What to Know About Workers’ Comp Coverage for Medical Services, Including ER Visits

Suffering an injury on the job is devastating enough without having to worry about the costs related to medical care. In Illinois, workers’ compensation covers medical expenses. If you’re injured on the job and require immediate medical attention—including emergency room care—those expenses are usually covered by your employer’s workers’ compensation insurance.

Any time you are injured on the job, be sure to report the injury to your employer as soon as possible. Tip: Document it in writing, if possible. Some states, like Illinois, require only verbal notice, while some require it in writing. If you are injured at work, here’s a list of what you should do.

What types of workers’ comp medical services are covered?

An employer must pay the necessary medical expenses of an employee who is injured on the job. This includes first aid, hospital, surgical and medical expenses incurred due to a work-related injury. An employee can also receive medical benefits for ongoing treatment related to the injury, such as visits to specialists, physical therapy, assistive devices like wheelchairs and more.

Are emergency rooms covered?

Yes, workers' compensation in Illinois does cover emergency room visits if the injury or illness is work-related. Doctor’s fees, tests and necessary treatments related to the injury are also covered by workers’ comp insurance.

Does my employer have to send me to the doctor after I’m injured?

Under Section 8(a) of the Illinois Workers’ Compensation Act, an employer is not obligated to provide or facilitate medical treatment for a work injury. The employer must pay for all charges for the necessary first aid, medical, hospital and surgical services that are required to cure or relieve the effects of an injury. But, this provision does not require the employer to call an ambulance, transport an employee to a doctor or facilitate an employee to seek care. Employers are only required to pay the bill.

If you report an injury to your employer and they do not send you to the doctor, you must seek treatment on your own as soon as possible. Waiting for an employer to send you to get treatment can hurt your case. Go see a doctor on your own as soon as you can after an injury.

Do I have to see a doctor selected by the insurance company?

An employer can ask you to go seek treatment at a doctor or clinic of their choice. If they do so on the day of injury, you should go. After the appointment is finished, go see the doctor of your choice. Treatment afterwards can be with your own doctor, unless you receive a letter from your employer saying they’ve scheduled a Section 12 independent medical evaluation (IEE). If your employer requests this type of exam, it’s likely they are trying to dispute something in your case. Get in touch with one of our attorneys to get advice before going to your IME appointment.

The team at Black & Jones can help you navigate the claims process, fight for your rights and ensure you’re getting the full coverage of your benefits. We’ll be there every step of the way. Give us a call at (815) 967-9000 or get in touch online to set up your free legal consultation.