Medical Benefits After An Injury

It’s important to choose your medical providers carefully after a work-related injury. If your employer has established a Preferred Provider Program (PPP), you may be restricted to certain doctors and hospitals for nonemergency care.

Additionally, injured workers in Illinois are limited to two providers. If a PPP is applicable, those two providers must be “in network”. If there is no PPP, the worker can choose any two providers. First aid, nonemergency care, and treatment that is sought before the injury is reported does not count toward the number of providers a worker may see.

Employers have a right to evaluate the necessity of your medical treatment after a work injury. By performing a “utilization review”, employers may review all past, present, and expected future medical treatments and determine their necessity. Findings from the review may be brought before the Commission if the employer wishes to challenge certain treatments. To determine whether a treatment is reasonably necessary, the Commission will review all evidence including the employer’s finding. Treatments that are determined to be excessive or unnecessary may not be covered under the Workers’ Compensation Act.

At Eames Law Group, we take prompt action to ensure that you have access to the medical treatment you need after a workplace injury. If your employer refuses to authorize medical treatment, or your request for payment of medical bills has been delayed or denied, our firm will bring your case to the Illinois Workers’ Compensation Commission for arbitration. We’ll request a 19B Emergency Hearing to resolve authorization or payment issues fast so you can continue to heal.

Hearings under 19B allow attorneys to expedite the process and can give your claim priority over all the other claims which are pending before the Arbitrator. The arbitrator can then order your employer to authorize medical care and pay for the treatment, tests, or special equipment you need.