Recent changes in the Illinois Workers’ Compensation Act have created new issues and challenges for injured workers. The stated intention of the changes is to make the program more efficient and flexible, but that may not be the case. The changes are significant enough that the many workers will not be aware of their new options and requirements for compliance with the law. The changes in the law make it more important than ever to contact an experienced Illinois workers’ compensation attorney.
Before the new changes, the employer was responsible for all first aid and emergency services, two treating doctors of the employee's choice and any additional providers to which the employee is referred by the two treating doctors. That is no longer the case.
The new law establishes Preferred Provider Programs (PPP). This affects how employees select their own treating medical providers. The amendments to the existing law also change the employer’s role in providing first aid and emergency service, as well as the two treating doctors.
The options employees have are largely dependent on whether the employer is enrolled in a Preferred Provider Plan. Since the employee has more choices, it is important to understand what each situation means for treatment.
If the employer IS enrolled in a PPP, a worker must make a decision to opt in or out of that program. Employees choosing to participate will have the choice of up to two doctors from the listed medical providers and the providers they may recommend. Those employees opting out of their employer’s PPP are limited to selecting only one doctor and the providers that doctor may recommend.
If the employee opts out of the program, he/she is limited to only one doctor of choice and any providers the worker is referred to by that doctor. In essence, the choice to opt out of the program will be considered one of the employee's two "choices" of doctor.
If the employer IS NOT enrolled in a PPP, workers can select up to two doctors for medical treatment as well as the providers those doctors may recommend.
A workers’ compensation attorney who has carefully studied these new changes will point out that emergency care and first aid does not count against the number of doctors allowed. At the same time, non-emergency care by a doctor may eliminate the opportunity to choose another provider.
Employees retain the right to see a third doctor, but the employer has no obligation to pay that provider, and it may be left to the employee to cover that expense. Additional amendments to the Act cover a number of areas related to the benefits and means by which they are adjudicated. This includes how permanent disability is determined, giving more reason to retain an experienced Illinois workers’ compensation attorney.
Other changes to the Act:
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