Filing for workers' compensation does not mean a law suit

 
A lot of our callers and clients are thankfully in a good situation with their job.  Yes they sustained a work related injury, but they also enjoy where they work and don’t want to ruffle any feathers.  The common statement I hear is that “I don’t want to sue my employer.”
 
The good news is that filing for workers’ compensation benefits is not a lawsuit at all.  There is never a Judge or jury.  You can have an arbitration hearing if your benefits are disputed, but that is us dealing with the insurance company and their lawyer.
 
We are very sensitive to that fact that most people don’t want to make waves with their employer.  We deal with the insurance company and their lawyer exclusively.  That’s because they are the ones who are really handling the case against you and trying to figure out a way to minimize what they give you.  By getting an attorney involved, even when it appears the insurance company is doing the right thing, you are essentially leveling the playing field to make sure that you don’t get screwed over.
 
It’s really no different than getting help with any other insurance issue you might face be it a fender bender or a dispute with your health insurance company.
 
Not every injured worker in Illinois needs a lawyer and we tell you when you don’t need help.  But if you don’t get one because you are worried about “suing your company” then you are making a big mistake, one that could potentially bite you in  a bad way.

Illinois work comp - When is the insurance company going to pay me?

A reader asks:

 
About 4 months ago I got hurt at work I hurt my knee from kneeling a lot at work from working on equipment I have seen doctors and did 12 appointments of pt and have been released from doctor I lost about 35 hr of work for doctor appointments, haven't heard anything more from workmans comp .I have been done for three weeks now do you think they will pay me for lost time or a settlement?


If this reader is entitled to be paid for missing time from work, that should have been paid already.  Insurance companies often say, “We’ll pay that when it’s time to settle,” but the reality is, that’s not what the law is in Illinois.  TTD payments and medical payments are due ASAP, not when the insurance company feels like it.  Unfortunately, insurance companies are doing this more and more in an attempt to squeeze workers as much as possible.  The good news is that this is an easily problem to solve.
 
As for the settlement, insurance companies don’t just give money away and there is no law that punishes them for not offering a settlement, unlike when they don’t pay lost time or medical bills.  We can force a settlement by filing a trial motion or actually going to trial.  But with changes to the Illinois Workers’ Compensation Act, you’ll find that if you don’t have an attorney that they won’t offer anything or if they do it won’t be very much because they can get away with that.  I don’t say this to scare anyone in to hiring a lawyer.  Like everything else that I write on this blog, it’s the truth.
 
Big picture is to not freak out, but instead make informed decisions.  Almost every problem that comes up in work comp is solvable.  You just need to know what the answers are.

We are workers' compensation attorneys who 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 your situation.

05/19/13

When can an insurance company get away with screwing you over?

Imagine you are up on a scaffold at work and doing some painting when suddenly the scaffold collapses and your ankle gets crushed.  It’s witnessed and your employer and the insurance company agree that your injuries are work related and the insurance company says they will pay for all of your medical care.  So how can they get away without having to pay all of your doctors?
 
The answer is, they can screw you if you screw up.  Let me explain.
 
Under Illinois law, when you are hurt on the job you are entitled to see a doctor of your choice.  If you don’t like what that doctor recommends or has to say you can see a second doctor.  Any referral you get from either of these physicians is considered part of their treatment.  So if the first doctor order a MRI and then some physical therapy and then suggests a surgeon, that’s all part of your first opinion.
 
The problem develops when you don’t get a referral to a new doctor.  Once you are on your third choice, you have to pay for that treatment out of pocket, no matter what.
 
The insurance company isn’t going to warn you about this.  They aren’t going to tell you to get a referral to make it happen.  And if you don’t, you will get screwed over, especially if you like this third doctor and want them to take care of you.
 
It can get even trickier because for accidents after September 1, 2011, the insurance company can pick one of your doctors for you.  You don’t have to see them, but if you don’t it will really limit your options.
 
So the bottom line is to make sure that you always get a referral.  If you don’t it could cost you a ton of money.  And there won’t be anything you or the best lawyer in the world can do about it.

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When the insurance company downplays your injury

When an insurance company downplays your injury – or denies it altogether – it can be incredibly frustrating. Unfortunately, it’s not surprising. Insurance companies don’t want to pay you. That’s how they work. If they can deny your claim or make it worth less, they’ll do it.

In some cases, they look to prove that you already had an injury unrelated to your job. For example, they might say you have arthritis and that’s what’s causing your pain. Even if it’s true that you have arthritis, it doesn’t mean you didn’t suffer a legitimate work injury on top of it. You still should be entitled to benefits for your work injury. In other cases, the insurance company will acknowledge an injury but call it less than what it is. They might describe your injury as a back strain rather than a herniated disc. This makes your claim much cheaper for them.

Clearly, the insurance company isn’t on your side. It can seem like they’re on your side because the insurance adjuster (the person handling your claim) might be very nice. They might call and check in on you, offer to attend your doctor appointments, etc. While these gestures seem friendly, to us they are red flags. The adjuster wants to find a way to deny or lessen your claim, and the more they know about you and your injury, the more likely they are to succeed.

Don’t let anyone from the insurance company attend your doctor appointments. Better yet, let your attorney deal with insurance company. They understand how these companies work, how they handle claims, and how they negotiate settlements. And the insurance company is less likely to give a really low settlement offer to someone who is represented by an attorney with a good reputation. Even if they do give a low offer, your attorney will know that it’s low.

It’s hard, as an injured worker, to know how much your injury should be worth. Don’t be discouraged by what the insurance company says. It’s their job. Just know that you don’t have to accept their assessment and that you can hire an attorney to level the playing field.
 

We are workers' compensation attorneys who 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 your situation.

05/17/13

Do I have to go to the IME appointment?

A reader asks:

 
I injured my back two years ago and had surgery.  Before surgery, the insurance company sent me to one of their doctors, I think it’s called an IME.  I’m still not better and they want me to see the IME doc again.  I no longer live in Chicago as I moved to Indianapolis.  Do I have to come back to see this guy?  Are they allowed to make me see him multiple times?
 
 

An IME is short for independent medical examination.  Under Section 12 of the Illinois Workers’ Compensation Act, an insurance company can send you to a doctor of their own choosing.
 
This reader does have to attend the exam and if he doesn’t his benefits can get cut off.  There is no set limit for how many times they can make you see the doctor, but do realize that every time you go the insurance company has to spend a bunch of money, so they typically don’t do it for frivolous reasons.  That doesn’t mean the doctor isn’t a hired gun, but it does mean that they won’t make you go every week or every month.
 
Typically a follow up IME happens because there has been a change in your condition or because it’s been quite a while since the doctor last saw you and the insurance company is fishing around to see if the care you are getting is still appropriate.
 
If we felt the insurance company was trying to schedule an IME purely to harass you, we’d file a motion with the Arbitrator to prevent you from having to go.  And while we’ve seen that happen and some insurance companies try to pull lots of dirty tricks, the truth is that burdensome IME’s are almost never a problem.  Usually the client just goes because there is no choice under the law and we deal with the results from there.  Often the IME report seals the deal when it comes to winning the case because their doctor will confirm what your doctor is saying.
 
So don’t fret about an IME.  Just don’t miss it or your benefits could get cut off.

Neck injuries can affect many parts of your body

There are nerves in your neck that are connected to other parts of your body, such as your arms. An injury to your neck can affect many things. If you have numbness or tingling in your arm, for example, it could be the result of something you did to your neck. Nerve injuries like this can be serious, so get medical attention as soon as possible if you think you might have this type of injury.

If your neck injury happened while you were working, Illinois law says that you are entitled to workers’ compensation benefits. This means that you can file a claim and get your medical bills covered (100%). You also can get checks to cover some of your lost wages if you are unable to work because of your injury.

The first step is always seeing a doctor. Next, you would file a claim for benefits. Your employer does not pay workers’ compensation – it’s handled by their insurance company. Most employers in Illinois are required to carry workers’ compensation insurance. If the insurance company accepts your claim, they will start paying benefits. If your claim is denied, you can request a hearing to prove that you should be getting benefits (an attorney is very helpful if your claim is denied because they know how to prove your case and how to do so as quickly as possible).

Workers’ compensation covers injuries that occur suddenly, such as when a worker slips and falls, or lifts something heavy, and it also covers injuries that occur slowly over time. These are called repetitive stress injuries. The basic rule is that if your injury was caused by your job then you are entitled to benefits. Even an old injury that is re-injured at work should be covered. If you have questions, talk to an Illinois work injury attorney.
 

We are workers' compensation attorneys who 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 your situation.

05/13/13

Illinois work comp - Independent medical examiners and what they do

An independent medical examiner is not the doctor who treats you for your work injury. Rather, they are a doctor who provides a “second opinion” at the request of the insurance company. Usually an independent medical exam (IME) is requested because there is some dispute about your claim. If you are asked to attend an IME, Illinois law says that you must comply. If you don’t show up, your benefits can be suspended.

When you go to the exam, the examining doctor will ask you a lot of questions about your injury, such as how you got hurt and how you’re feeling now. Usually there is a specific reason that the insurance company has requested an IME. They might be looking to find out whether you can return to work, how severe your injury is, how much your injury is worth, or whether your injury was caused by something other than your job. The doctor will produce a report and may testify to give their opinion.

We recommend taking the IME seriously. It’s important to not be defensive or angry during your IME. Answer the questions as honestly as possible. Don’t exaggerate anything. Be calm and respectful. We believe this approach gives you the best chance at a positive outcome.

It may sound like these doctors aren’t independent at all, and in some cases that’s true. Independent medical examiners are hired by insurance companies, and they often come out with findings on the insurance company’s side. However, not all examiners are hired guns. And thankfully the arbitrators usually know which ones to believe.

It’s very common for your treating physician to disagree with the IME results. For example, maybe your doctor thinks you need surgery but the IME doctor says you do not. This is where the experience of a good workers’ compensation attorney comes in. Your attorney will argue your case to the arbitrators and present your doctor’s opinion in the best way possible. The doctor who has seen you all along, rather the doctor who saw you just once, usually carries more weight.
 

We are workers' compensation attorneys who 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 your situation.

05/11/13

 

Going back to work after an injury

It’s important to not rush back to work after an injury. We understand that you need to get back to your pre-injury income, and back to your routine, but if you return too soon you risk re-injury or a related injury. Further injury could set back your recovery and keep you out of work much longer.

So how soon can you return to work? We recommend following the advice of your doctor. Talk to them about the job duties you perform and whether you are ready to go back. They may advise you to return to work but with certain restrictions. These restrictions might limit the tasks you can perform, and you might not be able to go back to your full job. In some cases, your employer might offer you a completely different job to do during this time.

If you don’t follow your doctor’s restrictions, and you re-injure yourself, your benefits could be at risk. If it’s determined that you purposely ignored the doctor’s recommendations, you could lose your wage loss benefits. In some cases, your employer may not have a job available that complies with your medical restrictions.  You do not have to return to that job if that’s the case. However, if a job is available, and you do not take it, then you can lose benefits.

If the job you can do with restrictions pays less than the job you had pre-injury, there are wage loss benefits you should be able to collect. This is called wage differential, and it’s for a portion of the difference between your current wage and your pre-injury wage.

Going back to work after an injury is a step that you shouldn’t take lightly. Talk to your doctor and your attorney to protect your health and your benefits.
 

We are workers' compensation attorneys who 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 your situation.

5/09/13

Going back to work after an injury in Decatur, Illinois

Workers' comp checks: How much will I get, and how often?

In Illinois, workers who are injured on the job are entitled to certain benefits. These are not paid by the employer but rather by an insurance company. Most employers are required to carry workers’ compensation insurance. After an injury, you file a claim with the insurer.

Illinois law says what workers’ compensation benefits must be paid. One important benefit is essentially a continuation of your paychecks if you can’t work. These checks cover some, but not all, of the money you regularly earn. You can expect the amount of your workers’ compensation checks to be two-thirds of your “average weekly wage.” These checks should be paid regularly, basically on the same schedule as your paychecks would have been. So, in general, you can expect to get a workers’ compensation check every two weeks.

It sounds straightforward, and it should be, but you’re dealing with an insurance company, so there may be delays, miscalculations, denied claims, etc. Don’t get discouraged. If you need help, a good workers’ comp attorney can get you back on track fairly quickly. These attorneys know how the insurance companies work, which puts you at an advantage.

If you think that your wages have been miscalculated and your checks are less than they should be, or if your claim has been denied, your attorney can request a hearing to get things sorted out as soon as possible.

We are workers' compensation attorneys who 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 your situation.

05/07/13


 

Chicago workers' comp checks: How much will I get, and how often?

What if your employer tells you not to report an injury?

There are a lot of misconceptions about how workers’ compensation works, and unfortunately it can lead to unreported injuries. If your employer tells you that you shouldn’t report a work injury, or that you should lie to your doctor about how you got hurt, you don’t have to go along with it.

Filing a claim for workers’ compensation is not going to hurt your employer. The whole point of workers’ compensation is to help you if you get hurt on the job. It pays your medical bills – 100% -- and pays you for lost income if you have to miss work because of your injury.

The money does not come out of your employer’s pockets. Most employers are required to carry workers’ compensation insurance. It’s the insurance company that pays your medical bills and your lost wages. Your employer is not billed for these things.

This misconception may be the reason that a supervisor would tell you not to report your injury as a work injury. Or perhaps they have other reasons. But the bottom line is that you need to look out for yourself first. Further, lying about how you got hurt can be considered insurance fraud.

It is illegal for your employer to fire you or retaliate against you for filing a claim for workers’ compensation. You can and should file a claim. The benefits are there for you, and the purpose is to help you recover, pay your medical bills, and get back to work. Don’t let your employer convince you otherwise. Your employer should not put you in this position. They are asking you to lie, and they are asking you to forgo benefits that you’re entitled to.
 

Nursing home employees injured on the job

People in all types of jobs get hurt while working, but there are different risks depending on the type of job you have, how much you work, where your job is located and what demands are put upon you.

Nursing home employees face unique working conditions that put them at high risk for on-the-job injuries. People who work in nursing homes are at risk for slipping and falling, especially if floors aren’t kept clean and clear of water and other substances. They are constantly lifting and moving patients, moving equipment, and dealing with people who might resist or become violent. On top of that are the dangers of dealing with contagious disease and illnesses.

It might not be surprising, then, that the rate of work injury among nursing home employees is much higher than at other jobs. Even coal miners and construction workers don’t see the same amount of injuries.

The types of injuries suffered by health care employees, and particularly nursing home employees, include shoulder, neck and back injuries. These can occur when lifting a patient, moving heavy equipment, or from slipping, tripping and falling on something on the floor. A slip and fall also can cause knee and head injuries. Another common type of injury is a repetitive stress injury from using the same part of the body in the same way, time and time again. This can happen with repeated lifting, bending, reaching, etc.

If you are a nursing home employee who has been injured at work, the first and best thing to do is get medical attention. Once you know the extent of your injury, you can take steps to heal physically and seek help from workers’ compensation. In Illinois, workers’ comp covers 100% of your medical bills and can pay a portion of lost wages if you miss work while you are injured and recovering. These benefits make a big difference to those who can’t work due to a job injury.
 

We are workers' compensation attorneys who 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 your situation.

05/03/13

Hotel workers face health hazards on the job

Workers’ compensation is for employees who are injured while doing their jobs. For hotel room cleaners, these injuries range from physical strain to contagious illness. When someone is injured on the job they can make a claim for benefits, which include 100% coverage of medical expenses, as well as payment of a portion of lost wages. In other words, if you are unable to work while you recover from a work injury, then you can still get some of your pay through workers’ compensation.

The hotel industry is large, with hundreds of thousands of workers cleaning rooms daily. The responsibilities of the job vary widely and often are physically demanding. In any given day, a hotel room cleaner vacuums, cleans bathrooms and changes bed linens countless times. All of these activities involve repeated lifting, bending and reaching.

In the hotel industry, those who clean rooms are at the greatest risk of work-related injury. In addition to physical injury, these workers are at risk of illness. Cleaning products can cause respiratory illness and skin irritation. Contact with various waste products can expose them to infectious disease. It’s also a stressful job because of the constant physical demands.

Hotel workers are entitled to workers’ compensation benefits if injured on the job. The first step is getting medical treatment. Next, talk to a workers’ compensation attorney about the benefits you’re entitled to, as well as the best way to go about getting those benefits, particularly if you have filed a claim and it has been denied. An attorney can request a hearing and get your claim back on track.
 

We are workers' compensation attorneys who 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 your situation.

05/01/13

Illinois office workers at risk for Carpal Tunnel Syndrome

Workers’ compensation isn’t just for people who do physical labor or work with dangerous equipment. In fact, office workers are at risk for one of the most common types of workplace injuries – Carpal Tunnel Syndrome. Typical office tasks, such as dialing the phone, typing and other repetitive motions can lead to this type of injury.

Carpal Tunnel Syndrome (CTS) is caused by compression of the Median nerve at the wrist. This pressure causes pain, numbness and tingling. If you have CTS, you may have trouble using your fingers and hands the way you used to. Feeling clumsy or dropping things may be signs that you have CTS. If you work in an office, imagine how hard it would be to do your job if you couldn’t type on a computer. This type of injury can seriously impact someone’s job and career.

If you suspect that you have CTS, see a doctor. Tell them what type of work tasks you perform every day so that they can determine whether you have a work-related injury. CTS is most common in people ages 40 to 60, as the problem tends to build up over time. Pregnant women can be at higher risk of CTS as well, but it often resolves after pregnancy.

CTS can be treated with surgery, depending on the severity of the injury. The operation is a simple procedure, often taking as little as 10 minutes. However, the recovery is a bit more significant. You may not be able to work for some time. This is where workers’ compensation becomes particularly important.

In Illinois, workers’ compensation covers 100% of the medical costs of a job injury. It also pays you a portion of your wages while you are out of work. This can be essential in allowing you to get past your injury without ruining your financial stability. After seeing a doctor, talk to an Illinois workers’ compensation attorney to make sure you’re getting all the benefits to which you’re entitled.
 

We are workers' compensation attorneys who 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 your situation.

04/29/13

The most important thing in any Illinois workers' compensation case

Almost every client I talk to wants to know what their case is worth.  Maybe not in the beginning, but it’s natural to think about that and it almost always comes up.  But that’s not the most important thing to think about.

 

The most important thing in your case is by far your health.  You could settle your case for millions, but if you are now brain damaged or paralyzed, what’s the good of that? 

It sounds easy to say, but I’ve seen more and more clients ignoring it.  So here are some rules to live by:

 

  1. Listen to your doctor.  I mean really listen.  If they tell you to stretch, do it.  If you aren’t supposed to go bowling anymore then don’t.
  2. Get a second opinion if your health isn’t improving.  Some doctors just aren’t good at their job.  I’ve seen too many people stick with a crappy doctor because they assume that the doctor must know what he’s talking about.  If you aren’t getting better, remember that this is your life.  Check around for other options.  It doesn’t mean that you have to switch, but it never hurts to have options.
  3. Think about your long term health, especially when it comes to settling your case.  This is a biggie.  When you settle a case, you close out your medical rights for that injury for the rest of your life.  If it’s anticipated that you might need future medical care, the insurance company is supposed to give you a Medicare set-aside which is basically a check for your anticipated future medical needs.  Never settle without discussing this.  Beyond that though, if you are physically as good as you are going to get, but not really better, you don’t have to close out your medical rights.  Instead, you can go to trial and assuming you win, your medical rights will be open for life.  You can still get the money you’d get from a settlement, but you also look out for your health.  So if five years from now you wake up and can’t move your arm (and it’s related to an old work injury) you can get the insurance company to pay for it.  This is huge, especially because health insurance carriers won’t pay for this treatment if they know that it’s from a work injury.
  4. Never settle a case right after you stop your medical treatment.  There is no law on this, but a good rule of thumb, in my opinion, is to wait at least three months after you are finished with treatment to consider closing out your medical rights.  Once it’s done it’s done unless you have a new accident.
  5. Make sure your treatment is with credible doctors.  The cold truth is that chiropractors for the most part have no credibility at the Illinois Workers’ Compensation Commission.  If you’ve got a back injury that doesn’t resolve in a week, you need to see an orthopedic doctor.  If you’ve got carpal tunnel, you should go to a hand surgeon.  If you have a neck or head injury, you are best served by making an appointment with a neurologist.  The chiro or your family doctor should be nothing more than an initial point of treatment, if anything.

Finally, talk to your lawyer about your health.  If you have concerns, share them.  If you aren’t feeling well, let it be known.  Same with your doctor.  Keeping your mouth shut causes people to assume that you are fine and nothing is wrong.  Speak up and look out for your own life.  You have to be your own biggest fan.

We are workers' compensation attorneys who 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 your situation.

4/27/13

 

Illinois truck driver denied benefits for injury while preparing for work

When an injury happens outside of the workplace, workers’ compensation benefits are still available in many cases. It often depends on how close of a connection there is between your job and your injury. Traveling employees, for example, spend a lot of their work time away from their employer’s physical place of business. The law recognizes this and compensates traveling employees for injuries that occur away from the physical work place, as long as the injury happened in the course of his or her employment.

Truck drivers are a good example of traveling employees. If they get hurt on the road, in an accident for example, it’s usually considered a work injury and they can get workers’ compensation benefits. However, insurance companies may try to deny benefits in cases where the traveling employee was injured doing something other than a direct work task.

In a recent case, a truck driver was preparing for his shift by putting an overnight bag in his car at home before driving to the trucking terminal where he would pick up his truck. The truck driver injured his back while putting the bag in his car. Benefits were denied and the Illinois Workers’ Compensation Commission agreed that the driver was not eligible.

We weren’t involved in handling this case, and we disagree with the decision. The Illinois Workers’ Compensation Commission found that the driver’s injury was the result of a personal risk. In other words, that he was at no greater risk for this injury than the general public. It’s a legitimate reason for denying benefits, but it shouldn’t have applied to this worker in this case. In our opinion, the truck driver was at greater risk of this injury than the general public because of his job. When the driver put his bag in his car, he was not doing it for any other reason than for his job, which required him to perform this routine regularly. The general public does not have to lift a suitcase into their car every time they go to work.

If benefits are denied because the insurance company says you weren’t working at the time you were injured, or that your injury happened while doing something that regular people do every day, you need an experienced and aggressive workers’ compensation attorney to prove your case. You need to show that you were at greater risk for your injury because of the type of work that you do. The insurance company will take any opportunity to deny benefits, but that doesn’t mean it’s over.

We are workers' compensation attorneys who 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 your situation.

4/25/13