When you are injured on the job in Illinois, medical treatment is one of the most immediate concerns. Many clients come to us confused about whether they must see the doctor their employer suggests or whether they can choose their own. The answer is critical, the physician who treats you plays a major role in your recovery and in documenting your injuries for your workers’ compensation claim. The Illinois Workers’ Compensation Act provides specific rules about how medical care works, including how many doctors you can choose and when your employer’s input matters.
We want you to understand your rights clearly. Too often, workers accept the first doctor their employer sends them to, without realizing they may have other options. That decision can impact the quality of care you receive and the outcome of your claim. Let’s break down what Illinois law actually says, what it means in practice, and how you can protect your right to the care you need.
The Illinois Workers’ Compensation Act sets out the “two-doctor rule.” This means you can choose two physicians of your own, and each physician can refer you to specialists or other providers without those referrals counting against your two choices.
820 ILCS 305/8(a) states that the employer shall provide and pay for all the necessary first aid, medical and surgical services, and all necessary medical, surgical and hospital services thereafter, limited, however, to treatment by the two physicians of the employee’s choice, or any such physicians to whom the employee is referred by said chosen physicians.
In practice, this means you are not limited to a company doctor. If you are not comfortable with the employer’s suggested physician, you may select your own doctor for the first choice and, if necessary, choose a second doctor later. Any specialists you see as a referral from one of your chosen doctors do not count as an additional choice.
Illinois law also allows employers to set up a Preferred Provider Program for workers’ compensation medical care. Under 820 ILCS 305/8.1a, if your employer has an approved PPP, you will need to choose from doctors within that network unless you opt out in writing. If you opt out, one of your two allowed choices will be used immediately.
820 ILCS 305/8.1a(b) explains if the employer has established a Preferred Provider Program and the employee declines participation, then the employee’s choice of provider shall be limited to one physician and any referrals therefrom.
This means that opting out of the PPP reduces the number of independent doctors you can choose from two to one. Before making that decision, it is important to weigh the benefits and limitations, and we often help our clients understand whether opting out is in their best interest.
The treating physician’s medical opinions will heavily influence whether your claim is approved, the benefits you receive, and how long those benefits last. Independent doctors you trust are more likely to focus on your best medical interests rather than the employer’s bottom line. The medical records from your chosen doctor will form the backbone of your workers’ compensation case.
If you only see the company’s doctor, there’s a risk they may understate your injuries, recommend a premature return to work, or leave out details that support your claim. Choosing your own physician ensures you have a medical professional who is committed to your recovery and can provide credible testimony if your claim is disputed.
Even if you choose your own doctor, disputes can arise over whether the treatment is “reasonable and necessary,” as required under 820 ILCS 305/8(a). Employers or their insurers may challenge certain procedures or therapies, arguing they are not covered. In those cases, we present medical evidence and testimony to the Illinois Workers’ Compensation Commission to prove the treatment is essential for your recovery.
Another common issue involves unpaid bills. If your medical provider is not paid promptly, they may try to bill you directly, even though Illinois law prohibits that during an active workers’ compensation claim. We step in to enforce your rights and make sure payment disputes do not interfere with your treatment.
From the moment you are injured, every decision you make can impact your case. Choosing the right doctor is one of the most important. We recommend reporting your injury immediately, seeking necessary emergency care, and then carefully considering your physician options under the two-doctor rule or PPP rules.
By understanding your rights under the Illinois Workers’ Compensation Act, you can take control of your medical care while preserving your claim for full benefits. We are here to ensure that the law is applied fairly and that your recovery, both physical and financial, remains the priority.
Yes. You are entitled to choose your own doctor for treatment, and you are allowed two such choices. You do not have to see only the company’s doctor unless you decide to do so.
If your employer has a PPP, you can either choose a doctor within the network or opt out. If you opt out, you will only have one choice of physician under the two-doctor rule instead of two.
No. Any specialists or other doctors you are referred to by one of your chosen physicians do not count as a separate choice. This allows you to access specialized care without using up your choices.
They can only deny payment if they can prove the treatment was not reasonable or necessary for your recovery. We often contest these denials before the Workers’ Compensation Commission.
You can change to a second doctor of your choice at any time, as long as you have not already used both of your choices. Once you have used both, further changes require agreement from your employer or an order from the Commission.
No. Illinois law requires that medical providers bill the employer or insurer directly for work-related treatment. If you receive a bill, you should notify your attorney immediately so it can be addressed.
If you’ve been injured at work and have questions about your right to choose your own doctor, we can help. At The Law Offices of Robert T. Edens, P.C., we have decades of experience helping injured workers across Illinois secure the care and compensation they deserve. We will review your case, explain your rights under Illinois law, and protect you from employer or insurer tactics that could limit your treatment.
Contact our Illinois workers’ comp lawyers at The Law Offices of Robert T. Edens by calling us at 847-395-2200 to receive your free consultation. We represent clients from our offices in:
We serve injured workers throughout the entire state of Illinois. Let us help you secure the medical care and benefits you deserve.
The Law Offices of Robert T. Edens, Personal Injury and Workers' Compensation Law Office, have offices in Antioch, Waukegan, Grayslake, Woodstock and Barrington. We represent clients throughout the communities of Antioch, Waukegan, Grayslake, Barrington, Woodstock, Buffalo Grove, Deer Park, Gurnee, Lake Zurich, Round Lake, McHenry, Cary, Crystal Lake, Libertyville, Lincolnshire, Mundelein, Vernon Hills, Wheeling, North Chicago, Zion, Inverness, Palatine, Wauconda, Island Lake, Fox Lake, Barrington Hills, Spring Grove, Lake Bluff, Lakemoor, Long Grove, Lake Villa, Kildeer, Wadsworth, Indian Creek, Fox River Grove, Lindenhurst and other cities within Lake and McHenry Counties Illinois.
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