"My lawyer didn't want to upset the other side"

Sometimes I get phone calls that really just make me shake my head.
Now I don’t talk to these lawyers with the alleged bad behavior so sometimes some of the things they are doing can be explained away.  But a recent caller to my office told me that his case had gone to trial and the Arbitrator had awarded him 40% loss of the man as a whole.
I never even heard what the case was about because that is not why the worker was calling, but it sounds like the attorney did a good job at the trial.
The reason he was calling me is that it had been almost 40 days since the Arbitrator rendered his decision and he hasn’t been paid yet.  His lawyer told him that it could be another 60 days or more until the check arrives.
When you go to trial, each side has 30 days to file a notice of appeal.  Once that 30 days has passed, if you haven’t filed then you are stuck with whatever the Arbitrator awards.
What I told the caller was that if I don’t want the other side to appeal then I won’t call them to see what they are going to do until more than 30 days have passed.  If I don’t care if they are going to appeal, I’ll tell them that we aren’t either so they can just go ahead and pay now.
But once the 30 days has passed, there is no reason to not call them up and say “when should I expect the check?”  The caller to my office said he asked his current representation to call the defense lawyer, but was told that he wasn’t going to do that because “he didn’t want to upset the other side.”
What???????  If you are worried about not upsetting someone, it should be your own client.  You don’t have to call them and be an a-hole or unprofessional.  You can and should call and ask what is going on and when the check should be expected.  Who cares if the defense attorney is mad that a lawyer is doing their job.  That’s their problem, not my problem and it certainly should not be your problem.
If 30 days has passed since the appeal deadline and they won’t tell me when the check is coming, I’d file a petition for penalties and fees.  That should more than give the nudge needed to cut the check.
I don’t think some attorneys realize that not being paid can cause real harm to their clients including getting kicked out of a home and bankruptcy.  We can’t always avoid this collateral damage, but we should certainly try to if we can.  And being worried about someone who is not your client b being upset is the most ridiculous thing I’ve heard in a long time.  And it’s too bad because it seems as if this firm did a really good job at the trial.  But this bad experience is going to be what the client remembers from working with them.

Death benefits after a fatal work accident in Illinois

Illinois workers’ compensation law sets rules for when workers can get benefits after a job injury. In the case of an employee who suffers a fatal work accident, the law provides death benefits to the spouse, children and dependents of the worker.

Like any Illinois work injury, a fatal injury also needs to meet the requirement that it arises out of and in the course of employment. That’s just the legal way of saying that the injury must happen at work while you are performing duties that are part of the job. You don’t necessarily need to be at your employer’s office or performing your specific job duties in order to qualify for benefits. If you were doing something for the benefit of your employer, it likely falls into the right category.

A few examples: A heart attack at work, or at home right after work, may be covered if you can connect it to the job and show what caused the heart attack. Benefits are usually available regardless of fault, so if your loved one wasn’t following safety rules when the accident happened, it shouldn’t matter. On the other hand, blatant goofing off, drinking on the job, etc., is not covered in most cases.

Available benefits include related medical bills and funeral expenses. If there is a surviving spouse, minor child, or other financially dependent family member, the insurance company has to pay death benefits, which can be more than $500,000 in some cases. The dependent family member has to prove that they are financially dependent and to what extent. Their recovery of death benefits will be in proportion to how much they relied on the employee. Minor children and spouses do not have to prove anything.

Keep in mind that death benefits – and all Illinois workers’ compensation benefits – are only available to employees and the families of employees. Independent contractors are not eligible. That said, don’t assume that your loved one was what your employer said they were. It’s not up to the employer to classify them one way or the other. The law decides. If the employer exercised a lot of control of the worker’s schedule, work product, equipment, etc., then he or she was likely an employee. We’ve been able to prove this in truck driver cases. Many truck drivers are hired as “independent contractors,” but they are treated more like employees, which makes them employees under the law and eligible for benefits, including death benefits.

Another option is a third-party lawsuit. If someone other than the employer was responsible for the death, then they can be held liable in Illinois. Your attorney should explore both possibilities – workers’ compensation death benefits and a personal injury lawsuit. Just keep in mind that you can’t sue an employer after a work accident. Illinois workers’ compensation law protects employers from lawsuits.

Make sure your lawyer not only understands death benefits under Illinois workers’ compensation law, but that they have handled similar cases in the past and done so successfully. It’s definitely not a routine case, and it’s appropriate to ask if your attorney has death benefits experience. Your lawyer shouldn’t earn a fee unless they win benefits for you. In fact, Illinois caps lawyer fees in these cases, so don’t hesitate to get legal advice.


Your doctor says you're ready to go back to work, but you disagree

Unfortunately, the insurance company isn’t going to take your word for it. In order to continue to get temporary total disability benefits, you’re going to need your doctor to agree that you are unable to return to your job. That’s the law in Illinois.

If you legitimately feel as though your doctor is wrong, we believe you. You know your body best. But the law has to draw the line somewhere or everyone would go around saying they can’t work. If your doctor can’t be convinced, you’re in a tough spot.

The best way to avoid a problem like this is to value your relationship with your doctor from the beginning. Your goal is that you want your doctor to trust you and believe you and genuinely want to help you. So being a good patient is a good start. This includes being honest about how you were injured and how you’re feeling. Keep your doctor posted if your pain or condition changes. If they don’t feel you are being honest, they might not believe you when you say you are still in pain.

If you’ve already gotten to the point where you have a disagreement with your doctor about your readiness to return to work, make sure to let them know that you disagree. You might be able to get them to agree to a few weeks of light duty work as a trial run. Maybe there is some rehabilitation you can do first to get you ready to go back. Make sure you ask what you can do if you feel pain while working in the future.

Your doctor may have seen patients in the past who have tried to take advantage of workers’ compensation system. Let them know that you aren’t one of them, that you want to return to work but that you are worried that it’s not time (as long as this is the truth, of course).

In the end, you might just have to go back to work and give it a try. Maybe you’ll be pleasantly surprised, or maybe you’ll get re-injured. But if you don’t try, your other option is to sit at home and not get paid. We wish we could give good news all the time, but our philosophy is to be honest about what you’re facing and then help you figure out how to make it better.

Strict deadlines can keep you from getting benefits

Deadlines are one of the few predictable things in the law. Like most areas of law, Illinois workers’ compensation law provides specific deadlines. There is little room for argument if you wait too long to file your claim for benefits. Your time starts on the date of your injury.

In Illinois, the general rule is that you have three years from the date of your work injury to file a claim for benefits, or two years from the last payment of benefits, whichever is later. (You can begin receiving benefits without filing a claim.) The deadline is called the statute of limitations.

Pretty much any attorney will recommend that you do not wait until the deadline is near before filing a claim. In fact, there is generally nothing to lose by filing right away. Even if you start getting benefits without filing a formal claim, having one on file will give you a head start if you need to request a hearing because an issue comes up down the road. The official form is called an Application for Adjustment of Claim, and they are filed with the Illinois Workers’ Compensation Commission.

One situation where the deadline is not as certain is when you have an uncertain accident or injury date. If you do not know when your injury occurred because it was not a single incident that caused the injury, there is another rule. The statute of limitations still applies, but it starts on the date you knew or should have known that you had a work-related injury.

Overall, Illinois is one of the more worker-friendly states in which to file a claim for compensation. If your injury arises out of and in the course of your employment, you are entitled to payment of lost wages (2/3 of your average weekly wage), plus 100% coverage of your medical bills. However, these benefits are not available if you fail to obey the statute of limitations.

We talk to people all the time who are unsure of the deadline in their case. The most important thing is not to wait. When you call us, we don’t want to have to tell you that you missed your chance.


How much does workers' compensation pay?

If you can’t work after a job injury, and you qualify for Illinois workers’ compensation, you should receive 2/3 of your average weekly wage in the form of benefits checks. This benefit is called Temporary Total Disability, or TTD. Your TTD checks should come on a regular basis, with the first one ideally arriving within two weeks.

So what is your “average weekly wage?” It’s an important question. For some, it’s a simple calculation. You add up your gross pay over the 52 weeks prior to your injury and divide by 52. It may not be simple, however, if your pay varies considerably or includes commissions, bonuses or overtime. For example, bonuses might not get included. The more pay that does count, the bigger your benefits checks will be, so make sure everything is included and don’t trust your employer or their insurance company to do the math in your favor. Note that there are minimum and maximum amounts, set by law, for TTD in Illinois.

TTD doesn’t start on the first day you are injured. The benefit doesn’t kick in until you have been out of work for a certain amount of days. Once you miss three days of work because of your injury, you qualify for TTD. If you end up missing 14 days, you can get paid retroactively for those first three. In other words, missing a day or two of work doesn’t get you any lost-pay benefits.

Sometimes, an employer has light-duty work available for an injured employee. If that position pays less than your regular position, you can get benefits in the amount of 2/3 of the difference. Whether you can do light-duty work depends on your work restrictions after your injury.

Most employers are required to carry workers’ compensation insurance, and it’s the insurance company that is in charge of paying benefits. It’s also the insurance company that you’ll be dealing with, not your boss or supervisor. If anyone at work is encouraging you not to file a claim, it’s a red flag.

Despite what the law says, insurers deny claims and benefits all the time. If you aren’t receiving your checks, or if the amount of your checks is incorrect, contact an Illinois workers’ compensation attorney. Find someone experienced and be sure they are familiar with the intricacies of the average weekly wage rules. They also should be familiar with the games insurance companies play.


What you need to know about an IME appointment

In Illinois, workers’ compensation law requires your employer or their insurer to pay for all reasonable medical treatment that is related to your work injury. They’re also required to pay you a portion of your lost wages if you are unable to work as a result of your work injury. Frequently, the worker and the insurance company disagree on these issues.

When the insurance company disagrees with your doctor’s stated medical opinion, they will try to dispute the opinion with one of their own. They do this by having an “independent” doctor evaluate you and go over your medical records. While technically it’s independent, it’s not always the reality. While some IME doctors remain impartial, others tend to say what the insurance company wants them to say.

You have to go to this appointment. It’s usually brief. While this is good for your convenience, it shows how silly it is that a doctor looks at you for five minutes and makes a decision about your injury and treatment. If you refuse to submit to the exam, then your benefits can be cut off.

Sometimes, you might have to go to more than one IME during the course of your claim. Often, it happens after a change in your condition or because your case has gone on for a long time. While multiple IMEs are allowed in Illinois, the insurance company can’t use them as a way to harass you. We’ve seen that happen. It’s not the norm, as it’s expensive for the insurance company because they pay for it, and your attorney should notice if there are any red flags there.

Try not to worry about an IME. If you have a credible doctor and you’ve been honest and straightforward with everything, there’s no reason the IME opinion should overrule a reasoned opinion of your own physician or specialist in the end. Hiring a good Illinois lawyer can make a difference. The arbitrator will hear both sides, but the opinion of the doctor who has seen you routinely and has much more experience with you carries weight. And many times, the IME simply confirms what your doctor has said all along.


The truth about Utilization Review in Illinois workers' compensation cases

“Utilization Review” actually sounds rather benign, but it can seriously affect your case. It’s one of the ways insurance companies try to hurt your claim or deny certain medical treatment. The law in Illinois says that the insurance company has to pay for all reasonable medical care that is related to your job injury. Even so, they’ll try to avoid paying if they can.

One way they try to avoid paying for treatment is with an independent medical examination or IME. Whether it’s really independent is up for debate. The way it works is that they choose a doctor who then examines you, reviews your medical records and writes a report about what they think of your injury, treatment, etc. The goal with an IME is to get an opinion that says your injury isn’t job related, or surgery isn’t necessary, or something else that will allow them to deny your claim or treatment.

The Utilization Review is worse. For a UR, you don’t even know it’s happening because the doctor doesn’t actually meet with you. They only review your medical records and then make a decision about whether the treatment is reasonable. You’re probably asking how that’s even remotely reliable. We don’t think it is.

An experienced work injury attorney can act quickly with a trial motion. In most cases we are able to prove that the doctor who examines you in person multiple times has the more reliable opinion. But even when we are successful, it unfortunately causes delay in both your case and your medical care.

It’s crazy to think a doctor who doesn’t know you and has never even met you can make a determination about your injury. But that’s how it works in Illinois. Your best defense is a good workers’ compensation attorney and being upfront and honest with your own doctor.

Will I lose my benefits if I get fired?

No. You should not lose your workers’ compensation benefits because you get laid off or fired. That doesn’t mean your employer won’t threaten you with it, or that you won’t get bad advice from someone else out there, but in general your benefits should not stop if you lose your job. Getting fired doesn’t change the fact that you were injured in the course of your employment and that you need your benefits in able to recover and get back into the workforce. This is what the benefits are for, and you are entitled to them under the law.

It’s not illegal for your employer to fire you during your recovery. There is no law that says you can’t be fired while you’re out on workers’ compensation. Employment in Illinois is largely “at will,” which means that you or your employer can end the relationship at any time and for any legal reason.

However, your employer cannot fire you for an illegal reason, which includes discrimination as well as something that’s relevant here – retaliation. Your employer cannot fire you to get back at you for filing a claim for workers’ compensation (or any other legal claim against them). They can’t fire you because they think you might file a claim. In some cases, this is hard to prove. But if your employer tells someone else this is why they fired you, or if they say it to you, then you probably have a good case. The retaliation case would be separate from your workers’ compensation case.

So even if you got hurt because it was your fault, or you were fired because you did something you shouldn’t, the insurance company should continue to pay your workers’ compensation benefits. Your related medical expenses should be covered 100%, and you should receive TTD benefits, which are 2/3 of your average weekly wage while you can’t work. Once you are fully recovered, or at maximum medical improvement (as good as you’re going to get), then your TTD benefits will end.

If you’re worried your benefits will end before you are finished with your recovery, either because you lost your job or because the insurance company is telling you that your benefits will be cut off, talk to an experienced Illinois work injury attorney to find out what’s really going on and what you can do about it.


What if I was hurt doing something other than my assigned duties?

You can get workers’ compensation benefits in Illinois even if you get hurt doing something outside of your job description. Don’t let your employer or the insurance company tell you otherwise. There are some exceptions, but for the most part you are covered for any injury that arises out of and in the course of your employment.

If a cashier stops to help a stockroom employee move some boxes and hurts their back, it’s most likely covered. It comes down to whether they were doing something to the benefit of their employer. The cashier was, even if they weren’t supposed to be doing it. The cases in which an employee can’t get benefits is when they are doing something so far outside their work duties that it’s no longer considered work related. Examples: Goofing off at work, doing something dangerous just for fun, etc.

Don’t let your employer tell you that your injury is your fault and therefore you can’t file a claim. Even if it’s partially your fault, because you lifted the box wrong, or whatever else, it doesn’t matter. Workers’ compensation in Illinois is a “no fault” system. You are entitled to benefits regardless of fault.

And don’t simply accept a denial by the insurance company. They deny claims all the time, even when it’s a long shot. They hope you’ll get frustrated and go away, or that you’ll fail to hire an attorney and learn that you really do have a good case.

As an employee, it’s your job to do whatever your employer needs. You can’t just stand there and refuse to do something because it’s not in your job description. And most people help their co-workers out if they need help. It would be crazy to not allow benefits to these employees, who were simply being good employees. And the law doesn’t deny benefits in these cases. The insurance company might try to, but you can fight back.

It’s not ideal that you have to hire an attorney and request a hearing before an arbitrator in order to receive the benefits the law entitles you to, but that’s the reality. Hire someone who knows what they’re doing so that you can get your case on track quickly, get your benefits, and hopefully get better and back to work.


If it sounds too good to be true ...

It probably is.

We encourage you to shop around for a lawyer. Not for cost reasons, but to find the best fit. Experience should be a major factor in who you hire. Many years of focused practice is not an unreasonable expectation. Ask an attorney about their past successes, general strategy and the potential outcomes in your case. And as you gather this information, pay attention to your gut feeling about them.

It sounds simple, but when you’re caught up in a legal issue, especially one that’s personal, you can lose perspective. We talk to a lot of people who hire their Illinois attorney without much thought and then start questioning whether they made a bad decision. Sometimes the attorney disappears for long periods of time and never calls them back. Other times, the attorney is rude or seems ill equipped to handle the case.

On the flip side, beware of something that seems too good to be true. A big red flag is when an attorney tells you exactly what you want to hear. We had a caller once who was seeking workers’ compensation payments but didn’t want to pay any child support from his checks. In other words, he didn’t want it to count as income for that purpose. Well, pretty much everything counts as income when it comes to child support. We told him that, because we refuse to sugar coat things in order to get someone’s business as a client.

This caller decided to hire an Illinois attorney who promised him that no child support would have to be paid from his temporary total disability checks. When that turned out to be a lie, he called us back to see if we’d take over his case.

Promising a result is something we never do, because we can’t predict the future. We want you to focus on what’s best for you in the long term, and we do the same. Lying to get a client and to make that client feel better hurts everyone in the end.

If you have a specific concern, like our caller about child support, ask more than one attorney. If you get different answers, talk to a third attorney. Ask for proof if their claim or promise seems too good to be true. In this example, it’s pretty clearly stated in the law that workers’ compensation counts as income for child support purposes, and it would have taken little effort to find this out.

Illinois workers' compensation tip: Know your arbitrator

You don’t have to personally know your arbitrator, but your attorney ideally should.

In an Illinois workers’ compensation case, a judge doesn’t oversee hearings and trials. Instead, an arbitrator is in charge. They act just like a judge – deciding disputes, holding status hearings to check on the progress of a case and presiding over trials. It’s just a different system with different players.

The rule of thumb about knowing the arbitrator is similar to that of knowing the judge. If your attorney knows the tendencies of the person making the major decisions in your case, then they can tailor their argument to give you the best shot. Knowing the arbitrator helps an attorney make decisions about strategy, such as whether to go to trial. An attorney can’t know the arbitrators without dealing with them often. Look for an attorney who handles cases day in and day out, and focuses their entire law practice on workers’ compensation.

Along these same lines, when your attorney appears before an arbitrator often, that arbitrator develops an opinion of your attorney. Hopefully it’s a positive one. If they have a good working relationship, and each respects the other, then it can have a positive effect on your case. We’re not saying that anything unethical is going on. It’s quite the opposite. An attorney who knows what they’re doing, works hard for their clients and respects the arbitrator has an advantage simply because arbitrator has a positive opinion of them. You want this type of lawyer presenting your case.

Work injury cases don’t start with a lawsuit, nor do they play out in a typical courtroom. Instead, Illinois law has created a system in which injured workers file claims for benefits, which are then paid (hopefully) by their employer’s insurance company.

The system protects employers from lawsuits. An injured worker does not even have the option of filing a lawsuit; a claim for benefits is their only recourse. For the injured worker, the intended benefit is compensation, regardless of fault, without having to file a lawsuit. It doesn’t always work like it should, especially for the injured workers, but it’s what we have. You can give yourself a leg up by hiring a well-respected attorney who focuses in this area of law.

Determining the accident date for a repetitive stress injury

It’s important to know the date of your Illinois work injury in order to receive workers’ compensation. It determines when benefits begin, allows the insurance company to verify your injury and tells them whether you filed a claim within the deadline.

For an injury caused by a specific incident such as a slip and fall, the date of accident is obvious. For an injury that is caused over time, such as a repetitive stress injury, that date can be hard to pinpoint.

The rule, when it comes to accident dates for repetitive stress injuries, is the date on which your injury was apparent and you were aware (or a reasonable person would have been aware) that it was related to your job. This could be the date you see a doctor about arm pain and he or she asks you about your job and diagnoses you with carpal tunnel syndrome, for example.

Telling your doctor what your job entails is important after an injury. If the insurance company tries to argue that your injury was not caused by work, your doctor’s opinion that it was caused by work will be very important.

Carpal Tunnel Syndrome is a common example of a repetitive stress injury, but it can be any injury caused by repeating the same motion over and over again. It can be assembly line work, typing, lifting, pushing or pulling, etc.

Illinois law gives you three years from the date of accident to file a claim for benefits. Or, if you have received some form of benefits, then the deadline can be two years from the last payment of those benefits. Whichever of these dates is later, that is your deadline. You also have 45 days to notify your employer of a work injury in order to be eligible for benefits. That 45 days also starts on the date of injury.

If you have questions about the date of your work injury, or any other questions about getting benefits in Illinois, talk to an experienced work injury attorney. Illinois law provides injured workers with disability benefits payments, coverage of 100% of their related medical expenses, and many workers end up with a settlement if their injury is permanent.

The same attorney who tried your case should handle the appeal

Nobody wants to go to trial and lose, but if you do, you can appeal your case and so can the other side if you win.

Sometimes people come to us asking us to handle the appeal part of their case after it’s been tried by another law firm. We’ve never agreed to do this.

It makes the most sense for the attorney who handled your case through trial to be the one to handle your appeal, if you’re going down that road. We’ve written before about switching attorneys if you feel you need to. Generally, if you realize you hired a bad attorney, we encourage you to find someone competent and make the switch. But this specific situation is somewhat of an exception. If your case has already gone to trial then it’s pretty much too late to hire someone else.  Here’s why,

Any new attorney will be stuck with the case as it was prepared by the first attorney. On appeal, you don’t get to re-do anything, such as calling on witnesses, presenting new evidence, etc. So very few attorneys, if any, want to pick that up on appeal, knowing they don’t have much control over it. On top of that is the fact that the majority of appeals are denied in Illinois workers’ compensation cases.

If your attorney is willing to handle an appeal, then go with it. If they are reluctant, and you feel that you want to appeal, insist that they follow through. Even if they’re inexperienced or not on top of things, they’re likely your only chance. You might be able to hire someone and pay them by the hour to work on your appeal, but no workers’ compensation attorney I know would take on an appeal of a case they weren’t involved in. We certainly wouldn’t. We would rather focus on helping our clients who came to us in the beginning or at least before trial.

Some firms allow inexperienced attorneys to handle cases. Many are high-volume, which can affect the care taken on an individual case. If this hasn’t happened to you, you can avoid it by putting some work into the hiring process. Don’t go with an attorney because they ran an ad on TV. Look into their experience, track record, reputation and client satisfaction.

What filing an Illinois workers' compensation case is not

At least once a week I talk to someone who has never talked to an attorney before, at least not to hire them potentially.
Some of these callers hate that they had to pick up the phone and seek my help.  They hate it so much that they let themselves get taken advantage of and abused by insurance companies and nurse case managers who are messing with their medical treatment following a work injury.
I recently talked to one nice guy who got illegally fired after a work injury and had his benefits cut off without cause at all.  But before he would hire a lawyer he said he wanted to talk to his priest to make sure it’s ok.
Lobbyists and others have done a great job of painting the legal industry in a terrible light.  And to be honest, many of my peers have made law firms as a whole look terrible.  So I understand why lots of people have a terrible perception of our industry.
Most of those that are hesitant don’t want to get an attorney because in their mind they are “not the suing type.”  Well, I have good news for them.
First off a claim for workers’ compensation benefits in Illinois is not a lawsuit.  It is simply a claim for getting an employee benefit that you are entitled to and no different than filing a claim for your health insurance company to pay the hospital bill if your appendix ruptures.  When you hire us we are never filing a lawsuit against your employer or anyone else.
Beyond that, there is no “suing type” at least not in reality.  We only represent honest people with honest claims.  If we thought that a client was faking an injury we wouldn’t help them.   If we sign you up and catch you lying, we’ll withdraw from your case.
But if you are like most of the people we meet that bring claims in that you are a hard worker who had an accident while working and sustained an injury, we want to protect you and make sure that you get the benefits allowed by law which will allow you to get healthy and financially survive.
There is nothing immoral about hiring an attorney when you are being honest.  What’s immoral is how some of these insurance companies and IME doctors will screw you at a moment’s notice in order to avoid having to do what they are supposed to under the law.
And the truth is that this isn’t unique to work comp.  Any car accident lawyer I know, for example, wouldn’t take a b.s. case either.  But the good news for you is that if you don’t want to sue anyone, you don’t have to, as work comp is not a lawsuit.
If you have any questions about Illinois law and want a no cost, no commitment consultation, just call me any time at 312-346-5578 and we’ll try to point you in the right direction.

By Michael Helfand

Think of Animal House when it comes to your case

There are a lot of great scenes in the movie Animal House, but one of the best is John Belushi’s speech where he says, “Over?!?!?  Was it over when the Germans bombed Pearl Harbor?”
Bluto Blutarski goes on to offer a great piece of advice for most Illinois workers’ compensation claims: “Nothing is over until we say it is!”
I’ve lost track of the number of people that have called me and told me that they were injured on the job and received some benefits, but then the insurance company told them that their case was closed.
There are really only a few ways to “close” a case for good.  1. Wait to long to actually file a case with the Illinois Workers’ Compensation Commission and have your claim barred for a statute of limitations violation. 2. Settle your case and sign settlement contracts that get approved.  3. Go to trial although even then your case won’t likely be closed for good.
If you haven’t waited too long to file, we can magically re-open your case by filing the proper paperwork and there is nothing that even the meanest insurance company can do about it.  You still have to prove your case to receive benefits of course, but nobody from the insurance company can just tell you that you’ve waited too long for their taste.
Well, they can tell you that and they do, but you don’t have to follow what they say.  Insurance adjusters typically get bonuses for how many files they can close.  The sooner they close a file, the more they can make.  So it’s not unusual for them to call your file closed.  That means no more work for them and some money in their pocket.
Of course, just because it’s good for them does not mean it’s good for you.  In fact, most things that are good for the insurance company are not in your best interests.  This is especially true when it comes to getting medical care which can be expensive and ruin your life if it’s delayed too long.
Bottom line is that you should never trust advice that comes from somebody that has a competing interest with what is best for you.  And we’ll always talk to your for free if you want to verify something they told you.

By Michael Helfand