Medical Benefits

Reasonable and Necessary Treatment

By |2017-02-04T16:45:36-06:00February 4th, 2017|Medical Benefits|

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 thereafter incurred, limited, however, to that which is reasonably required

Employee Choice of Physician

By |2017-02-04T16:46:06-06:00February 3rd, 2017|Medical Benefits|

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 463 (2011) Google Scholar | Illinois Courts PDF. The Chain

Independent Medical Exams

By |2017-02-11T12:29:44-06:00February 2nd, 2017|Medical Benefits|

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 offer their expert opinion on issues such as: diagnosis accident

Utilization Review

By |2017-02-06T22:35:05-06:00February 1st, 2017|Medical Benefits|

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 or provided health care services to determine the appropriateness of