Employee Was Referred to Treating Physician by Another Physician, and Not by Choice

On Behalf of | Sep 8, 2021 | Firm News |

It can certainly be difficult sometimes for employees involved in accidents at work, to obtain necessary treatment for their resulting injuries, as there are limitations imposed under the Illinois Workers’ Compensation Act (“WCA”) on the number of physicians that an injured worker can choose from, to be treated by and/or receive treatment from. See Claimant’s line of doctors fall within her two-choice limitation. Illinois Workers’ Compensation Law Bulletin, Volume 29, Issue 7, June 11, 2021, pages 6-7.[1]  Under Section 8(a) of the WCA, a claimant is allowed a maximum of two choices for treating physicians, unless the claimant is also referred by one physician to another.[2]  The case discussed in the article, Bockhorn v. Three Springs Lodge, 29 ILWCLB 75 (Ill. W.C. Comm. 2021), involved an employee that suffered back-to-back accidents while at work, with the second accident occurring merely a week after the first one.[3]  The worker suffered an injury to her left elbow and was referred by her initial treating physician to an orthopedist that concentrated on treating injuries to elbows. The orthopedist treated the employee and placed her at maximum medical improvement, but since the claimant-employee still felt left-elbow pain, she sought out a second opinion from another physician (who in turn constituted the employee’s second choice of physician allowed to her under the WCA).[4]  This additional doctor treated the claimant’s elbow as well, but since the claimant also began to feel pain in her right shoulder, the latest physician referred the claimant-employee to a physician specializing in shoulder issues.  In reviewing the testimony of the physicians that treated the claimant-employee’s elbow, especially the last one that treated it, the Commission found that, since the final elbow-treating doctor referred the claimant to the shoulder specialist, and as the aforesaid physician that treated the claimant’s shoulder confirmed that she had in fact been referred to him as well, this was seen as evidence that the claimant being treated by the shoulder specialist was not a choice on her part, but instead was a recommendation/referral by the claimant’s last physician that treated her elbow.[5]  Thus, according to the Commission, this chain of referral(s) fell within the exception to the two-physician choice limit allowed under Section 8(a) of the WCA (as it involved referrals, and not choices by the claimant).[6]  This decision must have been a relief to the claimant-employee, since she appeared to require extensive and lengthy treatment, both for her elbow and her shoulder, and especially since her having to navigate the WCA’s sometimes frustrating and stymieing rules regarding choice(s) of treating physician(s), to obtain her aforesaid treatment, must have been stressful for her.

[1]See Claimant’s line of doctors fall within her two-choice limitation. Illinois Workers’ Compensation Law Bulletin, Volume 29, Issue 7, June 11, 2021, pages 6-7.

[2]See Id at 6.

[3]See Id at 6.

[4]See Id at 6.

[5]See Id at 6.

[6]See Id at 6-7.

Attorney Matthew Ludwinski