Workers Compensation Commission

Future Medical Treatment

Dirk May Insurance, Law, Medical, Workers Compensation Commission

The way to get future medical treatment in your Illinois Workers Compensation case is often misunderstood.

As I have discussed before, usually the only way possible for future medical bills to be paid is to go to trial and win. This leaves open the avenue for you to collect on future medical needs.

There is not a medical card or insurance card issued. Instead you must request that the insurance company pay for the treatment needed. If they refuse, you must file a case with the Illinois Workers Compensation Commission.

For example, if you injured your back and had a surgery and went to trial and won, then 5 years later the doctor says you need a fusion. Assume the insurance company denies your request for the fusion, you then file for the Commission to review your case. Your doctor will have to testify that surgery is needed and it is related to your original work injury. You will also testify to your  condition, and the insurance company doctor will testify. A panel of 3 commissioners will review the testimony, documents and arguments. They will then issue a decision. This process can take anywhere from 1 to 3 years. So you can tell this process is far from perfect, but it is the only one in place to deal with future medical requests.

Does My Employer Have Workers Comp Insurance?

Dirk May Law, Workers Compensation Commission

In Illinois, every employer must have Workers’ Compensation Insurance. You can check the Workers’ Compensation Commission website to determine if your employer carries the insurance. If you are injured and your employer does not have the proper insurance, you should report it to the Commission immediately. Employers who do not have Workers Compensation insurance can be fined and in some cases face criminal charges. If the employer is solvent, it may be able to pay the claim.

In addition, you can file a claim against your employer and the State Treasurer. The State of Illinois has a new fund which may be used in certain circumstances to pay injured workers whose Employer’s do not carry workers comp insurance. The fund usually will pay only a percentage of the award, but the alternative is usually not recovering anything if the employer is insolvent or has disappeared.

Who is my Judge?

Dirk May Law, Workers Compensation Commission

In Illinois Workers’ Compensation cases the trial judge is called an arbitrator. The arbitrator is a full time employee of the State of Illinois. Her job is to conduct workers’ compensation trials, approve workers comp settlement contracts and rule on motions. She is usually assigned to one or two arbitration sites in the State of Illinois. For instance, in Central Illinois there are arbitration sites in Peoria, Bloomington, Springfield, Urbana, Clinton and Decatur. Cases are assigned to a specific site which is determined according to the location of the accident. For example, if you are injured in Champaign, but live in Lincoln, your case will be assigned to Urbana. The arbitrator remains responsible for all workmans compensation cases at her sites as long as she is assigned to the location. If she is transferred, then the new arbitrator hears your case.

Most arbitrators are lawyers, however, they do not have be a lawyer. Some have backgrounds in labor relations or insurance.

The arbitrator will hear the testimony in the trial, read the medical records and any of the doctors’ testimony, and write a decision in your case. This will usually take 60 days. Both sides have 30 days to appeal the decision to the Illinois Workers Compensation Commission if they disagree with the decision in any respect. More about appeals later.

Illinois Workers Compensation Commission Chairman

Dirk May Workers Compensation Commission

The Chairman of the Illinois Workers’ Compensation Commission is running for Circuit Court Judge in Madison County Illinois. The Chairman runs the Commission and sometimes decides cases at the appeal level. If elected Judge he would not leave the Commission until the end of 2008. The effect would be limited in terms of the way cases are decided. The Chairman to a limited extent drives the agenda for legislation and how fast cases move. The bottom lines is that I do not think a change in the Chairman will speed up or slow down how fast cases will move or whether decisions become more liberal or conservative.