Utilization Review: An Important Part of Any Workers' Compensation Defense Toolkit

In July of 2005, the Illinois Legislature amended the state's Workers' Compensation Act in several important ways. Among these changes was the inclusion of an additional right for employers: The Utilization Review.

Essentially, a work comp utilization review allows employers to question the reasonableness or necessity of medical treatments administered to an injured employee and to challenge the reasonableness or validity of medical bills as well. Such reviews can be done "prospectively" (before treatment is provided) or "retrospectively" (after). In either case, reviews are done through a peer review of the medical records by a physician of "equal standing" to the workers' physician.

The primary benefit of a proper utilization review is that, if you have done one, you cannot be penalized for denying benefits.

Experienced Legal Representation

Despite their obvious advantages and potential for medical cost savings, utilization reviews are still a very "under-used" tool by most employers and, for that matter, lawyers practicing in the field of workers' compensation defense.

Not at Knell Law L.L.C..

Here, you'll find attorneys who know how to use the utilization review process to your advantage and how to do that in compliance with the requirements of the statute. This being said, our practice is almost exclusively dedicated to workers' compensation defense, and utilization review is just one of the many tools we use in providing quality defense representation for comp carriers, third-party administrators and employers who are faced with these issues throughout the state.

Make arrangements for a free initial consultation by contacting us online or by calling our Peoria offices locally at 309-740-9115 or toll free at 866-958-5843.

For general information, please see:

Workers' Compensation Defense
Defense of Third-Party Administrators & Self-Insureds
Independent Medical Evaluations / Suspending or Terminating Benefits