Workers' Compensation Medical Benefits
Workers’ Comp Pays for Your Medical Care
For most people who receive workers’ compensation benefits, the provided coverage for all required medical treatments is the most important benefit. After all, it might only take a single hospital stay to add up a massive medical bill that would cripple your finances if not for workers’ compensation coverage.
If you need help getting the medical benefits you need after a workplace injury while working in Chicago or Cook County, then you can count on McHargue & Jones, LLC for comprehensive legal guidance. For the last 20+ years, we have been supporting the honest people of our communities who have been hurt while working and then let down by their employers and insurance companies. We’re on your side, every step of the way, so let’s discuss your case today.
On This Page:
- What Your Medical Benefits Cover
- Can You Choose Your Own Doctor?
- What is "Necessary Treatment"?
- Does Workers' Comp Cover Copays?
- How Long Will Workers' Comp Pay My Medical Bills?
- Get Legal Representation Today!
As a no-fault system, workers’ compensation is designed to help you get back to work as soon as possible without worrying about who to “blame” for your accident and injuries. If you were hurt while at work or while acting in the scope of your employment, then you should be covered, and you should be eligible for medical benefits that protect your finances.
Your medical benefits through workers’ compensation should pay for:
- Emergency medical care
- Copays and deductibles
The coverage for your medical costs should be complete. Not a single cent should come from your own pocket when your case is concluded. If you are being told to pay a medical bill related to your work injury, then there could be a serious legal issue unfolding that should be brought to the attention of our workers’ compensation lawyers right away.
FAQ About Workers' Compensation Medical Benefits
In Illinois, you have the right to see a primary care physician of your choosing after being hurt on the job. However, you might first be taken to an in-network medical clinic or medical professional for initial treatments if you have not selected a suitable medical professional of your own, or if your injuries are not serious. Typically, workers are more easily able to see their doctor for follow-up treatments, such as when they need to see a specialist or might require surgery later.
Although, if your employer belongs to a Preferred Provider Program (PPP), then your freedom to choose your own medical provider will be limited. Rather than picking any doctor you want, you will have the option to pick a doctor within that PPP network. Or you can request to see just one doctor of your choice, regardless of their insurance network, for a second opinion.
The biggest obstacle to your medical benefits through workers’ compensation might be the term “necessary.” The insurance company only has to pay for medical treatments that are necessary, and not those that are elective or optional. If an insurer is desperate to look for a way to pay less of your medical bills, then they might try to argue that some of your medical care was elective. This argument is often made by medical professionals contracted by the insurer to conduct an “independent” medical review of the claimant’s case. The use of a medical expert to act as a witness in your own case could become necessary to refute them.
Yes. If you are seeing a doctor within the workers' compensation insurance network you should not have to pay anything out of pocket for your treatment. This includes copays and deductibles.
Securing fair medical benefits through a workers’ compensation claim is essential to your recovery. Or it might make sense to pursue a workers’ comp settlement that pays for all of your medical benefits, including those in the future, at once. In either situation, McHargue & Jones, LLC in Chicago would be happy to help you explore your options and pursue the best one.