Choose Your Own Doctor
We're going to talk about how you can see a doctor of your choice and how to make your employer pay for the doctor.
The first thing you need to know is that if you got hurt at work, you're supposed to be able to see a doctor of your choice and your employer is supposed to pay the doctor. But there's a specific reason they don't want you to choose your own doctor. We'll talk more about that in a little bit.
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Fee Schedule
Under Illinois workers comp law, you're supposed to choose your doctor. The employer or their insurance company is supposed to pay the doctor that you chose. The amount that they're supposed to pay the doctor is called the fee schedule amount.
Illinois worker's comp law sets up a fee schedule for what doctors get paid for various services. Those amounts are pretty generous. Generally, they're more than health insurance companies pay for the same or similar services. So doctors actually like workers comp cases.
So if you got hurt at work, it should be pretty easy for you to find a doctor who's willing to treat you. Because they know it's very likely they're going to get paid under that fee schedule amount under the Illinois workers comp law. It's a pretty good payment and doctors are happy to accept it as full payment for the services they give you.
The Two Doctor Rule
The next thing you need to know is about the two doctor rule. The two doctor rule says that an injured employee is entitled to a choice of two doctors when they've been hurt at work. I'll bet you figured out that pretty quickly when I called it the two doctor rule. But here's a wrinkle it doesn't mean two doctors it means two chains of referrals of doctors.
So let's say you choose a doctor and you go to that doctor. Then that doctor sends you for an MRI. Then he sends you for therapy, and then that doctor refers you to a specialist and that specialist sends you to another specialist and another specialist. Well you've now seen four or five different medical providers, but because they're all in the same chain of referral, it only counts as one doctor under the two doctor rule. You'd still have one more doctor or chain of doctor referrals to go to.
This is pretty important to understand. Because if you go to a doctor outside the two doctor rule, the judge or arbitrator assigned to your case might decide that your employer or the workers comp insurance company doesn't have to pay any doctors who you saw outside the two doctor rule.
Examining Doctor Or Treating Doctor
Here's the difference between an examining doctor and a treating doctor comes in. It's a big difference. Even though the company can designate a doctor that can examine you as much as they want. You get to decide who the treating doctor is. Your treating doctor gives you a diagnosis, decides what the treatment plan is, what medical care you need and whether you should have an off work note or not.
So your ability to choose the treating doctor is very powerful in a worker's comp case. That's why your employer and their workers comp insurance company want you to choose their doctor as your treating doctor. That means a doctor, who is beholden to your employer and loyal to your employer, gets to decide whether you work or have an off work note, and whether you get the medical care you really need.
Choose Your Own Treating Doctor
You probably don't want a doctor who's loyal to your employer and not you, calling the shots on your medical care. That's why I always tell injured people, you should choose your own treating doctor and not treat with the company doctor. Even though the company doctor does get to examine you. If you choose your own treating doctor and you're within the two doctor rule, then the law says that your employer and their workers comp insurance is supposed to pay for all of your necessary medical care.
File A 19 B Petition If They Don't Do It Voluntarily
If they don't do it voluntarily, they can be forced to do so by the arbitrator or a judge assigned to your workers comp case. You might have to go to court or over to the Commission and file a 19 B petition in order to get the judge or arbitrator to force them to pay.
That's why you have to make sure to follow the two doctor rule and choose a treating doctor who's on your side. If you do that you're very likely to be able to force them to do what the law says they're supposed to.
I really hope this information helps you in your situation. If you have a question or something you want to talk about privately go ahead and call my office or just message me and I'll see if I can help you and point you in the right direction.
