Workers' Compensation FAQ
Are Most Workers Comp Cases Totally Closed Following a Settlement Agreement?
The greater majority of workers compensation cases are closed once a settlement is reached. Medical is not left open in a larger majority of the cases. Only those cases where someone is gravely debilitated and needs care around the clock or is expected to have future surgeries is that medical going to be left open.
What Happens if Someone’s Condition Worsens After the Settlement Is Reached and The Case Is Closed?
Unless there is a specific provision that would make the insurer or the employer liable for any additional surgeries that may be required, once the case is settled, it’s settled. There’s no turning back unless that medical is left open. There’s no going back to get additional funds from the employer or the insurer.
How Important Is It to Receive the Required Medical Attention?
In Illinois Workers Compensation cases, it’s incredibly important that the employee or the claimant follow every recommendation of their treating physician. If the employee or the claimant fails to follow those recommendations, they risk the employer stopping benefits. They also risk their claim becoming worth a lot less because they did not do everything they could to ensure that they were going to reach maximum medical improvement. Therefore, it’s very important that the Illinois worker follow all recommended care and treatment.
For example, with physical therapy, it’s incredibly important that the employee does not miss any appointments and is trying to do their very best during those treatment sessions. It’s also important for the employee that they stay within the chain of referrals. In most instances in Illinois, the Illinois worker only entitled to two different medical professionals that are not in the chain of referral.
With a serious injury where different body parts are injured, the employee might be required to see different types of doctors for example, the Illinois Worker might be required to see an orthopedic doctor, a gastrointestinal doctor, a spine doctor, a neurosurgeon. If someone’s severely injured and they have been required to see a lot of different specialists, they’re going to have to get a referral from their primary care physician to see those specialists. If they don’t stay within that chain of referral, then the employer will not be obligated to pay those medical bills.