Illinois Workers’ Comp System Set to Debut Preferred Provider Option

 Posted on November 08,2011 in Articles

Amendments to the Illinois Workers' Compensation Act in 2011 have implications for several aspects of the system that awards benefits for work-related injuries. These changes include new guidelines for determinations of permanent partial disability, limitations on recovery for hand injuries and reductions in the duration of wage loss differential awards.

One particularly important change is a new limit on a worker's choice of medical providers to assess a workplace injury or illness. Under the new law, employers and workers' compensation insurance providers will be able to provide a list of doctors available for the employee's first of two available choices under the existing "two doctor rule." If a worker declines to choose from that list, the first choice will effectively disappear.

One stated objective of the implementation of preferred provider organizations (PPOs) for workers' comp care is to lower the cost of awarding benefits by guiding injured employees toward providers who specialize in assessing work-related injury claims. The state Department of Insurance has yet to finalize provider network rules, but this new practice should be fully implemented by early next year.

Uncertainty about the effect on a worker's ability to receive effective medical treatment is one major concern cited by Illinois workers' comp attorneys. Free choice under the two doctor rule is a crucial part of the process for many workers' compensation applicants, because medical opinions about various types of harm, including repetitive stress injuries, back injuries and occupational diseases, can be difficult to diagnose and treat.

However, the recent changes to Illinois Workers' Compensation Commission procedure underscore an important aspect of the process of applying for benefits: counsel from an experienced workplace injury lawyer can be crucial to success. Workers who deserve compensation for lost income and medical expenses will benefit more than ever from seasoned advice about medical referrals for second opinions, specialized care and related issues.