Will Workers’ Compensation Cover All My Medical Expenses?

Illinois workers’ compensation laws are primarily intended to cover medical treatment for work-related injuries. However, this does not necessarily mean that every expense you file will be automatically approved for compensation. Unfortunately, on top of having to deal with the pain and suffering of your injuries, you may have to worry about your employer’s insurance company disputing your claims. If this is your current predicament, please read on to discover whether your workers’ compensation benefits will take care of all your incurred medical expenses and how a seasoned Illinois workers’ compensation medical benefits lawyer at The Law Firm of Kevin A. Moore can help maximize your coverage.

Is workers’ compensation supposed to cover all my medical expenses?

Generally speaking, the Illinois Workers’ Compensation Act states that employers or their insurance carriers must pay for all “reasonable and necessary” medical care related to an employee’s work-related injury. The operative words “reasonable and necessary” refer to treatments that are most appropriate for diagnosing and treating your condition, per accepted medical standards. With that being said, core medical services deemed necessary for recovery typically include the following:

• Your initial ambulance trip from your workplace.
• Your initial emergency room visit post-accident. 
• Your testing (i.e., bloodwork, X-ray, MRI scan, etc.) for a diagnosis.
• Your emergent and ordered surgical procedures.
• Your overnight hospital stays for observational purposes.
• Your follow-up visits with a physician, specialist, or chiropractor.
• Your prescribed physical and occupational therapy sessions.
• Your prescription medications. 
• Your necessary assistive equipment (i.e., brace, crutches, wheelchair, etc).

Am I supposed to seek medical treatment from specific doctors?

Under Illinois workers’ compensation law, there is something known as the “two-doctor rule.” With this, you may choose up to two different doctors or specialists to treat your work-related injury. Plus, any referrals made by these two doctors or specialists (i.e., to another specialist, a physical therapist, occupational therapist, etc.) are considered part of the same chain of care rather than a new choice of yours. Also, emergency room treatment immediately after your workplace accident does not count as one of your two doctor choices. 

Of note, your employer may request that you undergo an independent medical examination (IME). Essentially, this is an evaluation of your condition conducted by a doctor pre-approved by your employer’s insurance carrier. While you may have to comply with this, you do not have to use this assigned doctor for your ongoing treatment. Contrastingly, your employer may have a Preferred Provider Program. If they give you written notice of this, your selection may become limited. If anything, you may opt for one in-network and another out-of-network provider. 

Before you go ahead and schedule a medical appointment, consult with a competent Illinois workers’ compensation medical benefits lawyer from The Law Firm of Kevin A. Moore. We will ensure you receive the medical attention you need for your physical recovery and financial protection.