No one wants to see an unfamiliar doctor after being hurt. When it comes to workers’ compensation claims, though, going to a doctor chosen by the employer is a common fear. If you live in Illinois and get hurt at work, can you choose your own doctor or do you have to head to a stranger’s office or urgent care because of your employer’s workers’ comp insurance policy?
For the most part, you should be able to choose your own doctor if you’re getting workers’ compensation benefits in Illinois. Your employer and their insurer might have some medical providers picked out if you need a recommendation or don’t have a primary care physician you need to see, but you shouldn’t be obligated to see them first. However, there are some situations in which you will need to see a doctor that isn’t of your choosing.
Independent Medical Evaluations
Your employer can order an independent medical evaluation (IME) while you are receiving workers’ compensation benefits. During an IME, you will see a medical practitioner selected by the employer or the insurer. This medical practitioner will evaluate your injuries and the disabilities they are causing to provide a second opinion.
You need to attend an IME when it is ordered. The IME doctor’s second opinion can’t be used alone to deny your benefits. Although, it could be the start of a furthered investigation into your injuries if that doctor notes significant discrepancies with your other medical records.
Medical Emergencies
If you have been severely injured at work, then you will likely be taken to the nearest emergency room for medical treatments, which means your doctor will not be there to treat you. If you have been rendered unconscious or unable to respond, then you will also not be able to see your own doctor first.
When you don’t see your doctor first, whether there was a medical emergency or not, you might still have the option to see your own doctor later. You can request that the medical provider assigned to your workers’ compensation case and related treatments be changed from the employer’s choice to your own.
Denied Claims
When an insurance company or employer suspects that you intentionally caused your work injury, or that you were acting unreasonably negligent when it happened, your claim could be denied. If your claim is denied for this reason or another, then the good news is that you are free to see your own doctor. The bad news is that you will have to pay for their services using your health insurance.
A denied claim is not the end of things, though. You might have the chance to challenge the denial and get the benefits you need, including reimbursement for medical treatments you needed but had to pay for yourself. When there are challenges about the validity of a claim and its value, a workers’ compensation lawsuit will often follow. A successful case can end with the injured worker being paid a lump-sum settlement that accounts for all of their benefits, reimbursements, and other damages.
Do you need help with a workers’ compensation case in Illinois? Do you think you should be able to see your own doctor but your employer is interfering? Get the legal help of McHargue & Jones, LLC in Chicago. We have stood up for injured workers since 2000, and we aren’t slowing down our history of victories yet! Call (312) 739-0000 or contact us online to schedule a free initial consultation.
