Illinois Work Comp – When You Only Miss A Week Of Work

A recent caller had a common situation.  He’d never been hurt at work before. He works Monday to Friday in Chicago.  He got hurt on a Monday and went straight to the hospital with a shoulder injury.  The doctor said it was a sprain and told him to take off the rest of the week.  He went back the following Monday and was released back to work. He missed five total work days, seven calendar days.

The insurance company accepted the case, but said they weren’t going to pay for the lost time.  The company told him he had to use his sick or vacation days.  He didn’t want to.  What should have happened?

Under Illinois law, if you are authorized off work by a doctor for a work related accident, the insurance company does not have to pay the first three calendar days that you miss.  They must start paying you benefits on the 4th day missed.  If you miss 14 or more days, they then have to go back and pay you for the first three days.

The key point is that calendar days count, not scheduled work days.  So in this case, the worker missed a total of seven calendar days of work.  He should then be entitled to four days of TTD benefits because the first three aren’t paid until he missed 14 total days.

The biggest concern is being asked to use sick or vacation days.  That’s against the law and should not happen if you were hurt while working.  The good news is that these can easily be reinstated if your lawyer knows what they are doing.

This injured worker seems to be fine, but if he ended up with a torn rotator cuff or torn labrum and had surgery that kept him off work for three months, he’d have to remember those first three days because you can bet that the insurance company will somehow “forget” about them.  Every penny counts to them, but this is your life, so it should count to you too.

Does this make sense? Any questions about TTD benefits or anything else? Call us any time at (312) 346-5578 or fill out the contact form to the right and we’ll call you. It’s free and confidential.

“My lawyer won’t answer my questions”

Why do you hire a workers’ compensation lawyer if you are hurt on the job in Illinois?

I think everyone has their own reasons, but for most people it’s because either you don’t know the law and want an expert and advocate in your corner or because you are getting jerked around and need some help.

While it costs nothing up front to hire a work comp lawyer, we don’t take these cases out of the goodness of our hearts.  We get 20% of whatever settlement we get you in the end. Up until that point we work for free.  Well, at least most of us do.

Some lawyers for whatever reason don’t want to work. They just want to get paid. It boggles the mind. At least once a week I get a call from someone who says, “My lawyer won’t answer my questions” or “My attorney never returns phone calls.”

Just because we don’t bill you by the hour doesn’t mean we can blow you off.  Why would someone act this way?  And why would you as a client stick with someone like this?  You don’t have to.

We are happy to talk to anyone at any time about their case.  But at some point it comes down to you as a client standing up for yourself.  20% of a settlement can be a lot of money if the lawyer does a good job.  If they won’t answer your questions, they are not doing a good job.  What are you paying them for?

You have a right to put yourself first.  And you should.  This is your case.  Your life.  You should expect customer service.  Answering a question or returning a phone call is essentially the bare minimum. It’s not making them go out of their way.  It’s asking them to do their job.

If you call at noon on Monday and it’s Thursday and you haven’t heard back, that’s a problem.  If you ask if the nurse case manager should be allowed to talk to your doctor and they tell you not to worry about it, that’s a problem.  If you can only speak to their secretary, that’s a problem.  If you want to know if you need to show up for the next court date and they never tell you, it’s a problem.

Some areas of law are really complex.  Work comp requires experience and knowledge of case law, but it’s not rocket science.  The biggest factor in success is usually putting forth an effort. If your lawyer isn’t doing that then you probably won’t get a good result.

UPDATE: Shortly after I wrote this, I got the following “tip of the month” from my insurance company.  It’s so true.

It is easier and more cost effective to keep an existing client than it is to win a new one. Communication is a core competency on which clients can and will judge you. So, accessibility and prompt, clear communication with your current clients is essential. Keep in mind that if you fail to return repeated phone calls or emails, you may be violating your ethical responsibility of communication, and may also be jeopardizing a future revenue opportunity. 

You Don’t Need Health Insurance If You Are Hurt At Work

At least once a week I talk to someone who was injured a while back at work, but never went to a doctor because, “I don’t have health insurance and can’t afford it.”

In Illinois, if you are hurt at work, 100% of your medical treatment is paid for by the insurance company for your employer. There are no co-pays, no out of pocket expenses.

For some of my readers this may be obvious, but for too many people it’s not.  The biggest mistake a lawyer can make is to assume his client knows what they are talking about.  I’d rather err on the side of telling you too much rather than too little.

It also doesn’t matter if you just started working.  As long as your injury arises out of and in the course of your job then you get workers’ compensation benefits.  People don’t usually get hurt on the first day of the job, but it happens.  If it does you can go to the doctor and assuming it’s a work related injury, they will have to cover it.

Bottom line is if it’s a work injury it’s covered. If it’s not then you use your own insurance if you have it.

As always, any questions about this or anything else, call us at (312) 346-5578 or fill out the form to the right.

The Chicago Bulls and Illinois Workers’ Compensation

I like the Bulls.  Not like in the 90’s when I LOVED the Chicago Bulls, but I root for them.  Hopefully one day they will be good again.

There has been talk about Illinois work comp reform and professional athletes.  Specifically the billionaire owners of the Bears are trying to prevent having to pay out wage differential claims to 2-3 players a year.  They are asking for special interest legislation.  This is a joke because it’s really just for them for the most part.  Talk of reform is a joke too because we had major reform in 2011. Overall claims are down 40%, costs per case are down almost 10%, but insurance prices haven’t declined.  That’s where reform is needed.

I got a call from a reporter who wants to do a story on this issue and didn’t realize that it’s just a money grab from the McCaskeys as this affects so few people every year.  In most years the Bears have 0-5 cases filed at the Illinois Workers’ Compensation Commission and most of the ones I reviewed were not wage differentials.

We started looking at other teams by checking the public records at the work comp commission website and looked at the Chicago Bulls.  If you type them in to a search you will see only three people have ever filed a case against them, none are anyone you’ve ever heard of.

So why aren’t Chicago Bulls players filing cases?  We know that they get injured.

It’s likely a few reasons. The biggest though is probably because they are worried about being black balled.  Jerry Reinsdorf is less likely to give you a job once you retire if you bring a case against him or at least that’s how players are taught to think.  It’s no different than some of your jobs where people worry if they bring a case they could get fired.

Problem is that all of it’s illegal, especially when it’s happening to you where it’s easier to prove.  It’s against the law to fire someone for pursuing a workers’ compensation case.  There have been lawsuits over this and in one where it was proven to have had happen the worker won over $2 million.

What’s crazy about the Bulls, Bears or any sports team is how few cases actually get filed, especially by lesser players.  Ka’Deem Carey is a backup running back and has a case filed right now.  You can bet if he gets cut that this has something to do with it.  The reality though is that almost every player is sustaining a serious injury.  Derrick Rose destroyed his knees for the Bulls and hasn’t filed a case.  He’s made millions, but that doesn’t mean he should give up his benefits and the money he is owed.

I’m passionate about this issue because if we let them chip away rights of any workers it will eventually spread to everybody.  So while I’m personally more concerned about the teachers, laborers and nurses I talk to than I am over an athlete who seems entitled, my job is to fight for everyone and by fighting for them we are also fighting for everyone else.

Their Doctor Says You Are At MMI

One common dispute in Illinois workers’ compensation cases is when your treating doctor, who knows you well and truly understands your injury says you need more treatment. The insurance company doesn’t want to spend any more money on your case so they send you to an IME doctor (doctor that they choose for a one time visit) that looks at you for three minutes and says you are fine.

The phrase you will hear at this point is that you are at MMI or maximum medical improvement.  In plain English it means that the doctor says you are good as you are going to get.

Being at MMI should be your goal.  Every client I’ve ever had wants to be healthy and back to work.  Just because it’s your goal doesn’t mean that the IME doctor saying you are at MMI is true.

In fact, we’ve seen countless cases where the treating doctor says a worker needs surgery and the IME doctor says not only is a surgery not needed, the worker is totally fine.  As you can imagine, often these IME docs are hired guns who make a ton of money off performing these exams.  They get more business by telling the insurance company what they want to hear.

There was a case with this exact situation that recently went to trial at the Illinois Workers’ Compensation Commission.  So how does the Judge decide who’s telling the truth?

A lot of it comes down to how prepared your lawyer is and if they ask the right questions and present all the relevant evidence.  In the recent case, the lawyer for the injured worker did a good job for his client.  The IME doctor said the worker was fine even though they were recovering from two surgeries.  The treating surgeon said that further treatment was needed.

The medical records and testimony of the worker showed that she had ongoing symptoms and need for treatment.  That is essentially the opposite of being MMI unless you don’t think the condition can get better.  For that to be true it means the condition is stabilized.  The credible testimony of the worker and doctor showed that she wasn’t at MMI.

Big picture for you is that you shouldn’t be surprised if an IME doctor says a bunch of nonsense.  You just need to be prepared.  Have a lawyer in your corner who knows their stuff, shows you through their customer service that they care about you and can demonstrate a track record of taking cases to trial.  You don’t want to go trial if you don’t have to, but you need that option in case it comes down to that.

Concussions and Illinois Work Injuries

My guess is that if you watch sports, play sports or have a kid who plays sports you have thought about concussions at some point in the last year.  It’s all over the news.  Not just football, but soccer, wrestling, basketball, cheer-leading and many other activities.

We’ve come to understand that a concussion isn’t a head injury, but instead a brain injury.  When I first started practicing Illinois workers’ compensation law 20 years ago, I was taught that a concussion is something relatively minor and many people who say they have one are faking.  Thanks goodness we’ve learned that I was taught wrong.

As you probably know, a concussion is no joke and for many people it can turn their lives upside down.  While it’s not always objectively seen on brain scans as compared to seeing a broken bone on an x-ray or a herniated disc on a MRI, it’s just as problematic if not more so.  These patients can have trouble focusing, constant headaches, blurred vision, difficulty with light, problems reading, memory loss or even permanent disability.

The best advice I can give to someone with a concussion is to immediately get medical help and don’t try to “tough it out.”  You can’t tough out a brain injury and a concussion is a traumatic brain injury.  In extreme cases it can lead to death.

The other advice I’d give to someone with a concussion is to not rush to settle your case.  You can go back to feeling normal and then go for a jog or bump your head and suddenly everything could come back again.

Bottom line is that we know way more about concussions now than we used to.  These injuries have settlement value much higher than was previously thought.  It’s important to get a lawyer in your corner who understands how serious they are.

Bonus thought.  If you are a professional athlete or other worker who is continuously experiencing head trauma, the day you stop being an employee of that team or company (or sooner if you can) you should file a workers’ compensation claim.  We now know of course that concussions can happen due to both single incidents as well as over time from taking repeated blows to your head.  Any pro football player for example could likely lock up lifetime concussion treatment by filing a claim when they retire even if major symptoms don’t appear for a couple of years.

As always, call the number at the top or fill the form to the right if you’d like a free consultation to discuss your case.  We cover all of Illinois.

Are You A Doctor Or Nurse With Cancer? You Might Have A Work Comp Case

One thing I love about my job and really life in general is that you always learn something new.  Anyone who thinks that they know it all is not my type of person.

A few weeks back I learned something new while talking to a couple of doctors.  I love to do this because I can pick their brains on rare injuries that I see in my law practice.  I always learn something new from those conversations.

This time what I learned was surprising because it wasn’t about any clients of mine, but about the job risks of being a doctor.  One of the physicians is a cardiologist.  You’d think that is a pretty risk free job when it comes to injuries, right?  It turns out that there is a really high rate of cancer in his field.  Apparently he is exposed to radiation during approximately 40% of his day.  He told me that during most of the day he’s wearing some form of lead protection, but the risks are really high.

The other doctor I spoke with is a vascular surgeon and he said that the same risks are there in his area of practice.  He told me about a colleague of his who always worked in a way where the radiation exposure was on the left side of his body.  He ended up with three different cancers in three different places, all on the left side of the body.

Other than surprise because I never really considered this, the first thing that popped in to my head was that if you are a doctor, nurse or other medical professional who gets cancer, you may have an Illinois workers’ compensation case, assuming like my two friends that you are commonly exposed to radiation.

A case like this would be similar to any other repetitive trauma claim where we’d have to prove through testimony of a doctor (likely your oncologist) that the radiation exposure played a role in the problem developing. It’s not as simple as showing a back injury happened after years of heavy lifting, but a case like the doctor with three left sided cancers has enough circumstantial evidence to likely be a winner.

If you do have a case, like any other injured worker in Illinois you’d get all of your medical bills paid, your time off work paid and a settlement.

If you’d like to know if you may have a case we’d be happy to talk to you.  Call us for free at (312) 346-5578 or fill out the form to the right and we’ll call you.

Occupational Therapy And Illinois Workers Compensation

Sometimes the more important question a doctor should be asking is “What matters to you” opposed to “What is the matter with you”. That is where occupational therapy comes in to a comprehensive treatment plan after you have been injured on the job in Illinois.  While most doctors will focus on healing the injury itself, an occupational therapist will work on healing your skills to return you to the daily activities that matter most to you.

Occupational therapy is specifically designed to hone in on the skills you will need to achieve full success and independence in your daily activities. For instance, if a person was injured on the job, had surgery and then was cleared for “light duty” work, what exactly could they do? With occupational therapy the rehabilitation goes way beyond healing the surgical site and the underlying issue. It also would help with transitional work clearance and modified movements of the injured body part to make sure no further injury occurs. The therapy itself centers around allowing the patient to heal while gradually progressing with skill and strength until they are able to return to work with no restrictions. Light duty work in the meantime may include shorter hours or adjusted positions while working, that all depends on the injury.

In some instances, occupational therapy is labeled “Work Rehabilitation” the treatment could be anywhere from 3-5 days per week for 2-4 hour sessions at a time, depending on the needs of the client. Most workers compensation claims will allow for occupational therapy, as it is a science based therapy that has been tested as productive, time and time again. The sole purpose of occupational therapy is to allow the patient to return to his or her daily activities after an injury.  This includes being able to do your daily work tasks.  Instead of just being thrown back in to your job, the therapy helps you work your way back in to condition.  It’s not much different than a runner training for a marathon.  You can’t just run one on day one.  You get to where you want to be over time.

We don’t give medical advice, so if you think occupational therapy might be good for you, talk to your doctor about. If you have been injured on the job and want to ask us questions or get help with your case, contact us today. We will do whatever we can to make sure that your case is successful.

Beware The Quickie Settlement Offer

We are Chicago workers’ compensation lawyers who have a state wide network of tough, experienced lawyers who fight for their clients.  If you want our help please call us for a free consult at (312) 346-5578 or fill out the contact form to the right.

I like to spot trends in Illinois workers’ compensation law and I’ve definitely noticed one lately.  Insurance companies are calling up injured workers shortly after they get hurt and offering them money to settle quickly.  This is copied from Illinois car accident law.

So why would an insurance company do this and why should you not take the bait?

They do it because to them a closed file is a good file.  And if a case might cost them $10,000.00 overall, to resolve it quickly for $2,000.00 is a win.  Sometimes a case you think is going to cost you 10k ends up costing you 250k.  The back strain could turn in to a back surgery.  If they can get you to settle right away it’s a win for them.  They take advantage of people who don’t realize that their problem is more serious than it seems.

The problem of course is that they are offering you way less than what your case is worth and if you settle then there is nobody who will pay for your medical treatment.  Even if you have group insurance, if they realize that your physical problems are from a work injury, they won’t pay for that treatment.

So what ends up happening is you get a few bucks in your pocket, but suddenly can’t work and can’t get better.  If it sounds like they insurance company is being nasty and ruthless with no regard for your well being it’s because that’s exact what is happening.

All I can tell you is don’t do it.  An offer today is not likely to ever go away and in fact it’s just likely to increase.  And of course nothing is more important than your health so even thinking about settling before you are healthy and back to work without problems is a terrible idea.

To the insurance company this is all just business and the way they treat you or other injured workers is based on business strategy.  You have to look out for you.

“Your case is under review”

If you have questions or need help with a case, fill out our contact form to the right or call us at (312) 346-5578.  We help with workers’ compensation cases everywhere in Illinois.

Insurance companies make money by not paying out money.  Even when it’s painfully obvious that they are liable to do so.

Why do they do this?   Because if they can frustrate you by delaying payments, maybe you’ll go away.  That sounds ridiculous to even write, but it’s true.  If they can make three out of 10 people give up who otherwise would have had good claims, they save a ton of money.  If they can do that to 3,000 out of 10,000 you begin to realize how insurance companies make billions a year.

I thought of this recently when a really nice Chicago guy called me after herniating two discs in his back on the job.  He had no history of any back treatment.  He lifts boxes all day at work and was doing so without problems for more than half of his shift.  At one point he and a co-worker were lifting a heavy box together and the co-worker dropped it causing my caller to absorb all of the weight.  He immediately screamed after hearing a pop in his back.

All of this is caught on video and the post accident drug screen showed he was clean. In other words there is no possible defense to this case.  It’s the cleanest one I’ve seen in forever.

So what has the insurance company been saying to him for the last two months while he’s awaiting medical treatment????  “Your case is under review.”

That is insurance speak for “You don’t have a lawyer, so we’re going to see how we can jerk you around.”  It’s ruthless and cold, but the reality is this is how they operate.  The caller was able to get a MRI and some physical therapy, but treatment for epidural steroid injections, which would provide huge relief, have been denied so far while the case is “under review.”

This is just another term for “being investigated” or “we are waiting for more information” or any other lie.  It’s just a delay tactic with hopes that you’ll either treat yourself or go through your group insurance.

Don’t fall for these tricks.  The law in Illinois is that these “investigations” need to be resolved within two weeks.

We are happy to help if you just have questions or want to stop the nonsense.

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