Never heard this one before

A reader called in and was explaining the problems with his case.  Basically his doctor has prescribed a spinal cord stimulator and the insurance company for no reason hasn't approved it for three months.

I explained that it's a simple problem to solve; file a trial motion and petition for penalties and fees.  His response floored me.

He said he told his attorney he wanted to go trial and his lawyer said no because he "doesn't want to hurt his relationship with the defense attorney."

Yikes!

Illinois wage differential laws- what a difference a day makes

Under Illinois workers' compensation law, if you can no longer return to your old job due to permanent restrictions and suffer a loss of what you can now earn, you might be entitled to wage differential benefits.   That allows you to receive 2/3 the difference of what you would currently have been making under the old job compared to what you can make now.

So let's say that you were an electrician who made $35 an hour when you blew out your knee and now would have been making $40 an hour.  Instead you can only earn $10.00 an hour as a security guard.  Based on a 40 hour work week, it's a difference of $1,200 a week, 2/3 of which is $800.

For accidents that happened prior to February 1, 2006, there was a maximum cap based on the permanent partial disability rate at the time of your injury.  In plain English that means that no matter how big your wage loss, the most you could get compensated if you could do any work is $591.77.  The Workers' Compensation Act was amended to change this rule.  For accidents after February 1, 2006 your maximum pay rate for a wage differential loss became 100% of the state average weekly wage.

So if you were hurt on January 31, 2006, the most you could receive for your loss is $591.77 a week.  If you were hurt on February 2, 2006 you would get up to $822.20 a week.

In the example above it would result in a difference of more than $10,000.00 a year.  Yes, it's crazy what difference a day can make.

Calling all nurses. Are you getting ripped off on your wages?

We only handle work injury cases, but like any other (good) work comp firm, we work hand in hand with labor lawyers when problems come up.   Recently a great wage and overtime attorney we work with mentioned a problem that has been happening to a lot of hospital nurses and others.  So . . . .

If you are in a job where you work a normal day plus a lunch break and don't get paid for your lunch break, let us know if:

1. You are working through your break, but not getting paid for it; or

2. You are eating in a lunch room or nurse's station, but regularly interrupted by patients, doctors, etc.; or

3. You just don't get a work break because of the work load.

If this is happening to you (and apparently it's the way business is done at a lot of hospitals) it is illegal.  If you or anyone you know would like to discuss this situation please call us at (312) 346-5578 and we will put you in touch with a labor lawyer.

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Falls in parking lots and Illinois workers' compensation

In general, accidents on the way to work or home after work are not covered under Illinois workers' compensation law.  In other words, if you are riding the train or driving in your car and get in to an accident, you can't successfully file a claim (note there is a big exception to this rule which would be a whole other post so call us if this has happened to you).

When you arrive to work or leave at the end of the day and are in the parking lot, however, you can technically be considered to be working.  If you have an accident from a slip and fall or anything else, you might be able to make a workers' compensation claim.

There are two key points to consider:

First, does the employer provide the parking lot for the employees?  If they restrict where you can park (e.g. an employee designated lot) then an injury from a fall is probably a case.  On the other hand, if it's a big public lot and you can park wherever you want, you are probably at no increased risk to that of the general public.  If so then the chances of prevailing are tougher.

The second point is do they maintain the parking lot?  If they own it and have to clean it or are responsible for the upkeep of the lot (even if they just contribute to it through rent payment) then accidents will probably be held to be work injuries.

This is all a very generalized statement of the law.  It's also important to know that any accident that is personal to you would not be covered.  In other words if you slam your hand in the car door that will never be an Illinois workers comp claim unless something about the job made that happen.  Most of the cases we are able to succeed on involve slipping on something icy or wet.

Does this sound confusing?  It can be.  If you have questions about parking lot accidents do not hesitate to contact us.

Three signs you don't have the best Illinois workers' compensation attorney

A recent streak of calls presented a bunch of red flags to us.  So in the hope that it will help someone out, here are three warning signs when it comes to hiring an attorney for an Illinois work injury.

Don't let the lawyer direct your medical care: If you want a recommendation of a good doctor then ask your lawyer; if your lawyer has an opinion about a doctor or your treatment they can offer it.  But we are lawyers, not doctors.  I get calls once a week from doctors that want me to send my clients to them and offer to send their patients to me.  It loses me a lot of money to turn that down, but we do because it is un-ethical.  If your doctor wants you to work with a certain lawyer or your lawyer wants you with a certain doctor then it just smells wrong.

What other areas of law does your lawyer handle: We typically suggest you get someone that does nothing but workers comp.  That said, personal injury, social security and employment law are natural extensions of workers comp.  On the other hand, if your attorney is also taking on divorce, criminal defense, estate planning, immigration, etc. it should make you wonder how much they really know about workers compensation laws in Illinois.

Are they assigning a brand new attorney to your file?:  Every lawyer has to start somewhere, but do you want them starting their career on your case?  I wouldn't, especially if it's a tough one.  We had a recent call where a law firm assigned a case of a steel worker with a herniated disc to an attorney who was admitted to practice law in November.  Saying that a senior partner will supervise the file is a load of crap in our opinion.  They certainly aren't on the phone when you have questions and they aren't on the phone or in court with the young lawyer.  If the attorney on your case hasn't been doing workers comp for at least seven years we think you are short changing yourself.

 

When should you settle an Illinois work comp case?

A reader called us and asked our opinion on his case.  As a FYI, when this happens usually we find that the lawyer the caller has is doing most things right.

In this case the caller had undergone a neck fusion two months ago and has at least four more months of treatment ahead of him.  He received a call from his lawyer who suggested that they make a settlement demand?

Huh? I think even the most naive person out there would know that settling your case, especially after a major surgery, before you are done with treatment makes no sense.  In fact, most Judges we know wouldn't even approve settlement contracts right now.

But the bigger point is that there is nothing more important than your health.  When it comes to thinking about settling your case you don't want to take too long, but you don't want to do it too soon.

If you are an office worker who breaks their leg when they slip on a wet floor, you can likely settle your case soon after you are discharged by the doctor if you are feeling well.  There is little chance that your leg will get worse and your job duties won't make your condition worse.

On the other hand, if you are a secretary that had carpal tunnel surgery, I'd tell you to wait until you have been discharged by the doctor and working pain free for 2-4 months before we settle your case.  Once you settle a claim you close out your rights as relates to that injury for the rest of your life.  You never want to settle before we are 100% certain you won't need more medical care.

And if you are like our caller and have had a fusion, especially if you are in a physically demanding job, I'd tell you that you don't want to settle your case until you have been working pain free for 3-6 months if at all.  This is especially true if you are younger as a fusion likely will have to be re-done at some point.   By going to trial you can still get paid and keep your medical rights open for life as relates to that injury.  Even if you do settle, you want to make sure your possible future medical costs are considered.

Moral of the story is that you never settle too soon and you shouldn't even be thinking about it while you are still under the care of a doctor.

Overview of Illinois workers' compensation benefits

Here’s an overview of what you can expect to receive in terms of benefits if you’re hurt on the job in Illinois. All work injuries are usually covered, and workers’ compensation is your only option – you generally cannot sue your employer for a work injury.

Medical bills

In Illinois, workers injured on the job are entitled to 100% of their medical expenses. This includes immediate treatment and ongoing medical care, as well as prescriptions, physical therapy and surgery in many cases. The basic rule is that the treatment has to be necessary and related to your injury in order to be covered.

Lost wages

If you are unable to work because of your injury, or if your doctor restricts your activities and your employer can’t accommodate you, you’ll get paid for part of your lost income. This is called Temporary Total Disability, or TTD. You will receive 2/3 of your average weekly wage over the last 52 weeks. There is no time limit on how long you can receive TTD payments. They end when you can go back to work, or when your employer can accommodate any restrictions.

Permanent disability

Permanent Partial Disability, or PPD, is for permanent injuries. The amount depends on the type of injury you have and how it affects your life now and in the future. If you can’t work, or can only work at a job that pays less, you may be compensated for part of the difference. The PPD amount is negotiated by lawyers and can be different in every case.

Employer penalties

If an employer wrongfully denies you benefits, they may have to pay you a penalty. Other than this, there are no punitive damages or “pain and suffering” damages in workers’ compensation cases in Illinois.

Suing a third party for your injury

Although you can’t sue your employer for a work injury, you may be able to sue a third party who was at fault. For example, if you’re installing cable for a customer in a high-rise building, and the elevator malfunctions and you get hurt, you could file a personal injury lawsuit against the building owner. You could still pursue workers’ compensation as well.

 We are workers' compensation attorneys that help people with Illinois work injuries anywhere in IL via our statewide network of attorneys.  Contact Us and we will answer your questions or find the right lawyer for you situation.

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Chicago work comp attorney view on intervening injuries

A reader asks:

I hurt my leg on the job six months ago and had surgery.  My injury was not disputed and the insurance company paid for everything.  I'm still undergoing treatment, but was getting better.  Last week I stepped in a hole in my yard, twisted the same knee and now am facing more treatment and probably another surgery.  The insurance company cut off my benefits.  Can they do that?

They can certainly cut off your benefits because all they need is a reasonable basis for doing so.  This is probably reasonable enough.  The bigger question is who will win that argument in the long run.

Of course every case is different, but when you are still under treatment and your body is "weakened" the good news is that Illinois courts have held that a new accident is not really a new accident, but a continuation of the old one.

So if your doctor will testify that your knee was weakened or de-conditioned then you stand a great chance at winning benefits.  On the other hand, if you were all better or almost there or your doctor won't agree you were in a weakened condition then you may have a problem.

If this happens to you, a quick review of your medical records should tell you if there is a case or not.  But don't assume that because something new has happened that you have no chance.

Paranoia and your Illinois workers compensation attorney

Every so often we get a call or e-mail like this:

I am really concerned that my Illinois workers' compensation lawyer has sold me out to the insurance company.  I say this because my case is taking forever and he was yucking it up with the defense attorney when we went in for a hearing before the Arbitrator.  After seeing the two of them talk in a corner, my attorney told me that the case was continued.  I could see them talking and they were laughing the whole time.  When they both came over to me, my lawyer introduced the insurance company as his friend.  Am I crazy to think that the insurance company is paying off my lawyer at my expense?

There are a lot of attorneys that we don't like at the Illinois Workers' Compensation Commission and many more that we both like and respect.  But no matter who the lawyer is, there is no way that an attorney is being "bought off" to harm a client and make a case go away.

First, workers' compensation cases aren't worth enough to risk your career and jail time over something like this.  Second, it takes multiple people from an insurance company to resolve a case and those cases and the checks written on them are audited.  You'd need a huge conspiracy of many people to make this happen.  The reality is that the insurance company has so many cases that they don't care about your case over any other.  And if they did this and got caught their company would go out of business.

Third, it's a good thing if your lawyer and the defense attorney are friendly.  We have to deal with these attorneys all of the time and if they don't like your lawyer then they are more likely to make the case hard on you.  It's the same thing with insurance adjusters.  We never pick a fight unless it's called for because it's just a fact that the decision makers (e.g. the ones that approve or decline benefits) are more likely to cooperate when they like who they are dealing with.

Fourth, if this ever happened, don't you think at least one person in the history of time would have been caught doing it?  In the history of Illinois work injuries this has never happened.  Insurance adjusters have been caught and charged with crimes when it comes to something like creating their own investigation company and then assigning cases to their company, but that's a scam that only requires them to participate.  Hundreds of lawyers have been busted for stealing from clients (e.g. failing to turn over a settlement check).  Many workers have been prosecuted for faking claims. But not once has an elaborate scheme been discovered that involved an insurance company paying off a lawyer.  It hasn't been discovered because it doesn't happen.  Can you imagine the balls it would take for an attorney to approach an insurance company and propose such a scheme?

Fifth, only a work comp Arbitrator can officially close out a case.  If your lawyer tells you your case is closed and you do some easy investigation, you'd find out that it wasn't true and the lawyer would be exposed to a legal malpractice lawsuit, possible loss of his law license and maybe even jail time.  The insurance company would also then still have to pay you for whatever your claim is worth once you hire a new lawyer.

Sixth.  Ok, I'm not going to go on, but I could.  Trust me though, this doesn't happen.  You might not have a good attorney or one that is fighting for you, but it's not because they have bribed to treat you that way.  It's just that they aren't good at what they do.

You drink. You work. You lose.

Ok, that sounds like a cheesy anti-DUI commercial, but it's true, at least when it comes to Illinois workers' compensation.

If you are drunk on the job and get in an accident because you were drunk (or high), you will not win a claim for workers' compensation benefits.  Strangely enough, if you are just sitting at your desk drunk and something happens (e.g. a forklift crashes in to you) that has nothing to do with your drunk state of mind then you'd probably have a case.

Traveling employees are actually allowed to drink on business trips and still win benefits if they get hurt unless they are sloshed.  In other words, if you are out of town for business and have a couple of glasses of wine at dinner, but then fall in the parking lot, you'd probably have a case if you didn't fall because of the drinking. 

On the flip side, a few years ago we got called by a trucker whose rig broke down at a rest stop.  He was stranded so he drank about 30 beers and fell out of his truck and blew out his knee.  That case is not a winner because while it's foreseeable you might have a beer, it's not foreseeable that you'd drink that much and put yourself in harms way.