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A Publication of WTVP

Among the many employers we’ve worked with throughout the Peoria area, the one consistency we’ve experienced is inconsistency in the interpretation of the Illinois Workers’ Compensation Act, particularly in regard to where an employee can be evaluated and treated for a work-related injury. How important is it for an employer to be involved in this decision? If your workforce is primarily clerical or white-collar, it may not be as important as it is for manufacturers, construction companies and the service industry. For these employers, workers’ compensation costs are a significant percentage of their operating budget.

Medical charges among providers in the Peoria area, apart from emergency room treatment, are fairly consistent in terms of treatment of most work-related injuries. Where costs vary significantly is, as usual, in the indemnity incurred by the length of time an employee is off work due to injuries sustained on the job. This length of time is determined by the medical provider and varies dramatically from one provider to the next. The last thing an employer needs is a medical provider asking injured workers the ambiguous question: “Do you feel you can go back to work?” The decision is then left to the employee and not based on sound medical information.

A study of more than 4,200 closed claims filed with Atlantic Mutual Insurance Company revealed that when compared to any number of medical practices, occupational medicine clinics, on average, reduced indemnity costs on lost-time injury claims by 49 percent, reduced direct medical costs by 29 percent and had an overall claim costs decrease of 52 percent. The question, then, is how do you get your injured employees to utilize an occupational medical clinic and stay in compliance with the Workers’ Compensation Act?

Under the act, employees may choose any doctor or hospital at the employer’s expense. The employer may request the employee be seen by the employer’s preferred provider and be offered treatment. However, the employee is limited to two chains of referral and may decline to treat with the employer’s suggested provider. This doesn’t exclude the employer from requesting intermittent visits to the employer’s provider of choice. It simply means the injured employee isn’t required to be treated by the employer’s preferred provider. In IWIRC’s experience, injured employees utilize a provider chosen by the employer about 85 to 90 percent of the time.

Employers who don’t encourage injured employees to use occupational medicine clinics are missing a significant opportunity to reduce their overall workers’ compensation costs. Organizations using public funds have an obligation to the public to manage funds which include workers’ compensation costs. Failure to manage these costs limits a company’s ability to deliver services and invest in infrastructure. This limitation exists in both for-profit and not-for-profit institutions and affects injured workers who deserve the best care from the proper specialists. IBI

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