Elfenbaum, Evers & Amarilio, P.C. » Legal Questions

What if my employer refuses to pay the medical bills for my injury or disease?

MikeEvers — Mon, 23 Jul 2007 21:44:51 +0000

Any medical debts incurred after February 01, 2006 are subject to special laws designed to protect injured workers with medical bill problems. How much protection you get under the law depends on whether your employer accepts or disputes your claim.

If your employer accepts your claim, your employer must pay your doctor within 60 days. You must provide your employer with all information required before they are obligated to pay. Your doctor must accept the payment your employer makes under the Workers Compensation Medical Fee Schedule as full payment. Doctors and hospitals cannot make you pay the difference between their charges and what your employer paid.

If your employer disputes your claim, however, unless you have filed your legal claim at the Workers Compensation Commission your doctor or hospital may seek payment of the actual charges from you directly. On the other hand, once you tell a doctor or hospital you filed a claim at the Workers Compensation Commission, the law bars them from seeking payment from you until your case is over. If you are having problems with medical bills or collections, this is another very good reason to file your claim.

After you file your claim and all collection efforts stop, should you resolve by settlement or by arbitration then doctors and hospitals may resume ordinary collection efforts. Any medical expenses left unpaid at the end of your case are your legal responsibility.

It is, therefore, critically important to keep careful track of all of your medical bills, charges and payments from the first day of your case to the last.

What information must I give to my employer?

MikeEvers — Mon, 23 Jul 2007 21:38:24 +0000

You employer must be given sufficient medical information to determine whether benefits are due.

Do I need a lawyer?

MikeEvers — Mon, 23 Jul 2007 20:19:14 +0000

In Illinois, both the employer and the worker can retain legal counsel, and frequently do. Law fixes the amount lawyers charge for legal services related to a workers compensation claim. You pay nothing for legal services until the end of your case. The amount that your lawyer is paid depends on how much money your lawyer gets for you.

In general, if you wonder whether you need a lawyer you probably do.

What if my employer lies about my injury, or destroys evidence?

admin — Mon, 23 Jul 2007 20:18:03 +0000

Anyone (employer, employee, company, corporation, insurance carrier, doctor, etc) who makes false or intentionally misleading statements in order to obtain or withhold benefits has committed a serious crime.

If you suspect this has happened, you should contact your legal representative immediately.

How are disputes resolved?

admin — Mon, 23 Jul 2007 20:12:47 +0000

We encourage you to try to resolve your differences with your employer informally, in the spirit of fairness and compromise. If that fails, you should know that the vast majority of disputes in Illinois workers compensation are resolved on a compromise basis between lawyers and insurance adjusters.

However, if all the parties cannot resolve disputes between themselves then they must submit the questions and problems to the Workers Compensation Commission for arbitration, a legal hearing.

The Workers Compensation Commission is responsible for:

Administering applicable Illinois laws,
Providing information and assistance to workers and employers, and
Resolving disputes regarding the workers’ compensation benefits.