What Medical Care Does Workers’ Comp Cover in Illinois?

 Posted on December 07,2021 in Workers' Compensation

People who are injured while on the job may experience multiple issues that affect their ability to continue working, as well as their overall health and well-being. Fortunately, workers’ compensation benefits are available for those who have suffered work-related injuries. While workers’ comp claims may be focused on disability benefits that address a person’s loss of income due to a work injury, an injured worker can also receive medical benefits. By understanding the types of coverage provided and the steps they should take following a work injury, a person can make sure they will be able to receive the proper medical care that will fully address the ways their injuries have affected them.

Workers’ Compensation Medical Benefits

An employer is responsible for paying for all medical treatment necessary to address a work-related injury and ensure that a worker can recover as much as possible. In addition to receiving first aid or emergency treatment following a workplace accident, an employee can also receive medical benefits that pay for ongoing treatment. This may include visits to doctors or specialists, surgery, physical therapy, medications, chiropractic treatment, and assistive devices such as prosthetics or wheelchairs.

Following a work injury, a person can protect their right to receive medical benefits for workers’ compensation by seeking medical care as soon as possible. By informing medical providers that an injury is work-related, this will ensure that the providers will bill the person’s employer for the care provided. An employee should also notify their employer of the date and circumstances of their injury and the name and address of the doctor or medical facility where they received treatment.

Injured employees are generally allowed to choose their own medical providers. However, an employer’s workers’ compensation insurer may use a Preferred Provider Program (PPP) with a network of approved medical providers. An employee will generally be able to choose two providers within a PPP, although emergency treatment a person receives will not count as one of these choices. If an employee wishes to see a provider that is outside the PPP, they may decline to participate in the PPP by sending a written statement to their employer. Declining to participate in a PPP counts as one of the two choices of medical providers. 

While all medical care related to a work injury will generally be covered by workers’ compensation, there are some situations where an employer may challenge the necessity of certain forms of treatment. In these cases, an employer may request a utilization review to review a person’s past, present, and future treatments and determine whether different forms of treatment are medically necessary. However, even if certain forms of medical treatment are determined to be excessive or unnecessary, an employee will generally not be responsible for paying medical expenses, as long as the treatment they have received is covered under the Illinois Workers’ Compensation Act. 

Contact Our Plainfield Workers’ Comp Attorney

If you have experienced a work-related injury, Attorney Daniel Flaherty can help you understand the types of benefits you are eligible to receive through workers’ compensation. He can help you file a worker’s comp claim that will provide you with medical coverage and disability benefits. To schedule a free consultation, contact our Will County workers’ compensation claim lawyer at 815-577-7500.

Source:

https://www2.illinois.gov/sites/iwcc/Documents/handbook.pdf