Can I Choose My Own Doctor for a Work Injury in Illinois?

Seeking medical attention after sustaining an injury is crucial to protect your physical health. However, when it comes to workplace injuries, choosing a physician can become more complicated. Many people wonder whether they can choose their own doctor after a work injury, but the decisions you make regarding medical treatment can directly affect your workers’ compensation benefits. Read on for more information and consult with a knowledgeable Illinois workers’ compensation attorney to secure the help of a legal professional today.

Can I Choose My Own Doctor for a Work Injury in IL?

Yes, the Illinois Workers’ Compensation Act generally grants employees the right to choose their own doctor after sustaining an injury in the workplace. However, this right is limited by what is commonly known as the “two-doctor rule.” This rule generally allows injured workers two choices of medical providers to treat their work-related injury. Any referrals made by the two initial providers, such as to a specialist, physical therapist, or chiropractor, are generally considered part of the same chain of care and do not count as an additional choice.

It’s worth noting that there are specific circumstances where this rule can be modified. For example, emergency room treatment immediately after a workplace accident generally does not count as one of your two doctor choices. However, if your employer uses a Preferred Provider Program, your selection may be limited.

What is a Preferred Provider Program?

A Preferred Provider Program (PPP) is a network of approved healthcare providers that have been selected by the employer or insurer. If your employer has a valid PPP, you may need to choose a provider from within the network initially. By law, the network must have an adequate number of doctors within a reasonable distance from your home for you to choose from. If you receive treatment within a valid PPP network, that care may count as one of your available choices under Illinois workers’ compensation law. You may still have additional treatment options available depending on whether you remain within the PPP or formally opt out of the program.

Employers must provide written notice explaining the PPP network, your rights as an employee, and any opt-out procedures. You have the legal right to opt out and decline participation in your employer’s PPP. However, it comes with certain restrictions.

You must generally provide a written statement declining to your employer or claims adjuster. Opting out of a PPP also may count as one of your available medical choices under Illinois workers’ compensation law.

What if My Employer Requests an Independent Medical Examination?

An Independent Medical Examination (IME) is a medical evaluation performed by a physician chosen and paid for by your employer’s workers’ compensation insurance carrier. The purpose is often to evaluate whether the injury is work-related, whether treatment is necessary, and whether you can return to work. The doctor will not provide treatment or medical advice; their role is simply to assess the status of your injury.

If you unreasonably refuse or fail to attend your IME, the insurance company has the right to suspend your benefits until the examination takes place. Some injured workers and attorneys believe IME evaluations may favor insurance companies, so it is important to secure legal representation during your workplace injury case.