Medical Benefits

Reasonable and Necessary Treatment

Injured workers with compensable Illinois workers’ compensation claims are entitled to reasonable and necessary medical treatment. The Illinois Workers’ Compensation Act provides: The employer shall provide and pay … for all the necessary first aid, medical and surgical services, and all necessary medical, surgical and hospital services […]

Doctor taking blood pressure
Medical Benefits

Employee Choice of Physician

Injured workers in Illinois are generally allowed to choose their own medical providers. This is limited, however, by the two-physician or chain of referrals rule. 820 ILCS 305/8(a) Illinois General Assembly | IWCC PDF; Absolute Cleaning/SVMBL v. Illinois Workers’ Compensation Commission, 409 Ill. App. 3d […]

Medical Benefits

Independent Medical Exams

Employers and their insurance companies can require injured workers to submit to an independent medical examination, also known as an IME or section 12 exam, to determine the nature, extent, and probable duration of the injury. Following the exam, the employer’s doctor will author a report and […]

Woman in physical therapy
Medical Benefits

Utilization Review

Employers and insurance companies can evaluate the medical necessity of proposed or previously provided medical treatment with a process called utilization review (“UR”). Section 8.7 of the Illinois Workers’ Compensation Act governs the use of utilization review, which it defines as: the evaluation of proposed […]