Under the Illinois Workers’ Compensation Act, employees have the right to two different medical opinions on treatment for a work-related injury. If you are injured at work and do not agree with the assessment of the first doctor you see, you are free to seek another doctor’s advice and the workers’ compensation insurance company has to pay for it. However, there may be an exception for injury victims if the first doctor says that the injury is not work-related.
Getting a Second Doctor’s Opinion After Your Injury is Deemed Not Work-Related
Illinois employers are allowed to contract certain hospitals or doctors to provide health care to their employees. When an employee is injured, the employer may demand that the employee see one of its approved physicians for treatment. As the physician is directly beholden to the employer, the medical opinion may not be in the patient’s best interest.
As a result, the law allows the patient to seek a second opinion for an Illinois work injury for any reason, including if:
- He or she disagrees with the doctor’s diagnosis
- He or she disagrees with the doctor’s treatment plan
- The doctor has cleared the patient to return to work, but the patient does not feel ready
- The doctor has recommended surgery
- The doctor’s medical opinion has been influenced by recommendations from the insurance company’s nurse case manager
- The patient does not feel like the doctor is listening to his or her concerns
- The doctor is misinterpreting or giving too much weight to previous medical history when evaluating the current injury
While the right to a second medical opinion is automatic, there is an exception to the insurance company’s responsibility to pay for the second doctor’s visit: if the first doctor says that the injury doesn't qualify for workers’ compensation. If you seek a second opinion and your new doctor agrees that the problem is not work-related, you will likely have to pay for this visit out-of-pocket. On the other hand, even if the new doctor believes that the injury is work-related, you may still have difficulty getting the workers’ compensation commission to consider the second opinion.
If you suffered a work injury in Illinois, our workers’ compensation attorneys can determine whether you are owed payment through workers’ compensation benefits or a third-party lawsuit. Contact Tapella & Eberspacher today at (217) 394-5885 or fill out our online contact form to schedule your free consultation.