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.

Lawyer Fees And Medicare Set Aside

I just read about a case (not handled by us or anyone in our network) about a very greedy Illinois workers’ compensation attorney.

He had settled his client’s case, but petitioned the Illinois Workers’ Compensation Commission for more money after the settlement contracts were approved.  His client had received a Medicare Set Aside which is money funded by the insurance company for future medical care related to the work injury.  Basically, you have to consider what Medicare might have to pay some day and the insurance company pays that amount.

This money is not negotiated, but rather is done by authorized companies who review medical records and determine what care will be needed and what that will cost.  100% of that money is to go to the client.

This lawyer asked for some of that money after the case was closed. His request was denied for a few reasons.

  1. Lawyers can’t re-open cases to get more money. Clearly he’s looking out for himself, not the client.
  2. The Commission noted that he didn’t do anything extraordinary to warrant a fee higher than the 20% allowed by law.
  3. Most importantly, it’s against the law to take a fee on a Medicare Set Aside.

I’m going to say it again, your attorney has to get you a Medicare Set Aside if needed and can’t take a fee for doing it.

This is part of our jobs and part of the 20% we get for representing you.  We have to do it morally (because it’s in your best interests) and legally (if the Government thinks we didn’t consider their interests, they can go after us to pay the bills).

I’ll file this one under shocked, not shocked. We see this gross behavior all the time.  Quite honestly, this attorney should probably lose their license because they made an illegal payment request.

For your purposes, if you think there’s any chance you are going to need future medical care, before you settle the case, ask your attorney about a Medicare Set Aside.  And if they want more money for doing it, know that they can’t do that.

What You Should Get Paid When You Work Two Jobs

While unemployment is down, many people are working two jobs to make ends meet.  For most people that means one full time job and one part time job, but we do talk to many injured workers who actually work two full time jobs.

Whatever your situation is, there is one VERY important thing you must do if you work two jobs and you must do it before you are injured.

When you have an injury and two jobs, your average weekly wage can be based on both jobs.  This is important because it can greatly increase your benefits.  So if on job #1 you make $750 a week and on job #2 you make $250 a week, if you are hurt on job #2, your benefits could be based off of an average weekly wage of either $1,000 or $250.

The way we determine what wage you will use will be if your employer knew about the other job and was OK with it.  It sounds pretty simple and it is. If they gave you permission to work the other job or more accurately, if they didn’t object, then the wages for both jobs should be considered.

In a case like the one I described, that can result in a difference of weekly pay of around $500 a week and of course would be a much bigger settlement if both wages are included.

To notify your employer of both jobs, it’s best to do it in writing, but in the least it should be verbal and you should document when you told them, who you told and what you said.  The biggest defense we see in these cases isn’t that they didn’t give permission.  Rather the insurance company will say that the employer didn’t know about it.  If you can’t prove otherwise, you lose.

For most employers, the second jobs aren’t a big deal as long as they don’t interfere with the first.  It’s just important that you communicate with them at some point before you are hurt.

Bonus tip.  It’s common practice for insurance companies to say that the wages from your other job should not be included.  They risk almost nothing by saying that to you and it’s just done in hopes of discouraging you.  Don’t get discouraged.  Talk to someone who knows what they are doing and make an educated decision from there.

Questions? Concerns? Want to talk? Fill out our form to the right or call us at (312) 346-5578.  We help everywhere in Illinois.

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