When should you settle an Illinois work comp case?

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

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

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

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

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

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

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

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

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

Overview of Illinois workers' compensation benefits

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

Medical bills

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

Lost wages

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

Permanent disability

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

Employer penalties

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

Suing a third party for your injury

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

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

 

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Chicago work comp attorney view on intervening injuries

A reader asks:

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

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

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

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

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

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

Paranoia and your Illinois workers compensation attorney

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

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

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

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

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

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

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

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

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

You drink. You work. You lose.

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

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

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

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

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

Illinois work comp- Where your drug screen took place is important

We have talked a lot on our blog about jurisdiction.  In plain English, that means do you have the ability to bring an Illinois workers compensation claim.   To do so you have to show one of three things:  The accident happened in Illinois; your employment is principally based out of Illinois; or the last act to hire you took place in Illinois.

The "last act" requirement has different interpretations.  We have seen cases won when you were offered the job while on the phone, but physically in Illinois.

For truck drivers, you often have to receive a drug screen before the employment is official.  For many Illinois based trucking companies, they bring you to Illinois for that to take place.  If the drug screen happens in Illinois we have seen many cases won because that happened.  On the flip side, we have also seen cases lost because a drug screen took place out of state and there is no other real connection to Illinois.

If you are hurt on the job and are wondering if you can bring an Illinois workers' compensation claim, it's important to think of every possibility that exists for you.  It is especially true when you weren't hurt here.  Remember to think back to when you were hired and exactly what happened.

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

I wish I knew that earlier

There is nothing worse than finding out a key piece of information when it's too late.  I'm looking to do a posting in the future about things injured workers wished they knew earlier or any tips you the worker might have.

If you have any, please either click on my contact link at the top or send me an e-mail to helfand@illinoisworkerscomplaw.com.  All submissions will of course be confidential.

HIPAA laws and injuries under Illinois workers' compensation

A client asked a good question about HIPAA laws and their doctor disclosing medical information about their claim.  Basically HIPAA says that you have to consent to a release of your medical information.  The client was upset that his managers could potentially see his medical records.

While medical records in work injury cases are typically seen by only the insurance adjuster, it's a valid concern.  The problem is that if you want to pursue an Illinois workers' compensation claim, you have to consent to your employer having access to your medical records.   It makes sense as how else would they know if you are really hurt and how can someone pay a bill if they don't know what it's for.

The problem to look out for is when the insurance adjuster or anyone else wants to talk to the doctor about your care.  That is against both HIPAA and the Illinois Workers' Compensation Act.  Too often we've seen this interference result in our clients not getting the treatment that they need.  Stopping it is often the first thing that we do.

We are certainly not HIPAA experts, but it can argued that while your employer does have a right to your medical records that relate to your claim, they don't have a right to records related to other problems.  This is up for debate as no one can agree who is the best judge of that and it has been rarely tested.

Finally, if you have a HIPAA violation, the right thing to do is complain to the Department of Health.   There is no right to sue over these violations although the Government can fine a provider up to $250,000.

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

Illinois work comp, "don't want the lawyer to take it all."

We met someone the other day, not a potential client, but just someone we met at a social gathering.  In the conversation they learned about my practice and said that their husband had a previous work injury, but didn't hire a lawyer because after thinking about it they decided that they "don't want the lawyer to take it all."

I'm not sure where this type of thinking comes from.  Under Illinois law, attorney fees for work injuries are limited to 20% of what is recovered for the settlement or trial verdict.  There are minor exceptions to this rule, but it applies in 99% of the cases.

This is true whether you hire one law firm or switch firms five times (don't do that); lawyer fees can never exceed 20% total.  If you settle for $50,000.00, the lawyer gets $10,000.  If you lose the case they get nothing.

I don't like to talk about personal business in a social setting so I don't know what this man got for his settlement.  I do know that she said he wasn't happy with it.  Whatever the case, I've never seen a time where someone did better in the end without a lawyer than they would with.  And no matter what happens, there is no way you will hire an Illinois work injury attorney and feel like they "took it all."

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

Chicago workers' compensation lawyers- If it doesn't look like a duck

There's an old saying that if it looks like a duck and talks like a duck then it's probably a duck.  That's a good thing to think about when hiring a Chicago workers' compensation lawyer.

A caller with a major injury came to us for advice on his injury.  He had found his lawyer through his doctor (side note, there are a lot doctors and lawyers that make their living by referring clients back and forth to each other regardless of what is best for the client.  We don't do this as we feel it's sketchy, but we get approached about this all the time).  The lawyer has an office in the northwest side of the City.  We had never heard of him so we looked him up.  His website said he handles workers' compensation, personal injury, real estate, bankruptcy and criminal cases.

Now we aren't saying that a lawyer in that location with multiple practice areas couldn't do a good job for you.  But it certainly doesn't paint a picture of someone who would.  First off, all Cook County work injuries are sent to Arbitrators at the Thompson Center which is downtown.  To have an office on the northwest side of town where it's 45 minutes or more by el to get to court and back would be very disruptive to a law practice, especially if you have to go back and forth to hearings a couple of times a day and do it every day.

Second, if you are in that location and don't regularly appear at the Thompson Center then you won't know the Arbitrators.  If you don't know them and the defense attorney does then you are fighting with one hand tied behind your back.

Finally, when someone is also a real estate attorney, bankruptcy attorney, criminal attorney, etc., it tends to lead to that lawyer not being up to date on the law.  In the case of our recent caller, he was being hounded by a collection agency over an unpaid bill that was part of the work comp case.  His lawyer didn't know that the law changed in 2006 making it illegal for a collection agency to try and collect when a case is active.  The client dealt with at least ten phone calls and had this put on his credit report.  If his attorney knew the law that could have been stopped easily.

So if it doesn't look like a duck (e.g. the lawyer does lots of areas of law, isn't located near a hearing location, etc.) then you better keep looking.

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

Illinois wage differential lawyer perspective on what you should settle for

A nice guy came to us looking for a second opinion.  He used to earn $35 an hour as a laborer, but sustained a major knee injury that prevents him from doing anything but a desk job.  He's in his twenties and didn't graduate from high school.  Right now he could probably earn minimum wage at best.

When we consider telling our clients to settle these cases we look at their needs for future medical care, the amount of their loss and what better job might be available for them.   For the sake of easy numbers, let's say that his earnings loss is $30,000.00 a year and he is expected to live for 50 years.  When valuing what a case is worth, we take 2/3 of the earnings loss (which is $20,000.00) and multiply it by the life expectancy.  In this case that would be $1,000,000.00.

We then figure out what the present value of that loss is.  In other words, there is no motivation for the insurance company to pay out that full amount because they could invest it and just pay you weekly hoping that you'll die young.  So for a million dollar loss let's say that the present value of that is $400,000 (we have a tool we use to figure that out.  FYI, we are just making that number up and didn't do it for this example).

So if the insurance company settled for $400,000, the caller who in theory be getting the equivalent of what they would get if they lived their full life.  Insurance companies, reasonably so, never pay more than 80% of present value and depending on the case, the client might get as little as 2/3.   If there are defenses to the case it could be worth less.

In this case, right now the caller is getting around $900 a week, tax free since he can't work.  Our take is that settling the case no matter how big the offer would be a mistake.  Under Illinois workers comp law he can get the insurance company to pay for him to get his GED.  If it's a reasonable plan that would succeed, he might even be able to get them to pay for college or an associates degree so his ultimate earning potential could increase.  The cost of those programs could reach the six figures by themselves.  If he went that route then they would have to continue to pay him at his $900 weekly rate.

In other words, the best thing for this guy to do is nothing right now.  If he can only make $8 an hour now, but with training will be able to land a job making $50,000 a year, doesn't that serve him best?  Of course it does.  I would make more money if this guy settled his case for $300,000.00 now than if he got a college degree and settled for $100,000.00 in five years, but is that best for him?  Of course not.  Any attorney who tells you otherwise is probably selling you out.

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

Illinois workers' compensation- IME doctors against the treating physician

This question came in from a reader:

My question is can Work Comp make you see their Doctor and go by his orders on stating you can return to work light duty when my own Doctor who performed my shoulder surgery stated I am not to return to work.

That's a good question and a scenario that pops up a lot.  If the insurance company has a doctor that says you are fine, they can rely on that opinion to deny you benefits.  In other words, can they do it, yes, but you do have options.

Option 1 is to try to go back to work and see what happens.  If you give it a go and it doesn't work then all of the sudden the opinion of the company doctor isn't very credible as long as you are credible when testifying.  Of course we can understand why you wouldn't want to do that because nothing is more important than your health so why should you risk it?

Option 2 is to go to trial and pit your doc against theirs.  Injured workers win most of these battles.  But nothing is guaranteed and even if you win you might be without money for quite some time which is really like losing in the end.

Option 3 is to see if the company will work with you.  Often the insurance company tells you one thing, but the employer is a good guy that says something else.  So if your boss wants to listen to your doctor then you might be ok.

Not one option is right for everyone.  You have to decide what is best for you.

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

Workers' compensation in Illinois when you don't do any work here

We recently were called by an injured worker who works for a company that is based on the west coast and was injured out on the east coast.  Kind of an odd trucking outfit in that he applied for the job on-line and without an interview got offered the position by e-mail with his first assignment.  No drug screen, no conversation.  Perhaps that's how things are going to be done these days, but when I first heard about it I thought it was quite odd and perhaps a scam.

But it's a legitimate company and he sustained a legitimate tear of his ACL in his left knee.  The question was does he have a case he can bring in Illinois?

To have the right to bring an Illinois workers compensation case you need to show that the accident took place in IL (not on this one), the employment is principally based here (nope) or the contract for hire took place in Illinois.   Contract for hire is deemed to be the last act necessary for the job to be offered. 

Since our guy was physically in Illinois when the job was offered and accepted he gets to pursue Illinois workers' compensation benefits.  This is significant for two reasons.  First, our benefits are great for workers, much better than most states.  Second, if he ever has to go to trial on his case he won't have to travel thousands of miles to a hearing location where he will also have to pay for a hotel.

Moral of the story is that if your employment has any relation to Illinois you can probably bring your case here and in the least it's worth investigating.

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

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Illinois carpal tunnel lawyer thoughts on filing after you no longer work

In some odd coincidence, I recently had two calls within 24 hours from two people that had very similar situations.  Both had worked for a company where they did a lot of repetitive work.   Both took a leave of absence for reasons not related to a job injury.  Both said that they had problems in their hands and wrists before they left, but never told their employer.  Both finally went to a doctor around six months after the last day worked.  Both now wanted to pursue an Illinois workers' compensation claim.

Unfortunately I couldn't help either of them.  It's possible under Illinois law to file a case for an injury even when you are no longer working for your company.  It's also possible for you to bring a case if you don't go to the doctor until after you are no longer working.  In one case a worker waited two weeks before seeing their doctor.  The Illinois courts have said though that the longer you wait the harder it is to prove that a repetitive trauma injury is related to your previous job.

In these cases six months had gone by.  They might testify credibly and honestly that their hands have bothered them the whole time, but the counter to that would be "why didn't you go to the doctor and why didn't your problem get better when you were no longer working the repetitive job?"  That's a hard defense to beat and we don't think any Arbitrator would rule in their favor.  On top of that there is a possible defense if they didn't notify their employer within 45 days of when they thought they had a problem with their hands.

We don't tell people what they want to hear, but we do always tell the truth.  The truth is that these cases just aren't winners.

 

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