IL Work Comp Settlements- This Makes No Sense

I recently had a consultation with a very nice injured worker who had a very serious injury case.  They really liked their lawyer, but for some reason he wasn’t very aggressive when it came to doing something about the tens of thousands of unpaid medical bills that he has.

This worker appears to be permanently disabled and while the lawyer had been mentioning that he’d recommend a settlement for a certain amount, out of the blue he called him with the offer from the insurance company and told them he needs to immediately accept it.  He says this even though that amount is around $50,000.00 less than what he previously said the case is worth.

I don’t have enough information to tell you if the offer was a good one although from what the caller told me it seems like it was within the range of fairness.

What makes no sense is that the lawyer told him he had to immediately take the offer.  This case is many years old and suddenly there is some urgency?

I can tell you that I’ve never seen an offer be taken off the table unless new evidence arises.  There should never be a rush to take a settlement, especially in a case like this where the worker is getting TTD benefits still, has outstanding medical bills and will need what is called a Medicare Set Aside to pay for his future medical needs.

Beyond that, before any injured worker signs a settlement contract, they should know very clearly from their lawyer all of the details.  In this case, the caller did not.  He wasn’t sure what the lawyer fees were going to be.  He didn’t know the expenses that the lawyer was claiming.  It wasn’t clear if the lawyer was going to try to take money from the Medicare Set Aside.  It wasn’t 100% clear what medical bills remained unpaid.

Everyone wants to settle a case if they can.  I don’t get paid if I don’t settle your case or win at trial.  I and every lawyer I know likes to get paid. But an attorney in Illinois work comp can’t rush through a settlement so they can get paid.  The best interests of the client must always come first. It’s not in the best interests of the client to agree to a dollar amount and worry about the fine print later on.

You are the boss of your case.  You are the one that has to be happy and live with the result.  Don’t let anyone pressure you or rush you.  If you aren’t happy with a settlement offer then you should wait or go to trial.

The Importance Of An Experienced Work Comp Lawyer

Despite what some lawyers will tell you, handling most workers’ compensation claims isn’t rocket science.  If you know what you are doing and will put in the work needed to make a claim successful, things usually work out well.

While it isn’t complex, Illinois workers’ compensation laws also aren’t basic.  By that I mean that there are a lot of exceptions and variables that will obvious to someone who handles these cases every day, they aren’t as obvious to a lawyer who only dabbles in work injuries.

If your case does need a lawyer, I can’t emphasize enough the two things needed to make sure that you are hiring the right firm.  1. You need someone who will work hard.  This is harder to figure out, but if they don’t return your phone calls, don’t do anything to get your benefits reinstated, allows the nurse case manager to walk all over you, etc. then you’ve hired the wrong firm.

The second thing needed is someone who is experienced.  This means you don’t want the law firm that is run by a lawyer who has handled work comp cases forever, but is going to let some kid who recently graduated law school work on your case.  It also means you want someone who isn’t also doing car accidents, medical malpractice, divorce or whatever else walks through the door.

None of this guarantees a result, but it increases your chances of success.  This was evident in a recent call to our office by a very nice woman whose husband had died of a heart attack while working.  Those are tough cases because most people who this happens to have some sort of blockage or other heart problem which will always be used as a defense to paying out a claim which in this case would be worth at least $500,000.00 if successful.

To win a  case like this you need to prove that the job duties were a part of the heart attack happening and aggravated any pre-existing condition.  In most cases that means that you were working in extreme heat or cold, doing a ton of heavy lifting or experiencing something else which is extreme.

You also need to know who a credible cardiologist is to testify that yes the job duties did in part lead to the the death happening.  An experienced attorney will have handled many similar cases in the past and will know which cardiologists testify well and which ones are not as respected.  Again this doesn’t promise a win, but it greatly increases your chances.

In the case that came to our office, there is a lawyer in our network who has handled more heart attack cases than any other lawyer I’m aware of and has taught other attorneys how to handle these cases.  That is the type of experience you want/need in your corner.  I think this client will win, but if they don’t it won’t be because their lawyer didn’t know what they are doing or didn’t put in the work.  That’s all any client should hope for.

If you want our guidance with your Illinois work injury case or just have questions, fill out our contact form to the right of this page or call us for free at (312) 346-5578.  We help injured workers everywhere in Illinois.

Illinois Workers’ Compensation Settlement Days Are Coming

I’ve written on this in the past, but it’s so important that I have to write about it again.

Insurance company adjusters make money off of bonuses based on how many cases they close.  So when they deny your injury and you go away that’s a win for them. But it’s also a win for them when they actually settle your case.

During the normal course of the year they aren’t motivated to close out your case because they aren’t thinking about bonuses in March or April.  At this time of year, however, the adjusters know that if they settle your case and many others it could mean more spending money in your pocket. As awful as some insurance companies can be on Illinois work comp cases, the reality is that at the end of the day most insurance adjusters could care less how much you are getting if it helps their bottom line.

I just received the first mention of a settlement day from a very large employer.  They are looking to settle all cases below a certain dollar threshold (in my experience that usually means the low six figures) before the end of the year.  To do so they need to start negotiations now because contracts have to be submitted to an Arbitrator with signatures from all parties and ALL issues, including outstanding medical bills, must be worked out.

This is not to imply that they are just giving away free cash or paying way more than the cases are worth.  It also doesn’t mean that you should settle.  That depends on where you are in your medical treatment and how fair an offer is as well as your employment status.

What it does mean is that if you have been discharged from medical care for a while and back to work without problems, there is no excuse for your attorney to not get the case over with. Insurance companies are literally doing whatever they can to close out cases.  So if your lawyer says they aren’t getting a call back or that they can’t get an offer, you might have a reason to be skeptical.

If you don’t have a lawyer, be careful.  For starters, you’ll be told that your case is based off of an AMA rating which is a low-ball tactic to avoid paying you what the case is worth.  If you do get a settlement offer before you get an attorney it can be hard to get a lawyer to take on the case when you realize the offer is unfair.  So you may be stuck with an insurance company that won’t offer you any more and no legal help to get a better result. Bottom line is that you will almost always get more with an attorney than without even when our 20% fee is considered.

If you have questions about what your case is worth or anything else related to Illinois job injuries, fill out the form to the right or call us at (312) 346-5578 for a free consultation. We help everywhere in Illinois.

Is Your Doctor Board Certified?

I tell people all of the time that if you want to have a successful Illinois workers’ compensation case, there can be nobody who cares about what happens to the case more than you.  That doesn’t mean that you need to obsess about it.  What it does mean is that you have to be invested in the process and making sure that not only are you following doctor’s orders, but also that you are going to the right type of doctor for your injury.

Most people think that they only have to worry about hiring a good lawyer and that a doctor is a doctor is a doctor.  That’s just not true. It’s generally held in court that for back, arm, hand, foot and leg injuries, an orthopedic doctor is much more credible in treating the problem than a chiropractor or regular family physician.  For neck and head injuries you want to be with a neurologist.  Sometimes you need a pain specialist.  While your lawyer can guide you to credible physicians, you have to be on the lookout for red flags too.

So what do I mean?

When you go to hire a lawyer, if your slime factor radar is going off and you still hire that attorney, you bear part of the blame when things go south.  The same holds true when looking for a doctor. Most doctors are credible and really just want to take care of patients.  Some, however, are clearly businessmen first, doctors second and the number of people in their waiting room and general disorganization reflects that. If they only give you a minute or two of their time, you know it’s a bad sign.

There are more subtle ways that you can verify if a doctor is good for your case too.  You need to find out if they are board certified.  While it’s not a requirement for them to practice medicine, it does seem to reflect their competence and certainly their credibility if they ever have to testify in your case.  Put another way, you don’t want to lose your case because you chose to treat with a doctor who is not board certified.

A doctor down in Normal was recently threatened by a Judge for providing misleading testimony about his lack of being board certified (see http://illinoistimes.com/mobile/articles/articleView/id:17380). I’ll never forget taking the deposition of a doctor who had failed his boards multiple times and wouldn’t admit that he wasn’t board certified but instead only said over and over that he was “board eligible.”  Soon thereafter an Arbitrator made it known that she would never trust anything this doctor says or award the huge bills that he runs up on his patients.

This might sound like a lot to handle and we can certainly help you through this process.  We don’t know every doctor out there, but we do know a ton of great ones.  This is one reason why we set up a state wide network. Having good attorneys throughout the state allows us to tell callers who is good and credible in their local area.

If you would like help with a case or just have questions, fill out the contact form to the right or call us at (312) 346-5578.  We help everywhere in Illinois.

“Is my injury work related?”

A lot of times the callers to our office don’t even know if they have a case.  Often they notice pain while working or someone has told them to look in to work comp benefits, but they haven’t had a specific accident. In other cases they are told (usually by an insurance adjuster) that they don’t have a case due to a pre-existing injury.

So how do you know if you have a case?

There are a lot of exceptions, but generally speaking you can bring a claim if you can prove that your job activities caused, aggravated or accelerated your physical problem.

The key word here is “OR.”  In other words if you have a pre-existing condition, but a job accident or activity accelerates that problem, you still can get benefits.  Now if you’ve been treating weekly for back pain for six months and then claim you hurt your back worse today at work, you’d need something along the lines of before and after MRI’s to prove your case.  On the other hand, if you last saw a doctor for back pain four months ago and had no appointments scheduled to see your doctor, if your back popped while lifting a box today, you’d have a much stronger case.

If you re-read that last paragraph, it in a nutshell explains that you win if you can prove your job aggravates OR accelerates a problem.  So how do you prove it?

The best and often only way to do so is to have a credible medical doctor write a report that states your condition was caused, at least in part, by your job duties.  This is usually where a lawyer comes in.

Most doctors don’t know the law and can actually torpedo a case due to their lack of understanding. Attorneys will either draft a letter to the doctor explaining the law or instruct the injured worker exactly what to ask. We don’t want the doctor to lie, we want the truth.  But the truth has to be based on the law in Illinois.  For example, if you have a hurting back and ask your doctor did your job cause your back problems, they’ll probably say no if you are older, overweight or have any history of back trouble.  And they’d be right.

On the other hand, if you asked the same doctor if your job duties contributed to your back problems and made sure to explain what you did on a daily basis, how often you did it and how long you’ve been doing it for as well as what you notice when doing that job, it’s much more likely that the same doctor would agree that your job contributed to your condition.

That explanation of the law is often the difference between winning and losing a case.  And if your injury is from repetitive trauma like carpal tunnel syndrome or degenerative disc disease or if you’ve ever treated for the same problem, you need your doctor to understand the law if you want to win benefits.

When Your Employer Won’t Tell You Who Their Insurance Carrier Is

It’s a law in Illinois that employers are supposed to post signs in common areas about certain State and Federal laws and rights of workers.  Included in that is listing who their workers’ compensation insurance carrier is.  It’s a felony not to carry insurance for work injuries in Illinois.

Despite these laws, every now and then we get calls or e-mails from injured workers that go something like this:

“I got hurt at work and was sent to urgent care.  When I got there they asked for my insurance info. When I told them I was hurt while working they told me they needed to know who the work comp carrier was.  I called my boss and he refused to give it to me. I left without seeing a doctor because I have no insurance and can’t afford the bills.”

What happens in these cases is either the injured worker pays his/her own medical bills which shouldn’t happen if they were hurt at work or they delay their medical care for so long that either the injury gets much worse or when they finally get to a doctor it’s impossible to prove that their injury is related to the work accident.

So what do you do in this situation?

  1. Nothing’s more important than your health so at the very least go to an emergency room or some other doctor.  If your injury is work related 100% of your bills will be covered.  No co-pays, no out of pocket expenses.
  2. You can call us or any other reputable law firm and we can look up who your employer’s insurance carrier is. We just need either their name or the tax ID number on your check.  It’s a free lookup.  Often people run multiple businesses under one corporation’s name so some times it takes a little digging.
  3. It’s a felony to not carry insurance for employees if you have any employees.  While it’s possible your boss is breaking the law, there is a fund for injured workers in Illinois to help compensate victims in this scenario.

In almost every case we are able to find insurance and get benefits paid.  But no matter what you should go to the doctor because if you don’t it will hurt your chances for having a case and more importantly you can make a minor injury turn in to a long term problem if it’s not addressed right away.

Bonus tip.  Beware the employer who tells you that they’ll pay for your medical bills if you report to the hospital that you didn’t get hurt at work.  This is almost always a lie and will likely lead you to not having anyone who can pay your bills.  Don’t do it. It’s a nasty trick.

As always, if you have any questions about any of this, call us for a free consultation at (312) 346-5578 or fill out our contact form to the right and we’ll call you.

Pain and Suffering and Illinois Work Comp

A month ago someone asked me if they could get pain and suffering after injuring themselves at work. I get this type of question a lot especially when someone is injured through the negligence of their employer.  For example, if you are walking down the hall and step on a loose floorboard which causes you to fall and tear your rotator cuff, you’d be pretty pissed and probably want to sue your employer.

Unfortunately pain and suffering are not allowed under the Illinois Workers’ Compensation Act.  You are barred by law from suing your employer for general negligence due to injuries sustained while working.  Pain and suffering only happens in lawsuits, so no lawsuit, no pain and suffering.

That might sound unfair, but in exchange for workers giving up their rights to sue their employer, they do not have to prove that their employer was at fault when they got injured.  In other words, if your back pops when lifting a box on the job that may be from bad luck or bad lifting form, but it doesn’t sound like anyone really is to blame.  You still have a great Illinois work comp case though because as long as you were injured while performing your job duties in a reasonable manner, you are entitled to benefits.

There are about 45,000 claims filed every year in Illinois and if you had to prove fault in every one of them my guess is that there would be only a few thousand cases.  You certainly wouldn’t see claims for injuries like carpal tunnel or other repetitive stress injuries. It would be terrible for workers because so many of you would be injured with no job and no income or way to get medical care.

While the benefits you get in a work comp case aren’t usually as high as in a normal personal injury claim, they do compensate you for your medical bills, lost time and while there is no pain and suffering per se, you do get a settlement for the permanent nature of your injury even if you are feeling back to normal when your medical care is over.  So it may not be called pain and suffering, but in a way it gives you a lot of the same things.

One caller wasn’t having it with my explanation and told me how unfair this all was.  I get that it seems that way, but the reality is that our system is way better for injured workers as a whole than if you could sue, but always had to prove fault when hurt.  It might not have been the best for that one caller, but for 95% or more of injured workers it clearly is.

Declaring War On The Insurance Company

Here’s a good story that’s making the rounds of the Illinois Workers’ Compensation Commission.

There is a lawyer for injured workers who has a reputation of a hot head. Apparently he was mad at an insurance company and their law firm and told an attorney at the law firm that he was “declaring war on them” and would never settle a case with them again.  Everything is going to trial.

It’s one thing to say something like that in the heat of the moment. It’s another to actually do it.  Refusing to consider settling your client’s case because of a personal beef on another case is not only bad lawyering, it’s legal malpractice and probably an ethical violation that could lead to the lawyer having his license to practice suspended.  Can you imagine your lawyer telling you that your case is worth $100,000.00 and the insurance company is offering that, but you can’t take it because they were mean in another case.

Being a lawyer is somewhat like being a politician.  You have to have thick skin.  I’ve had attorneys piss me off greatly over the years. I’ve learned not to trust some, but that just makes me cautious, not willing to refuse to even talk on a completely different case.  Nobody in my state wide network would act any other way.

Back to the story.  So this lawyer declares war and a few days later has a case that is up for trial, but shouldn’t go to trial because he’s not ready (doesn’t have all of the information that he needs to go to trial) and apparently his case isn’t that strong.  The Arbitrator advises him against going to trial, but he insists even though there is a settlement offer on the table.

As you can guess, the trial went forward and the Arbitrator found in favor of the insurance company leaving the injured client with nothing.

We consider ourselves fighters and do whatever we can for our clients within reason.  “Fighting” for your clients to me actually means getting the case ready for trial when it needs to be tried and going to trial while pushing for EVERYTHING that the client is entitled to.  Defense attorneys aren’t afraid of loud mouths. They are afraid of smart, prepared attorneys because they know that means they have their work cut out for them.

If you see that your lawyer is yelling at his secretary, co-workers or even you, that’s a sign of how they treat people in their life.  It might work out in your case, but if they are pissing off enough people instead of really fighting for their clients it may come back to hurt you even though you did nothing wrong. You become guilty by association.

Happy Labor Day!

No post today, just thanks to all of our clients.  We created our state wide network of lawyers more than 15 years ago and have been able to help thousands of wonderful people. Safe and happy Labor Day to all of you.  New post on Thursday.

Why Won’t Your Lawyer Answer Basic Questions?

We’ll talk to anyone for free at any time about Illinois workers’ compensation law.  We are happy to do it and will always give you an honest answer even if it’s not what you want to hear.  Telling you the blunt truth helps you and is the right way to practice law.

I’m amazed at how many lawyers lie to their clients because they don’t want to have a “hard” conversation about why the client might not have a case or what the case might actually be worth.  Others for whatever reason simply don’t answer questions by either not returning phone calls or telling the client not to worry about it.

I just don’t get it.  That’s what a lawyer is getting paid for!  If we won’t give advice, what’s the point?

A nice woman called me because her lawyer wouldn’t or didn’t answer her questions.  She had an arm surgery and her doctor gave a deposition in the case.  Her lawyer wouldn’t tell her why the deposition was needed (it’s to get his medical testimony in order to go to trial). He wouldn’t tell her what compensation she’d get if she won at trial.  He wouldn’t tell her what the next steps were after the deposition.

I was able to answer all of these questions except the one where she wanted to know the likely outcome. Since I don’t know the possible defenses that’s one I couldn’t help her with.

The only question I had for her is why are you staying with this lawyer?  Some attorneys are great at trial, but terrible at customer service.  More often than not though it seems that the lawyers who are disorganized or rude with their clients don’t do much better when it comes to the actual trial. I can’t imagine that the lawyer she has is inspiring confidence.

You don’t have the right to expect your attorney to be on call for you 24/7 and drop everything for you at a moment’s notice. That’s unreasonable.

You do though have the right to expect that your questions will be answered even if it’s not what you want to hear. You have the right to expect that your phone calls or e-mails will be returned within 24 hours.  You can expect that you won’t be belittled or talked down to or screamed at.  You should expect that your lawyer will fight for your benefits if your case is improperly denied.

If your expectations aren’t being met you should meet with your lawyer and try to correct the problem.  If that doesn’t happen then you can and should get a new firm. It doesn’t cost anything to switch.  And if your lawyer won’t answer basic questions then you don’t really have a lawyer at all any way.

 

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