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Workers’ Compensation

If you have suffered a work related injury we know that you deserve specific and attentive orthopaedic care. At Suburban Orthopaedics our physicians and staff are dedicated to efficiently return you to work by providing an extensive evaluation and treatment plan. We are committed to reducing your time off from work while simultaneously restoring you to your pre-injury status in the most efficient and cost-effective manner. With diagnostic and rehabilitative services located on-site, Suburban Orthopaedics is the perfect choice for management and care of your work related injury.

Almost each individual who is employed by a company in the state of Illinois is covered by the law from the moment they are hired for certain injuries or diseases that may be caused from their employment or duties required by their job .

In most cases the law will include injuries that are caused, in whole or partially, by the employee’s work. For Example:

  • An employee who is injured by the repetitive use of a body part.
  • An employee who suffers a stroke, heart attack, or other physical problem caused by work.
  • An employee who had a pre-existing condition*
  • Injuries accrued by employer sponsored recreational programs (athletic events, parties, picnics, etc.)**

* Patient must be able to show the work aggravated that condition

** Only if the employee is ordered to participate by the employer

  • Injuries, accidental or otherwise, that incur while participating as a patient in a drug or alcohol rehabilitation program are not covered under the law.

It is illegal for an employer to harass, discharge, refuse to rehire, or in any way discriminate against an employee for exercising his or her rights under the law.

The employer is required to pay for all medical care that is reasonably necessary to cure or relieve the employee from the effect of the injury. These costs include but are not limited to

  • First Aid
  • Emergency care
  • Doctor visits
  • Hospital care
  • Surgery
  • Physical therapy
  • Chiropractic treatment
  • Pharmaceuticals
  • Prosthetic devices
  • Prescribed medical devices*.

*Devices such as a shoe lift or wheelchair may be covered.

The law states the following benefit categories are provided to the employee:

  • Medical Care that is reasonably required to cure or relieve the employee of the effects of the injury
  • Temporary total disability (TTD) benefits while the employee is off work, recovering from the injury
  • Temporary partial disability (TPD) benefits while the employee is recovering from the injury but working on light duty
  • Vocational rehabilitation/maintenance benefits are provided to an injured employee who is participating in an approved vocational rehabilitation program
  • Permanent partial disability (PPD) benefits for an employee who sustains a permanent disability or disfigurement , but can work
  • Permanent total disability (PTD) benefits for an employee who is rendered permanently unable to work
  • Death benefits for surviving family members.

By law, the employer is responsible for the cost of workers’ compensation. Most employers buy commercial workers’ compensation insurance, and the insurance company pays the benefits on the employer’s behalf. No part of the workers’ compensation insurance premium or benefit can be charged to the employee. Other employers obtain the state’s approval to self-insure.

What are the time limits for notifying the employer?

The employee must notify the employer within 45 days of the accident. Any delay in the notice to the employer can delay the payment of benefits. A delay of more than 45 days may result in the loss of all benefits.

The employee or the employee’s attorney should contact the employer directly to determine why benefits are not being paid. Poor communication often causes delays and misunderstanding. If the problem persists, the employee should file a claim at the Commission. Please note that an accident report does not trigger any action by the Commission.

If the employer does not dispute a medical bill, it will pay the medical provider directly. The employee is not required to pay co-payments or deductibles. If the employer disputes a bill, it must promptly give the employee a written explanation for the refusal. If a case is pending at the Commission, the provider cannot try to collect payment from the employee; once the employee notifies the provider that he or she has filed a claim with the Commission to resolve the dispute. The provider may send the employee reminders of the outstanding bill, and ask for information about the case such as the case number or status of the case. If the employee does not provide the requested information within 90 days of the date of the reminder, the provider may resume efforts to collect payment.

Most treatments that are covered under the Act and were provided on or after February 1, 2006 are subject to a medical fee schedule. The employer shall pay the lesser of the provider’s actual charge or the amount set by the fee schedule.

Yes, however, there are limits; the state of Illinois cannot direct care to a specific doctor or hospital. The employee, after filing their claim with their employer, typically will see a physician directed by the employer. If the employee chooses to they may go see a physician of their own choice, even if that physician is outside of the employee’s regular insurance network.

Yes. On occasion an employer may request a full medical exam by the doctor of its choice.

If you have suffered a Personal Injury we at Suburban Orthopaedics are here to help! We know that personal injury cases can be difficult, especially when attempting to obtain medical care. If you have been injured at another parties’ expense we have physicians and staff that can help assist you through the arduous process.

To discuss your injury, address your questions, and set an appointment for consultation with one of our orthopaedic specialists please contact our office at (630) 372-1100, log onto our Patient Portal or email us at info@suburbanortho.com

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