, Mark Weissburg, has been practicing law for almost twenty years. He handles workers compensation cases in the state of Illinois and is a partner at Horwitz, Horwitz & Associates. In addition, he authored the book, “How to Win a Workers’ Compensation Claim in Illinois.” If you would like a free copy of this book please contact our office (see contact information below).
If you have more questiosn regarding the Workers’ Compensation Act in Illinois, our attorneys at Horwitz, Horwitz & Associates invite you for a free telephone or in person consultation to discuss your injury and any questions you may have. You can also email us or even speak with us right now on LiveChat. Even if you do not wish to retain an attorney, we can set you on the right path for free. Our Chicago workers’ compensation lawyers have many years of experience in handling workers’ compensation cases and we have an outstanding track record in helping our clients through creating a strong trust relationship, as you can see in our Success Record. Please call our Chicago office at (312) 372-8822, or our Joliet office at (815) 723-8822, or you can call our toll free number at (800)-985-1819.