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Who picks your workers’ compensation physician in Illinois?

On Behalf of | Sep 23, 2022 | Workers' Compensation |

When you’ve been injured on the job, getting the medical care you need is important – but the choice of doctor is also critical to your claim. After all, this is the person who has to certify not only the extent of your injuries but tie them into your workplace duties or accident. They’re also the person who controls when (or if) you can return to work, and what sort of limitations you have once you do.

In other words, you want to pick carefully. That means understanding exactly how the system works – and that’s not always easy, especially if this is your first claim. Here’s what you need to know:

Illinois follows a 2-doctor rule

Workers in Illinois have much more liberty to choose their own workers’ comp physician than folks in many other states – but they’re still subject to a lot of rules. In essence, you can pick your primary treating physician for workers’ comp, and you can change physicians once, for whatever reason.

There are a few caveats to keep in mind:

  • Emergency care physicians who see you do not generally count toward an employee’s “choices.”
  • Emergency care at a company clinic is often not considered part of your choices, either, although that’s not always so. A lot depends on how much freedom you have to pick a physician for other things.
  • If your employer has a preferred provider network (PPN), your primary and secondary choice of physicians must come from that list.
  • If your physician of choice sends you to a specialist, the specialist does not count against your two choices. Nor does any other physician in that line of referrals.

 

If, for example, your physician of choice refers you to a back and spine specialist, and that specialist refers you to surgery, nobody in that treating line eats away your right to make a change in your medical care.

Workers’ compensation is supposed to be an easy, no-fault system that gets injured workers the medical care and benefits they deserve, but the system isn’t perfect. If your claim is becoming problematic, legal assistance is wise.