Illinois work comp – “It could have happened anywhere”

One of the great parts about Illinois workers’ compensation law is the fact that having a pre-existing condition does NOT bar you from bringing a claim if your job aggravates or accelerates your condition.

Every injury has to be looked at on a case by case basis. If you’ve been treating for back problems for years and are currently undergoing physical therapy, it will be hard to state that lifting a box at work was anything more than a temporary aggravation if you notice pain while doing that activity.  The exception would be if you can prove that your back got much worse which would happen through doctor’s statements and usually a new MRI report that shows big changes from an older MRI.

Some insurance companies though try to be sneaky and say that any pre-existing condition bars a new claim and that is simply not true.  Recently I spoke with a really nice flight attendant who had injured her neck five years ago at home, received treatment for about six months and has been fine since.  Earlier this year she was on a plane that had bad turbulence and kind of threw her a bit.  She felt a pain in her neck and then woke up the next day with it feeling worse.  She went to a doctor and is started on physical therapy.  We’ll see where it goes from there.

Clearly this is a case where even if she had a pre-existing condition, it was recovered and she had been doing fine until the turbulence issue. She reported it to work and then got a call from an insurance company rep who heard her story and said that they were denying the claim because “it could have happened anywhere.”

In other words, they are trying to say that her neck was so brittle from the old injury that it was just a ticking time bomb waiting to go off.  The problem with that statement is:

1. They are not doctors and are making medical conclusions.

2. Common sense tells you that what they are saying isn’t true as she’s been working without problems for four years.

3. It didn’t happen “anywhere” it happened while she was doing her job.

So too bad for them.  To me this is a clearly compensable claim.

I told my caller that it’s just common insurance company strategy to try and frustrate an injured worker and make them go away.  They might even believe their own b.s., but while they do hold the checkbook, they are not the Judge and don’t have final say over any of this.

So don’t be frustrated or take their word for it.  It’s sad, especially because this is your life on the line when you are injured, but to a lot of insurance companies this whole process is just a game.  You have to play the game, but you don’t have to follow their rules.

This Chicago work comp lawyer’s advice on voc is a joke

In most Illinois workers’ compensation cases, you get injured, you get treatment, you get better and you get back to work.

Sometimes you get seriously injured and are left with permanent restrictions.  This usually means that your doctor is restricting how much weight you can lift (common for back injuries).  Other times they may limit your overhead work (common with shoulder surgeries that don’t go well) or reduce your walking/standing (leg injuries).

If this happens to you and your job can’t accommodate these permanent restrictions, you might get vocational rehabilitation.  Depending on your age, education, job history and professional goals, it’s possible that the insurance company will have to pay for someone to help you look for a new job or even pay for you to go back to school so you can start a new career.  Every case is different so while a 65 year old worker isn’t going to be sent to college, it could certainly happen with someone in their 20’s and 30’s as long as there is a realistic plan that makes sense based on what happened to them.

Recently I was called by a laborer who had a lawyer, but was giving advice that caused him some concern.  The worker had a major injury and could no longer go back to their old job where they were making around $30.00 an hour. The lawyer, who has limited experience practicing work comp law, told him to quickly get the lowest paying job that he could find.  He went on to say that by doing this it would increase the value of the case and prevent the insurance company from providing vocational rehabilitation.

That advice was unfortunately way off base.

First off, you can’t prevent an insurance company from offering vocational rehabilitation by saying “the only job I can get pays minimum wage.” The whole point of voc is to show what you can earn. Second, this worker should want to get voc rehab because he has a desire to go back to school and since he’s younger there’s a great chance that the insurance company would have to pay for it.  He could continue getting benefits while he receiving training which would better him in  the long run.  Finally, if the worker were to say that they could only make minimum wage and an Arbitrator didn’t find that to be credible, they could actually cause their case to lose value.  In this case the lawyer wrongly said that doing this tactic would increase what the case is worth.

I don’t think the lawyer is a schemer, just young and poorly trained.  This does demonstrate why I never recommend you hire a green lawyer who doesn’t have proper experience or guidance, especially for a bigger case.  A good defense attorney will run circles around someone like that and the only person who will suffer as a result is you.  You don’t want your attorney to get his/her training by practicing on you.

The only silver lining for this caller is that they can switch lawyers at no cost to themselves right now or armed with their new education see if a more experienced lawyer at their firm can take it over.

You definitely have to watch for insurance company scams.  But if your lawyer seems to be trying to pull a fast one then it probably isn’t going to fly either.

IL work comp – “If you don’t sign this paper, you don’t get benefits”

Insurance companies are always coming up with different ways to try to trick people out of their Illinois workers’ compensation benefits. The problem usually is that when an accident is initially reported, it goes in to the hands of an insurance adjuster who gets to call all of the shots on a case unless the injury turns out to be really severe.

As a result, some of these insurance company employees have free reign to try and  lower the value of a case or eliminate it all together. Doing a “good job” at this is how they get bonuses.  So some of them will get creative in their attempts to look out for their bonus efforts and not for you.

I heard a new one the other day from a caller who had fallen on some wet stairs and injured her leg.  It was a clearly compensable case and her doctor had recommended physical therapy for her.  She went to a couple of sessions and then suddenly the insurance company told her that they wouldn’t pay for any more physical therapy.  Was it because one of their doctors said that she didn’t need it?  Nope.  Did she fail a drug test?  Uh-uh.  Did someone dispute how the accident occurred?  Wasn’t that either.

What it was is that the adjuster wanted her to sign some forms and said that without the forms being signed she was not allowed to have a case.  I don’t know what the forms were, but I do know that there is no law that requires this to happen just as you don’t have to give a recorded statement as to how your injury took place nor do you have to sign a medical authorization which allows the insurance company to see any medical record from any doctor you’ve ever seen.

Many of these insurance companies operate under the “it can’t hurt to try” theory of business and sadly they are right because too often they bully around injured workers until a competent work comp lawyer steps in to stop them from taking advantage of good people who just want to get better and get back to work.

The other reason this type of stuff happens is that it’s legal in other states as many places like Indiana and Texas seem to have laws that give workers no rights at all.  Some adjusters work in multiple states and take the approach of “if I can do it there, I’ll do it in Illinois.”  That of course makes no sense either and doesn’t change what our laws are.  But it should let you know what you are up against and provide a warning to be aware and not assume that what they tell you is true.

“You should be better by now!”

If you regularly read my blog you know that I don’t give medical advice. I might tell you about similar cases I’ve seen in the past, but I don’t try and diagnose anyone or especially tell them what type of treatment they should have.  The farthest I’ll usually go is to tell someone who has a back injury with pain shooting down their legs that it sounds like they have a herniated disc and that they should see an orthopedic doctor to make sure.  I’m OK with that for two reasons.  First, it’s pretty much similar to telling someone who is sneezing that it sounds like they have a cold.  In other words it’s an obvious statement that is usually right 99% of the time. Second, if you delay too long in seeing the right type of doctor you can cause yourself some serious, long term damage.

A recent caller to our office suffered what sounds like a serious shoulder injury.  She has seen an orthopedic doctor and been going to physical therapy. An MRI has been recommended but hasn’t taken place.  In fact it was denied by the insurance adjuster.  When the worker called to find out why it was denied, the adjuster was very rude and said, “Look kid, I’ve been doing this for 20 years and I’ve seen a lot of shoulder injuries. I’ve seen your medical records”  She then screamed, “You should be better by now!”

Uhm, yeah, right.

This would be laughable if the adjuster wasn’t messing with the health of the injured worker.  She may have handled thousands of claims over the years, but the arrogance by a non medical doctor to tell our client that she should be all better by now is stunning.

I don’t believe in this case that the adjuster was trying to do anything other than pull a fast one and get the case closed.  But I’ve seen other times when adjusters really believe that they can draw medical conclusions based on reading the records or just their “gut feeling.” For most of them, their knowledge is limited to what they’ve seen on the job and some training seminars that discuss various injuries.

Whatever the reason or the motive -which in my experience is most often bitter people who don’t like seeing anyone have a claim – this type of activity violates the Illinois Workers’ Compensation Act and is not a valid reason for denying medical care.

It almost sounds like it’s nuts that this could happen, but sadly it happens all of the time in one way or another.  Selfishly it keeps lawyers like me in business.  But I’d gladly go out of business if it meant that people were being treated fairly and the law was being followed.

Does any Illinois employer care less about their workers than these guys?

Although I work for myself, I’ve had great employers in the past save my first law firm boss who was the classic entitled rich kid type who acted as if he created the firm that he inherited from his Dad.  But most places I’ve worked were run by good people and I believe my employees, many who have been with me for a long time, would tell you that I’m a good, fair boss.

Of the injured workers I talk to, most work at good places as well. Some are worried about what their employer will think and we make clear that we deal with the insurance companies.  Others though try to get their employees to lie and say that they weren’t hurt at work with fake promises that they’ll cover the bills.  That might work on a one time ER visit, but certainly won’t if you have surgery.  Still other employers will insist that their injured workers see their friend who is a doctor for medical treatment.  None of that is legal.

To me though, the worst employers in Illinois are temporary agencies.  By the nature of their work, they don’t really care about the relationship with the employees and having them stick around for a long time because day in and day out they aren’t dealing with you.  They are more concerned about the business where they placed you because that is where there money comes from.  It’s a bottom line world.

On a listserv I’m on, an injured worker reported a story that seems all too common with temp services in Illinois.  He reported a work injury and they immediately accused him of faking it.  They of course weren’t there when he was hurt because he doesn’t work at their facility.  He’s in physical therapy and a MRI has been recommended, but they are refusing to turn the case over to their insurance company who would pay for the treatment.  Basically they are trying to delay and make him go elsewhere.  It’s a lame and illegal tactic.

In this case they also told him that if he doesn’t get back to work soon he won’t be legally entitled to anything and his bills won’t get paid.  They also lied and got a co-worker who he barely knows to write out a statement that he’s been partying hard which is another lie.

He wanted to know what to do since it’s been a month and nothing is paid.  It’s a simple answer.  He needs to formally file a case as that will force their hand and stop them from acting as if they are a Judge and can decide what he should get and what he shouldn’t get.  That’s not their job and if he doesn’t hire an attorney he’ll continue to get bullied and taken advantage of.

I’m a business man and I like to make money for me and for my clients.  This bottom line (illegal) behavior by these temp agencies really pisses me off though.  We all can agree to disagree on any issue.  However when you try and manipulate someone for your own good, it’s crossing the line.  And nobody does it more or worse in my experience than these employment agencies.

No matter your situation, don’t let anyone ever take advantage of you.  If you’d like to discuss a case, find an attorney or just have general questions, call me at any time for a free consultation at (312) 346-5578 or fill out the contact form on the right of the page.

Illinois workers’ compensation – are you getting everything you can?

I got a call the other day regarding a workers’ compensation case that we began working on in 2010. It was actually a guy that did not have an Illinois case, but instead had a claim in New Jersey so I referred him to a lawyer that I know there who meets my selection criteria for recommending a lawyer (experienced, aggressive, great customer service).

He was calling to let me know that the client had just won over $2 million from a medical malpractice lawsuit related to the work injury. The worker hurt his back pretty badly and had to have a spinal fusion.  While no surgery guarantees a result and there are risks with every surgery, when you have a fusion it can be medical negligence if they insert the fusion screws in to your nerves. It can lead to something called failed back syndrome and it’s often irreversible and always very painful and disabling.

What makes this NJ lawyer great is that he recognized the potential issue here and got it in the hands of a top notch med mal lawyer to bring a lawsuit.

I’ve cringed over the years when people have come to me years after they’ve had a spinal fusion that’s gone wrong and want to talk to me about workers’ compensation and how they aren’t happy with their case.  Because I try to analyze every issue, I always ask if they’ve had anyone look in to a lawsuit against the doctor.  You wouldn’t believe the number of times I’ve gotten a response like, “I asked my lawyer about that years ago and he told me that I wouldn’t have a case” or “My lawyer referred me to the doctor and told me that I can’t sue him if he’s treating me for a work injury.”

It’s all nonsense and shows the danger of when your lawyer values his buddy-buddy relationship with your doctor (who sends them business) more than they do with you the actual client. There’s also a danger when an attorney fails to look in to every possible angle to a case.  Another common example is when truck drivers get injured because a load shifts causing their truck to tip over.  It happens all of the time.  If the load was put in place by a different company than the one the driver works for then they may have a lawsuit against that company.

Problem is that many law firms are lazy or incompetent and don’t look at these other related issues.  There are statutes of limitations for any and all of these lawsuits and if you wait too long then your case will be barred forever.  In a failed back surgery case that could be a difference of millions of dollars and a lifetime of care.

Is this nurse’s union acting in the best interests of their members?

The other day a Chicago nurse called me hoping that I or someone I know could take over her workers’ compensation case. I asked her who her attorney was and had never heard of anyone in Chicago who handles work injury cases by the same name. I told her that I had heard of a lawyer by a similar name in Springfield, but since she lives and works in Chicago I assumed it wasn’t him.

She then let me know that she did hire that Springfield attorney.  I asked her why she did that and she told me that her union told her that she had to.

That makes no sense of course.  First off, your union shouldn’t care who you hire.  They only recommend lawyers, in my experience, when they are getting entertained by them or receiving gifts.

But in this case they were insisting that she use an attorney who is three hours from her house.  That of course makes it hard for him to go to court here and is a sign that he probably doesn’t do much work up in Chicago anyway.

I’ve been asked to handle downstate cases and I always tell them that my partners down there are much better choices than me. I say this because it’s true.

So why would a union insist you have to work with a certain lawyer, especially when the attorney is no where near where you live?  I haven’t verified that this is true or that she just felt pressured to hire them, but I’ve also heard similar stories.

Whatever the reason, they don’t seem to be acting in the best interests of their members.  I’m a union proponent and love union clients.  One thing I’ve learned over the years is that just like their are good law firms and bad ones, the same is true for unions just as it’s true for politicians or any other profession or organization.

You typically know if your union does anything for you or not. If they don’t come through with you on normal day to day stuff, they won’t come through when you are in a time of need either.

Are you willing to share your story? It can be anonymous.

An author contacted me looking for someone to share their experiences going through workers’ compensation.  If you are interested in learning more, read on.  Her contact info is below as well.

Mike

 

Hi Michael,

Here is some more info on the story.

It will be a profile on someone who received workers’ comp. Here are some
questions I’ll ask:

1. What happened to the person when they got hurt?
2. How did they claim workers’ comp?
3. What is the process for applying for it?
4. Does the process differ depending on the state you live in?
5. How did the person make sure they were properly compensated?
6. What are some things they wish they had known ahead of time?

Here is the website the story will appear: http://www.howmoneywalks.com/

Here is a profile I wrote for the site:

http://www.howmoneywalks.com/jessi-fearon-being-a-mother-while-breaking-out-of-debt/

Deadline for answers either through email or to set up a phone interview is
next Friday at noon EST. And before would be better!

Thanks,
Laura

*Laura Agadoni*
*Writer & Editor*
770.363.7818
lagadoni@gmail.com
www.LauraAgadoni.com
<https://twitter.com/lauraagadoni>
<https://www.linkedin.com/pub/laura-agadoni/27/34b/295>

This is the best lawyer in Chicago (but not for you)

I read recently about a lawyer in Chicago who is doing amazing work.  He’s raised more than one million dollars for charity through his love of playing the piano.  He’s rather accomplished and puts on concerts all for the benefit of others.

This summer he’s playing 16 countries in 37 nights, all for the benefit of others.  It’s very noble and while I try to be a good person, it’s certainly more noble than anything I’ve done.

But what I do much better than him is be there for my clients. You can’t return calls very easily if you are half way around the world.

I’m all for attorneys having their own life and in my free time I coach youth sports and have run 10 marathons plus countless other races.  But it’s never interfered with my ability to help the people who reach out to me.  I travel, but when I do my cell phone is attached to my hip and I’ll always break away to call people unless I’m driving a car.

I’m not that unique and I know many other lawyers who do the same.  In fact, those are the ones who we recommend in our state wide network.

But I also know plenty of attorneys like this great piano player.  It’s clearly his passion and something he’s great at.  Good for him and good for anyone else who chases their dream.

Not good for you though if you are depending on an attorney to perform work for you.  They can’t be in court if they are in France.  They can’t meet with you either.  You can’t expect a lawyer to be at your beckon call 24/7, but you also shouldn’t expect that they’ll be gone for more than a month.

I imagine and hope that this attorney told potential new clients of his travel plans and worked it out with existing clients. Too many firms I know though have lawyers who take off for a winter or many weeks at a time.  I’m a soccer nut and would love to watch matches in England for a month.  But aside from not being acceptable to my wife, it would not be a good business decision as it’s no way to run a business.

So before you hire an attorney, don’t be afraid to ask about their plans and availability and who will cover for them when they are gone.  If it’s not a good answer go to the next person on your list until you get it right.

Is your doctor a pill pusher

A lawyer I’m friends with was complaining about a Chicago workers’ compensation attorney who has kind of a sleazy way about himself.

The complaint though was that the lawyer pushes most of his clients to a certain doctor who has a pretty bad reputation at the Illinois Workers’ Compensation Commission and is known as someone who aggressively recommends surgeries – which of course makes him a lot of money – when conservative medical care could solve a problem.

The bigger issue though is that this doctor is also known for prescribing a ton of pain medication to his patients and then having them fill those prescription orders at a pharmacy he runs.

I’m of course pro-injured worker.  Part of being an advocate for workers is calling out the bad actors that are on your side.  If you don’t then you are no worse than the politicians who support every issue and everyone in their party no matter how awful the position is.

This doctor is dangerous. It’s a clear conflict of interest for him to prescribe medicine that is often very expensive when he stands to make a profit from those medications being purchased. As much as you don’t want to have a surgery you don’t need, it’s far worse to become addicted to prescription pain meds.

Unfortunately, addiction is all too common and not talked about enough.  If you have a fusion or other invasive surgery, you are going to be in pain afterwards and medication will likely be needed.  But if your doctor isn’t closely monitoring your intake, you can go from a family man/woman one day to an addict who has ruined their life in no time.

Just as we advise you to look out for warning signs from a potential lawyer, you need to do so with doctors as well.  Some lawyers like to direct their clients to doctors because the doctor will in turn refer his injured patients back to the lawyer. You need to avoid these types of arrangements as they are clear warning signs of people who do not have your best interests at heart.

When it comes to pain drugs, most doctors are on the look out to make sure pills aren’t being abused. If your doctor wants you to take a bunch of medication and then wants you to fill it up at his pharmacy as compared to a Walgreens or a CVS (and remember, work comp insurance pays for everything) then something is really wrong.

If you do notice that you really are needing the pills, don’t be afraid to seek help.  In fact, if you do get addicted and it’s from treatment for a work injury, the insurance company would have pay for any rehab if God forbid it came to that point for you.

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