I Can’t Believe This Chicago Workers’ Compensation Lawyer Did This

Since I will talk to anyone for free, I get a lot of calls and I hear a lot of stories about bad lawyers doing dumb, rude, shady and usually just lazy things.  There isn’t much I haven’t heard in 20 years of doing this because most of the complaints we hear about are from about four firms in Chicago and two downstate. So we hear the same things over and over because these firms do the same things over and over to their suffering clients.

Every now and then I hear something new about a different firm, but the one I heard a couple weeks ago blew my mind.

A guy called me who had been seriously hurt at work and had major surgeries.  He wanted to know what his case was worth which is not an unusual question.  He said he already had an attorney so I told him that the lawyer, who knows the case facts and has his medical records, would be in a much better position to answer that question. His response was the crazy part.

He told me that his lawyer told him that as the client it was his job to say what he wanted.  This wasn’t after the lawyer gave him a range of what the case was worth, he just told the client to tell him how much he wanted to get.

That is nuts and what’s even crazier is that the attorney works for a reputable law firm.

You hire a lawyer for their expertise and part of that comes from them knowing how to value cases through (hopefully) having handled thousands of cases before you. What if the case is worth $250,000 and the client guesses it’s worth 100k?  Well they’d lose a ton of money.  What if the client wants $10 million when it’s worth 50 grand at most.  Then the lawyer has created a problem that will lead to distrust.

Your attorney should be the head coach of the case.  You are the owner, but an owner hires a coach to run things.  You need them to offer advice along the way even when it’s unsolicited, protect you, be there to answer questions, defend you, deal with the insurance adjuster, deal with the other lawyer, resolve unpaid bills or late TTD checks, prep you for testimony or an IME and when it comes time to settle, explain to you the range of what your case might be worth and how to get the highest end of the range.

In this case, the client didn’t ask about settlement and had only recently been discharged.  He doesn’t have a final evaluation report from his doctor which addresses his future medical needs and how the injury will impact him. He also hasn’t returned to work.  All of those things affect what the value of the case could be.  Why a Chicago work comp attorney would do this is beyond me.  I can only hope that they aren’t doing it to other clients.  If they are, I’m sure we’ll eventually hear about it.

If you have questions about what your case is worth or need anything related to Illinois worker comp law, contact us any time for a free, confidential consultation.

Is Your IME Doctor Known For Being A Liar?

The other day we did a post on United Airlines employees and have done other posts on how when you work for a big company that has a lot of workers and injuries, it’s important to get an attorney who has handled many cases against them before.  It doesn’t guarantee a result, but increases your chances of success if they know the players and some of the tactics the insurance company will take.

This philosophy also is true when it comes to the dreaded IME (independent medical exam) doctors.  You already know that many of these doctors aren’t independent at all and can best be described as hired guns.  But did you know that there are big companies that routinely use the same doctor over and over.

UPS (United Parcel Service) for example seems to rotate between a few different IME doctors which is likely based on their availability or UPS knowing that if they only used one doctor that it would look bad.

We’ve seen them use one doctor on lots of cases though who has been found in some Illinois Workers’ Compensation Commission trials to not be credible.  Knowing this and knowing why can give you a leg up and prevent this doctor from destroying your case.

There are plenty of similar examples from a hand doctor who doesn’t think your job can cause carpal tunnel to back doctors who think that almost any surgery is not needed and that most patients are really fine no matter how much pain they say they are in or what their MRI films show.

These doctors really can hurt you, but if you hire a lawyer who knows their bad reputation and knows how to push back against these IME’s, you will greatly increase your chances of winning.

Has Your Attorney Handled United Airlines Cases Before

We got a call recently from a flight attendant for United Airlines who had a really screwed up case.  This person wasn’t based out of Chicago, but was able to make an Illinois workers’ compensation claim because the collective bargaining agreement allows pilots and flight attendants to bring their cases in Illinois if they were originally hired in by United.

The problem was that this worker at first hired a lawyer in their home state which was not the best choice for the worker because the benefits in Illinois are higher.  That attorney didn’t know about this rule until the insurance adjuster told him.  He then referred the case to a friend who has handled some Illinois work injury cases, but doesn’t do it on a day in and day out basis.

So while some Illinois benefits were approved, my read on the situation is that there were two big problems:

  1. The new lawyer didn’t have much experience in dealing with Gallagher Bassett, the insurance company that handles all of the United cases.  Knowing them and dealing with them on a regular basis helps out all of your clients.
  2. They didn’t understand much of what was bargained by the union nor the rigorous return to work process through the United fitness for duty program.  As this case involved a very serious injury this lack of knowledge really hurt the worker.

In general, with a big company like United who often fights these cases, it’s important to have a lawyer in your corner who isn’t in their first rodeo.  It’s no different than having an experienced pilot.  We created a state wide network of experienced attorneys and many of them have handled hundreds of these airline cases. That can help you.

In general when dealing with a big company like this, it’s important that your lawyer know how they operate.  Some things we consider:

• Whether an employer has a light duty return to work program, what forms the worker will be asked to review, whether they should be signed, and what sort of work one can expect to be given if they return to restricted duty,
• Whether a particular employer typically accommodates employers with permanent restrictions
• Whether there is a collective bargaining agreement in place and, if so, what ramifications it may have on work status and job assignments,
• Whether disputed medical bills will be paid by a health insurance company that typically does not assert a reimbursement interest
• Who the recovery agent is for a group carrier that does seek a reimbursement interest
• Whether there is a Health and Welfare Fund that is paying medical bills and whether there is ever any negotiating a reduction in the lien

Not having to figure out these things as we go helps you.  It’s not that an inexperienced attorney couldn’t get the job done. It’s that an experienced one greatly increases your chances of success.

If you’d like to talk about your case for free, fill out our contact form or call us at (312) 346-5578.  You will usually speak with a lawyer right away.

Another Victory For An Illinois Worker With A Pre-Existing Condition

One of the best things about Illinois workers’ compensation law is that you don’t lose your case just because you have a pre-existing condition.  This is especially true when you’ve been without medical care from some time.  So if you hurt your back six years ago and haven’t seen a back doctor for five years, if today you injure your back at work, an insurance company would get nowhere if they tried to deny your benefits due to a prior problem.

On the other hand, if you hurt your back at home a month ago and have been under a doctor’s care since then, if something happened to you at work today you’d have to be able to prove that the job accident made things much worse.  That’s not impossible, but it can be difficult.

Despite many cases that have gone in favor of the injured worker, insurance companies still continue to deny Illinois work injuries because of preexisting conditions and they do it by finding hack doctors who will say that your problems aren’t related to the job, but something that happened a long time ago (wink, wink).

That happened in a recent case that fortunately worked out for the injured worker as most of these do.  He was a laborer who did a lot of heavy lifting and noticed blood in his urine after that. He had similar problems three years prior, but had been fine since then.  His doctor felt that his need for treatment was do to straining at work while dragging and carrying very heavy objects.  The worker also testified that as to what happened and that he had been fine before all of this.

Of course the insurance company found someone who was willing to view the medical records of this worker and said that his problems could have been from any number of daily activities that could place pressure on the prostate.

This consulting doctor was not believed, in part because he made his opinion without a clear understanding of the job duties of the injured worker. Just as we always tell our clients to be specific and detailed with their doctors, it can hurt the insurance company when they only provide vague information.

Bottom line for you is that if you have a preexisting problem you can bet that the insurance company will deny your case, but since they aren’t the final decision makers you should not give up and let them discourage you. That is their goal and the only guaranteed way to lose is by taking legal advice from them.  Just because they say you have no case does not make it true.

IL Work Comp – Don’t Be Like Bo Jackson

Bo Jackson is probably the best athlete I’ve ever seen.  Think about it, he won the Heisman Trophy, was a stud in the NFL until he got hurt (I hope he got a work comp claim) and was an All-Star in baseball.   He was powerful yet graceful at the same time and did some of the most amazing athletic moves.  The most famous is probably when he climbed the outfield wall and looked like a cat in doing it.

There’s a gym teacher in Illinois who recently lost his Illinois workers’ compensation trial because he tried to be like Bo Jackson.  The teacher sounds like an awesome guy, the kind you’d want for your kids and it’s kind of a shame he lost his case.

The long and short of what I’ve read about this case is that he was waiting outside the locker room when one of his students ran up the wall and jumped.  The teacher said he could do the same “Bo Jackson style” maneuver and on his second attempt he felt a pop in his ankle and tore his Achilles.  It’s exactly what would happen to me if I tried this move except I don’t think I would have made it past the first attempt.

This teacher was trying to connect with the students and in his own words, “be a physical fitness role model for them.”  Even though the principal said that this didn’t violate any school policies and synced with their goal of having him build rapport with the students, the Arbitrator denied benefits because it was an act of horse play.  The key reason he lost is that the act was initiated by the students, not him although to me that sounds like nonsense.

Two key points from this case:

  1. If you engage in horse play and get hurt, you’ll not get work comp benefits.  This usually happens when two workers are play fighting or joy riding or something like that.  This case seems like an extreme and bad ruling though because it doesn’t seem to me that the teacher was goofing off or way off from his normal job duties.
  2. He lost this case because of the insurance company.  Remember, they are the ones you are going to have a fight with and need to look out for.  His boss was on his side, but even then the insurance company did everything they could to screw him over and unfortunately in this instance they won.  You can be a good guy and a role model, but the insurance adjuster is only looking it from a dollars and cents standpoint.

So while this is a unique case, it does serve as a warning that insurance companies will deny you whenever they can and you need to be prepared to deal with it.  I did look the case up and while I’ve never heard of the lawyer for the injured worker, the defense firm is a major player out of Chicago so perhaps it was a matter of this guy getting out lawyered.

If you want to talk about anything related to Illinois workers’ compensation law, call us any time. It’s always free and confidential.

Rhomboid Injuries and Illinois Workers’ Compensation Law

Major rhomboid injuries can cause severe back pain and are nothing to joke around with. The rhomboid is a muscle on that connects your shoulder blade to your spine. Located in that sweet spot, near the upper middle of your back where you can’t really reach to rub the pain away, an injury could lay you up for a very long time.

There are many causes of pain, injury or loss of movement to this muscle. Some could happen simply by bending or making a swinging motion, however more commonly this muscle is injured while at work because of repetitive shoulder action. This is not an easy muscle to heal because of its location, typically the best way to get better from a major injury to this muscle is to rest and try to reduce the swelling. Once the pain starts to fade, a person could try to regain range of motion and flexibility by going to physical therapy.  Stretching and muscle building movements will help the body repair it’s self from such an injury.

If you are experiencing upper back pain from a work related injury, you may have an injured rhomboid muscle. In most cases, doctors’ appointments, medication, physical therapy and rehabilitation should be all covered by filing a workers compensation claim.  It’s important that you have a doctor who knows how to treat these injuries as they are often misdiagnosed as just shoulder pain. And of course as it’s a unique injury in some ways it’s important to have an attorney who knows how to handle these cases because they are very often fought by the insurance company.

We see a lot of these injuries with clients who bend frequently on the job or do actions which cause them to twist or shift their bodies in awkward or violent ways.  If your doctor has you off work it is important that those restrictions be followed by your employer and the insurance company because one big way rhomboid injuries go from a short term to long term problem is by having to continually lift heavy objects after the injury has taken place.  These injuries can heal in 2-3 weeks or last many months depending on the treatment you get and if restrictions are followed.

If you have a rhomboid injury or any other Illinois workers’ compensation issue that you’d like to discuss, please fill out our contact form or call us at (312) 346-5578. We cover all of Illinois and it’s always free to call.

IL Work Comp – Kids Can Play Doctor, You Can Not

When I was a little kid, I had a toy doctor’s kit with a stethoscope, little mallet for doing a reflex test and some fake medicine.  I got to pretend to be a doctor and probably enjoyed doing that for at least a couple days (side note, does any kid pretend to be a lawyer? I sure hope not).

Kids can pretend to be doctors and come up with a fake diagnosis. When it comes to Illinois workers’ compensation, even though you know your body better than anyone, you can’t make your own diagnosis or take yourself off of work.

In recent weeks I’ve gotten a handful of phone calls from people who were upset that they haven’t received work comp benefits even though they missed work. When I asked if their doctor took them off work they said they hadn’t been to a doctor yet, but felt they should be paid because they got hurt at work and felt too much pain to work.

While I’m sympathetic, this is not how the Illinois workers’ compensation system works.  You can’t make a diagnosis of what’s wrong with you and you can’t take yourself off of work. The reason is because you are of course biased in favor of you.  It would be the same thing as if your boss or the insurance adjuster was allowed to say you are fine even if a bone was sticking out of your leg.

Doctors are supposed to be independent and of course because they are doctors they are credible when it comes to making a medical opinion.

The biggest reason people don’t go to a doctor is because they don’t have insurance.  If you were hurt while working, you don’t need health insurance.  Workers’ compensation will pay for 100% of any medical care that is related to a job accident and is reasonable.  By not going to the doctor you are actually screwing up your chances of having a case.  The longer you wait to get medical treatment the harder it is to prove that your problems are related to work.

So while you can’t take your self off work, a doctor can.  Go see one, tell them how you got hurt, be descriptive about what your job duties are, tell them what pain you are having and ask them if you need restrictions at work or should take some time off.  If they say yes, make sure to get it in writing.

And as always, if you want to talk to an Illinois work comp lawyer for free, call us any time. We cover all of Illinois.

Which Illinois Work Comp Attorney Has The Best Won/Loss Record?

There is a Chicago workers’ compensation law firm that promotes themselves by saying that they recover compensation for their clients in 98% of cases.  That sounds impressive and like they are real winners.  The reality though is that if you settle a case for $500 because otherwise you’d lose at trial, this still counts as “recovering compensation” for a client even though it’s essentially nothing.

A lot of people who call me know that they have a tough case and want an attorney with a great won/loss record at trial.  Just like in baseball though where you can be the winning pitcher and give up 10 runs or the losing pitcher and only give up one run, won/loss records are misleading and in the law, they don’t actually exist.

In sports there is a clear winner and loser at the end of every game.  In your legal case that might be true, but there’s no way for anyone else to know that.  Let me explain.

Let’s say you get hurt at work and need a lumbar fusion.  You’ve missed 30 weeks of work by the time the trial happens and your medical bills aren’t paid. The case was denied because of an IME report, but we file for penalties and fees because we think that report is bogus.  We go to trial and the Arbitrator says you were hurt at work, you need surgery, the insurance company has to pay for it and they need to pay you for all of your lost time.  The Arbitrator denies the penalties motion because of the IME.  So we won most of the issues, but not all of them.  Is that a win?  To me it is, but to some clients it wouldn’t be.

Now let’s say it’s a case that can be settled.  We think the best case scenario is $200,000 and the worst is $80,000.  After a bunch of negotiations they make a best and final offer of $190,000.00. That’s 95% of what your best result could be.  Is that a win?  To some it wouldn’t be and to most it would.  But there’s no way to realistically measure that if you aren’t involved in the case. In another case we were involved in a while ago, the best case scenario was 175k and we think we could have gotten there, but the client took a 125k offer because it was a sure thing and would allow him to move out of state and start a new life.  That was a win for him, so that’s all that really matters.

Bottom line is that there is no lawyer that has the best win/loss record.  It doesn’t exist and anyone who tries to market you on that is likely just trying to sell you with something that sounds great.  What you want is a lawyer that will fight for you to get the best result possible.  It may not sound as great as someone who is trying to give you a gimmick as to why they are so great, but it’s in your best interests.

If you’d like our help with a case or just have questions, call us at any time.  It’s free and confidential.

IL Work Comp – How A Wage Differential Really Works

A wage differential is a substitute for the traditional settlement that happens in most Illinois workers’ compensation cases.  If you end up with permanent medical restrictions that your employer can’t accommodate, you then need to look for a job within your restrictions.  If you can only find a job that causes you a significant wage loss, you might be entitled to a wage differential payment.  In that case you can received 2/3 of the difference of what you would be making NOW (not accident date, but now) in your old job versus what you can make in a new job.

So let’s say you were a union carpenter and now thanks to a back fusion have lifting restrictions of no more than 25 pounds.  That’s a restriction you can’t do in that job.  You would currently be making $90,000.00 a year if you were healthy, but now you can only find a job making $60,000.00 a year.  That’s a $30,000 difference so you could be entitled to 2/3 of the difference of that (20k). For injuries after September 1, 2011 when a new law was put in to place, you are entitled to that payment until you are 67 or five years, whichever is greater.

So if you are 52 years old, you’d be owed 15 years of benefits or $300,000.00. The insurance company isn’t going to give you that in a lump sum because that’s right now their worst case scenario over 15 years.  Any settlement conversation would start with what 300k is worth in today’s money. That’s called present cash value.  We actually have a calculator that helps figure this stuff out.

The insurance company wants to pay as little as possible and will often start around 50-60% of what the present cash value is of your injury.  So 150k today invested properly over 15 years might turn in to 300k.  They’d probably offer you around $90,000.00 as a starting point.  Our argument would be that them paying off 7-10 years of benefits is still a total savings for them.

There’s another strategy though that to me makes more sense in a lot of cases and it has two parts.  1. If you are an older worker, I’d argue that you aren’t a wage differential candidate, but instead that there is no stable job market for you, especially if you have limited education and have done the same work for 30 years or so.  In that case you might be what’s called an “odd lot permanent total” which doesn’t have a time limit as to how long you can get those benefits so it increases the total value of your case. 2. We’d get your case ready for trial.  Even if you only get a wage differential benefit, that yearly payout is better than a low ball settlement.  And once you win the trial and get paid for a couple of years, eventually some accountant is going to audit your file and realize they’d be better off giving you a lump sum.

So what can happen is that you can get the wage differential payment for 2-3 years, pocket that money and then still negotiate a lump sum for a fair amount when that accountant just wants your case off their books.  And if you’ve proven that you are an “odd lot permanent total” then your case that might have been worth 200k can suddenly be worth 500k.

It’s worth taking a shot at the trial because it can only increase your leverage.  I think that it’s the lazy lawyers who won’t even consider this and because of them, some insurance companies are laughing their way to the bank with all of their savings.  In a case like this, you and your lawyer need to do whatever you can to maximize your result.  So while they wouldn’t give you $300,000 cash right away when they think their worst case scenario is a wage differential, they might if they know their worst case scenario is actually $500-600k.

If you take anything away from this, know that this is a long process if done right and any lawyer who tells you your case is worth close to what the max amount is without going through a fight is lying to you so you’ll sign up with them.

This is a long and perhaps confusing post, but hopefully it’s clear that these aren’t straight forward situations and having a real strategy and being willing to go to trial can put a huge amount more money in your pocket when all is said and done.  If you want to discuss a wage differential or anything else related to Illinois work comp, contact us at any time.  It’s always free and we help with cases everywhere in IL thanks to our state wide network of experienced attorneys.

When The Insurance Company On Your Case Switches

This post has a lot to with injured workers at really big companies. I’m talking places like United Airlines, Yellow Freight, The City of Chicago, ComEd, etc.  But it offers great strategy for those at smaller companies too.

Big companies are often self insured.  That means they don’t pay insurance premiums for workers’ compensation in Illinois, but instead are approved by the Illinois Workers’ Compensation Commission to pay all of their claims directly. To do this they have to be financially secure.  Some companies go from self insured to out of business (in recent years it’s mostly been coal and steel companies), but even then there is a fund to pay their claims.  Here is the most recent list of all self insured companies in Illinois http://www.iwcc.il.gov/SelfInsuredFirms.pdf.  It’s an interesting list because there are a ton of companies on there that I’ve never heard of which is amazing because they are all hugely successful.

For some of these companies, they will hire workers’ compensation adjusters to handle the claims internally (Ford Motor does this for example).  Most of them, however, use what is called a third party administrator or TPA.  So if you were hurt while working for United Airlines, you’ll end up dealing with an insurance adjuster for Gallagher Bassett.  The City of Chicago uses Sedgwick.

If you work at a non self insured company, the name of their insurance on your accident date is important and can go in to your strategy.  For example, if we know that ESIS is handling your accident, but now your employer is insured by Travelers, it’s possible that ESIS just wants to close out all of their claims with your company and might not worry about how that will affect the company long term.  You can use that to your advantage or at least a smart lawyer can.

For bigger companies that use a TPA, they might switch insurance companies, but it doesn’t impact your case the way it does when they aren’t a TPA.  In fact you have to be prepared that the new TPA might be looking to make a big splash right away by showing how they think the old TPA was doing everything wrong.  This could mean your file gets “reviewed” and all of the sudden your benefits are denied or you now deal with a not friendly adjuster or they send you to an IME with a hired gun.

It happens the same way whenever a defense lawyer gets fired and a new firm comes on. The new firm wants to make a big impression because the better they do, the more business they will get.  Who gets hurt by this new found aggressiveness?  You do.

These aren’t the worst problems to have, it’s just something you need to be prepared for and ready to counter.  Many of the lawyers in our network take the strategy that when there is a new TPA on the case, the best thing we can do is make an early phone call and get off to a good start as well as make sure that your benefits aren’t interfered with.

Big picture, don’t freak out if there is a new TPA or new insurance company on a case.  Just know that it’s a piece of the puzzle when it comes to getting you the best result possible.

 

 

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