Editor’s Note: This column was written by the following doctors: Avi Bernstein, Asokumar Buvanendran, David Fletcher, David Kanzler, Richard Kube, Steven Mardjetko, Brian Murphy, Michael Vender, Mike Zindrick
There’s a crisis looming in our state’s workers’ compensation system. If allowed to fester, it will keep workers from receiving timely medical treatment for workplace injuries.
It will delay workers’ recoveries and their return to their jobs. And it will end up costing more for the very businesses and insurers seeking efficiencies in the system. This crisis is not one you’ve heard about from the business and insurance communities. It’s a crisis created by their failure to implement laws that have been on the books in Illinois for more than a decade.
As doctors who care for workers compensation patients, here are our concerns: Illinois law spells out the right for medical professionals to receive prompt payment for the care we give to patients with workplace injuries. Just like any other business or profession, we need to be paid for that care we give, so that we can compensate our employees and keep open the doors of our medical practices.
Yet, many Illinois workers’ compensation insurers completely ignore the prompt payment law. To date, there has been no remedy for doctors and other caregivers who remain unpaid for months and months at a time.
Furthermore, state law mandates that insurers accept electronic billing and documentation for workers’ compensation claims. This expedites the process. Yet, many insist on an obsolete paper-based medical billing system, which delays medical care to injured workers and wastes resources.
Add to this bleak reality a recent, alarming increase in delayed payments for already-approved workers’ compensation medical care claims. The result is more and more physicians unable or unwilling to treat injured workers.
Since 2005, the Workers’ Compensation Act has allowed medical professionals a late interest penalty for approved workers’ compensation medical care. Yet there is no way for doctors and others to enforce or collect this interest.
Even if the workers’ compensation insurer approves care for an injured worker, it can and often delays payment for the medical treatment rendered. These delays can last for years.
A recent court ruling found that medical professionals can’t even go to court to collect this interest. Since the court decision, these payment delays have worsened to the point of doctors dropping out of the system.
What’s lost in the current debate on workers’ compensation policy is that medical professionals — the physicians, surgeons, hospitals, and specialists — actually provide the care that supports our entire system.
Medical professionals are the ones who get injured employees back to work, reduce employer costs for time off and long-term injuries, and work with employers to prevent work-related accidents from even happening in the first place. We are often blamed for the system’s ills, even though we are in a unique position to make that system function.
When workers are hurt on the job, they need timely access to dedicated physicians, surgeons and specialists to treat their injuries. We in the medical community stand ready with solutions to the problems that are threatening the health of our workers’ compensation system.
It’s time to pass legislation that forces workers’ compensation insurers to start following the law. The alternative is having doctors and care centers rush to the exits.
This article was first published by Dispatch-Argus.
