Keep your eyes open for more Utilization Review of medical treatment for injured workers in Illinois.

Utilization Review is another medical provider looking over your doctor or chiropractor’s shoulder and telling them whether your treatment is reasonable and necessary. This is supposedly based on national standards.

The change to the Illinois Work Comp law gives the employers more rights in relying on the Utilization Review.

If the employer uses Utilization Review it requires the injured worker’s medical provider to provide timely and complete reports to support their requests for the treatment. If they do not, then you cannot require Work Comp to pay.

In light of the Utilization Review, medical bills can be denied on the grounds that the extent and scope of medical treatment is excessive and unnecessary.

When Utilization Review denies treatment the burden of proof shifts to the injured worker to prove by a preponderance of the evidence that the treatment is reasonable.

The Illinois Workers’ Compensation Commission is required to weigh all the evidence, including the Utilization Review opinion.

What all this means for the injured worker is:

Most likely the Employer will order more Utilization Review;

More weight will be given to the Utilization Review; and

More treatment will be denied to injured workers.

If you get notice of a utilization review, then you need to contact a lawyer immediately.

Questions about your Work Comp case? Feel free to call Illinois Work Comp Attorney Dirk May at 309-827-4371.