Ridge & Downes - Law Firm

This FAQ section is provided as a general guideline to the rights and responsibilities of an employee who has been injured on the job. It does not, and cannot, contain all of the benefits and obligations pertaining to each specific case. Furthermore, it does not set forth the statute of limitations, nor the time limitations, of what you must do for proceeding with a workers ’ compensation claim. Each workers’ compensation case is unique and the law is frequently modified by the legislature and the courts.

This FAQ section is not intended as a replacement for the advice of an experienced attorney. In fact, if you have suffered an injury that is work related, you should consult an attorney knowledgeable on the law in your State for proper advice regarding the same.

Is my employer required to pay for medical expenses and treatment?

The law requires that the employer shall provide and pay for all necessary first aid, medical and surgical services reasonably required to cure or relieve the effects of the accidental injury. The employee has the obligation to cooperate in good faith in his or her own recovery at all times. The Act allows employers to utilize Preferred Provider Programs (PPP) as approved by the Illinois Department of Insurance.  If an employer does not have an approved PPP, the injured worker has the right to see two doctors of their own choosing.  If these chosen physicians refer the employee to other doctors or specialists (“chain of referrals”), payment of all such treatment remains the liability of the employer.  Emergency medical services do not count as one of these choices.

If an employer has an approved PPP, the employee must be notified in writing.  Employees should not assume that the company clinic is within the PPP.  After reporting an injury, the employee can opt out of the PPP in writing at any time.  By opting out, an employee uses up one of his two choices of physician.  If the employee opts into the PPP, he/she has the right to choose two providers within the PPP, plus all medical providers referred by those two doctors, at the employer’s expense.  If the Workers’ Compensation Commission finds that the care being rendered by the employee’s second choice of provider within the PPP is improper or inadequate, the employee may then choose a provider outside of the network at the employer’s expense.  If an employee seeks non-emergency medical treatment prior to reporting an injury, that provider would constitute the employee’s sole choice of medical provider outside of the PPP.

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