Illinois workers' compensation laws- They can't make you have surgery

A reader asks:

I suffered a severe injury at work a few years ago and have been getting TTD benefits since then.  I can either have surgery or conservative care.  I chose not to have surgery and reached MMI and can not return to my previous labor job.  The insurance company says I am not eligible for wage differential or vocational rehabilitation benefits telling me that if I had the surgery I wouldn't have had any permanent restrictions and could have returned to my old job.  Are they telling the truth?

They are not telling the truth.  Under Illinois workers' compensation laws you have to follow all reasonable medical care, except that you can't be forced to have surgery.  So if you refuse physical therapy your benefits can be cut off, but no one can make you get cut open.

Choosing to have surgery or not is a personal choice that should be made between you, your loved ones and your doctor.  From our end, we insure that you get whatever rights you are entitled to under the law.  You lose no rights, including wage loss or vocational rehabilitation, by not having a surgery.

This reader simply needs to hire an attorney and file a trial motion.  A Judge will surely order that vocational rehabilitation take place and I suspect that once a proper attorney is in place the tough talking insurance company will back down.

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.


 

Signs of a bad Illinois workers' compensation lawyer

Opening Day is around the corner.  Spring is in the air.  But there must be something in the water because I've heard a lot of crazy stories about problem attorneys.  Here are a few samplings from readers.  Has any of this happened to you? 

-I have literally never spoken to or met my lawyer.  Every time I call I get a paralegal or his secretary.

-Since my case started, I have been assigned to five different lawyers.  The first four quit the firm or were fired.  The fifth one, like the others, has only been an attorney for a few months.

-I live in Rockford, but got hurt on business in Joliet so apparently the case has to be filed there.  I hired a local Rockford guy who answers all my questions, but now that my case needs to go to trial he wants to refer it to someone else because he has no other cases in Joliet and says that handling my case will disrupt his practice.

-Ten messages in two weeks.  No return phone calls.

I don't want to defend bad lawyers and if you read my blog you know I don't.  But the first three complaints could have been solved with some smart interviewing and exploring.  In other words, those attorneys never should have been hired in the first place.  Most importantly, never hire an attorney before you actually talk to them.

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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IME reports. What weight do independent medical examinations have in court?

A reader asks:

My doctor says I need back surgery and it is related to my job injury.  I went to an "Independent" medical examination and not only did this hack say that I didn't have an accident, but he also says I can work full duty and need no further treatment.  How can he say I didn't have an accident when I was working with hundreds of pounds of raw materials?  My doctor is a respected orthopedic surgeon.  Will the insurance company get away with this because their doctor is a crook?

The situation described is not un-common.  Your employer or their insurance company has a right to send you to a doctor of their choosing.  If they disagree with your doctor then we go to trial.  That's one way we earn our money.

We can't guarantee who the Arbitrator is going to agree with, but all things being equal, treating surgeons who have seen you multiple times are given much more credibility than a one time visit doctor who maybe spent 10 minutes with you.  The Arbitrators know who the hired guns are and who gives an honest opinion.  If you testify credibly about how you got hurt and there are no other problems in your case like surveillance or intervening injuries, things will probably go fine.

If they get an IME we just have to go through the process.  It can be frustrating to hear that, but that is why you get a good attorney in the first place.

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.

Hiring the small town attorney. The classic Illinois workers' compensation mistake

Being an Illinois workers' compensation attorney is unlike almost any other area of law.  For example, if you are getting a divorce or arrested for a crime, hiring a local attorney can pay huge dividends for you.  Most county courts have hearings for these if not daily, at least a couple of times a week.  If you are a Freeport based attorney, you are not going to drive to Rockford and back on a daily basis for cases if you can help it.  You'd probably just handle cases in Freeport.

In work injury cases they don't hold hearings in every county.  Instead, a group of counties will have hearings at one location.  For example, if you live in Galena, Freeport or Rochelle, your hearing location will be in Rockford.  And there are not hearings every day of the week, rather there are just hearings for a couple of days out of the month.

So if you are a Galena based attorney, you not only have to drive to Rockford for hearings, you most likely make a living taking on most cases that come through the door.  We strongly believe that if your attorney handles not only workers comp, but also divorce, criminal, traffic, real estate, etc., it is a bad sign.

It's not that these attorneys couldn't do a good job for you, but since you pay a maximum of 20% to whomever you hire, don't you think you give yourself a better chance of a good result by hiring someone who handles only work injury cases?

We saw this recently when a woman called us because her small town, take every case that comes through the door, attorney was trying to get her to settle her case when her doctor said that she needed another surgery.  She had hired this lawyer because he did her divorce and real estate closing.  He would have likely been fine if the case was simple, but she needed to go to trial and he was over-matched against the insurance company lawyer who handles 100% workers comp.

If you go to any hearing location for workers' compensation and do a survey of the lawyers, you will find that most of them (unlike criminal and divorce cases) are not local, but rather are bigger city attorneys that travel throughout the area doing nothing but work injury cases.  If your attorney doesn't have a large case load of work injury cases then you are probably hiring the wrong firm.

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.

If you don't cooperate with treatment you hurt your case

Insurance companies have to pay you for the time you are temporarily totally disabled from working and must pay for all reasonable and related medical bills.  That said, you have to follow reasonable recommendations made by a doctor and can't do things that purposely hurt your claim.

Case in point, a friend of mine is representing someone who had a major injury and he is a nursing home for rehabilitation.  They have a rule that there is no smoking in the nursing home (something about not wanting to blow people up who are on oxygen).  The client didn't like that rule so he left even though he needs rehab and now his benefits have been cut off.

His lawyer can file a motion on his behalf, but you aren't going to impress the Judge if you are doing crazy things like that. 

Listen to your doctors and be reasonable.  It's as simple as that.

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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Lawyer fees and Illinois workers' compensation

I have written before about the laws on attorney fees in Illinois workers' compensation cases.  Search "attorney fees" on my site for that post.  In general a lawyer is limited to 20% of what they recover. In the extended entry of this page I am providing all of Section 16 of the Illinois Workers' Compensation Act as it discusses attorney fees.  But I just got a call from someone who had an attorney settle a huge case and is being taken advantage of by what I think is a real jerk (I won't name him, but he's a big screamer at his clients and advertises everywhere.  You would probably know if he was your attorney).

Part of what the Act says is:

However, except as hereinafter provided in this Section, in death cases, total disability cases and partial disability cases, the amount of an attorney's fees shall not exceed 20% of the sum which would be due under this Act for 364 weeks of permanent total disability based upon the employee's average gross weekly wage prior to the date of the accident and subject to the maximum weekly benefits provided in this Act unless further fees shall be allowed to the attorney upon a hearing by the Commission fixing fees.

In plain English it means that if you have a really big case, your attorney might get less than 20%.  This has happened to me a couple of times.  On one case I got a $620,000.00 settlement for my client.  My client had a weekly TTD rate of $1,000.  That meant that my fee was limited to 20% of $364,000.00 or around $73,000.  That is not a bad days work to say the least.  I could have petitioned the Arbitrator and said that I did a lot of work on the case so I deserved more (for example I had to fly out of state to take two depositions of my client's doctors), but at the end of the day I still had a huge pay day, all of my expenses were reimbursed and my permanently disabled client certainly needed the extra money more than I do.

The lawyer I was called about tried to deny that his fees should be capped and in general, in my opinion, is acting like an ass.  From what I understand, the lawyer fees will still be in the mid figures and he didn't do a ton of work. 

There are mostly hard working good attorneys at the Commission.  Most care about their clients.  In 99% of cases lawyer fees should be 20%.  But if you have a huge settlement then you owe it to yourself to make sure you are getting every penny you deserve.

 

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Surveillance, private investigators and Illinois workers' compensation

Recently we were contacted by a woman who is receiving workers' compensation benefits following a shoulder surgery.  Her passion is bowling and she asked her doctor if she could try it while she recovers.  She said the surgery was not to the arm she bowls with.  The doctor said to give it a try, but don't push it.  Seems sensible to me.

Problem is that the insurance company hired a private investigator to conduct surveillance on her. While she is following doctors orders, my advice to clients is to never create a situation that could potentially give the insurance company a reason to cut off your benefits or low ball you on a settlement.  I assure you that all they are looking for a reason.

In the long run if the doctor said you could try it things will work out, but it really can create problems.  First it could force a deposition of your doctor which in the end will probably mean $2,000 or so less in your pocket.  Second it could lead to weeks or months without benefits. 

Surveillance is legal and it happens on cases with big injuries or when you have been off work for a while.  Before an insurance company writes a big settlement check they are going to want to make sure you are telling the truth.  If you tell your doctor you can't even lift a gallon of milk and they get you on video playing tackle football then your case is pretty much over, you risk being charged with a felony for fraud and we would drop you as a client.

Just be honest and err on the side of caution.  There will be plenty of time for bowling or other activities when your case is done and you are as healthy as you can get.

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.

What is my Illinois workers' compensation case worth? We can tell you what it isn't worth.

A caller who was taken advantage of by an attorney called us recently, very upset.  He had a shoulder surgery and because his wage was low, the settlement amount he was offered - which his attorney recommended he take - was not that high.  He called us wanting to know what we thought was fair.

It's almost impossible to give a good valuation without seeing medical records, but that's not why I am writing this post.  During the conversation it was revealed that the reason the client was upset with the offer is because his attorney told him when he first signed up that he was shooting for a settlement of around $1.2 million!!!

Now if you aren't that familiar with Illinois workers' compensation laws, you might not know that in even the most serious, life altering situations, a case is not worth near that much money.  We obtained the highest settlement that we have ever seen at the Workers' Compensation Commission and that was for $800,000 for a young, permanently disabled client.   Most cases where the worker makes a good recovery go for somewhere in the five figures and some others where the injury is major or the recovery isn't good go in the low to mid six figures.

For a lawyer to tell his client to expect over $1 million on a case where the client is going to be returning to his normal job is just scummy and an example of why lawyers have a bad name.  If you went to me about handling your case and I estimated it was worth $50,000 and another lawyer estimated $1,000,000, you'd probably hire the other guy.  But if it seems too good to be true then it probably is.  Now this other lawyer is facing an ethical violations report and the client is pissed. 

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.

Do I have to see the company doctor?

A mechanic called us because he is mad about what has happened to some co-workers.  Long story short is that whenever they have gotten injured, the employer makes them go to the company doctor before they go to a hospital or doctor of their choosing.  In more than one instance these co-workers have been told that they are fine only to later find out that they have broken bones, herniated discs, ACL tears and other serious injuries.  The caller said that the co-workers were told that if they didn't go to the company clinic first (never mind that these particular docs appear to be negligent or hired guns) that they would not be able to receive any benefits.

So do you have to see the company doctor if you are hurt at work in Illinois?

While the employer or the insurance company has a right to make you see a doctor of their choosing for a one time examination with possible follow ups depending on the exam or the stage of the case.  But you absolutely do not jeopardize your rights to benefits by seeing a doctor of your own choosing first.  In fact, in some cases it's the smart thing to do. 

For example if you break your arm and it needs to be set right away, do you wait a day so the company doc can look at it?  Hell no!  Doing that could make an injury ten times worse.

We operate by two rules: 1. Always be honest.  2. There is nothing more important that your health.  So don't let your employer stress you out.  The law is on your side.

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.

Interesting questions about Illinois workers' compensation laws

We've recently received some good questions that we thought would interest our readers.

My daughter was volunteering at a hospital and slipped on a wet floor which caused her to break her wrist.  Can she file for workers' compensation?

Volunteers are not covered under the Illinois Workers' Compensation Act.  However, whereas workers can't sue their employers for negligence, she could sue the hospital for a slip and fall case.

I was told that I have to give my employer notice of my injury within 45 days.  What is the best way to do that?

The best way is in writing or to fill out an accident report.  If you are worried that they will throw it out or mess around with it, the easiest way around that is to officially file your case with the Illinois Workers' Compensation Commission by filing an application for adjustment of claim.  That is the first thing a lawyer does after you hire them.

My lawyer screwed up the trial.  Why can't I find anyone that will appeal the verdict?

We don't take these over because we aren't allowed to enter in new evidence.  We can only argue based on what the other lawyer did.  Since approximately 80% of these cases don't get overturned, we would basically be doing a ton of work for a 1 in 5 chance that we might win.  Our time is better spent serving our other clients.

What are lawyer fees in work injury cases in Illinois?

20% of what is recovered.  That is State law.  Note that we nor any attorney we affiliate with takes payment of your lost time benefits or medical benefits unless it's after a long trial fight.  In 99% of our cases we get paid, we only receive payment when the case is over and we've obtained a settlement.

What's the first thing I should do after I get injured?

Beyond getting medical care, that's a good question.  Probably report it to your employer and start a journal of everything that happened, e.g. how it occurred, when, witnesses, who you told, etc.  We always prepare as if we will someday need this information.

I heard the Arbitrator my case was assigned to doesn't like injured workers.  Can I get it switched?

No, but if the facts are on your side it's probably not much to worry about.

My injuries have been healed for a while, but my lawyer said that it takes years to get a trial date.  Is that true?

Not at all.  The list of cases at the Illinois Workers' Compensation Commission are a public record.  While some cases last years for unique reasons, there are a handful of attorneys that seem to dominate the list of old cases.  We find that odd because the lawyer doesn't get paid until your case is over.  Bottom line for you is that once you are as good as you are going to get from your injury and are back working, while it might take months to get a trial, it should never take years.

My representation agreement to hire my lawyer says I am responsible for expenses.  What would the expenses be and how much can they cost?

In most cases the only expense is for subpoenaing medical records.  Those subpoenas cost $20.00 a piece.  On average the cost is around $60.00 for the whole case.  In some matters we have to pay a doctor to give an opinion that your injury is work related.  That can cost up to $1,000.  We might also have to take a deposition of that doctor which could be around $1,500.00 plus another $300.00 or so for a court reporter.  We can't speak for other firms, but our firm does not spend this type of money unless we expect to get it back by winning the case.  No credible law firm would ask a client for up front money or to pay the costs of pursuing a claim.

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.

Never heard this one before

A reader called in and was explaining the problems with his case.  Basically his doctor has prescribed a spinal cord stimulator and the insurance company for no reason hasn't approved it for three months.

I explained that it's a simple problem to solve; file a trial motion and petition for penalties and fees.  His response floored me.

He said he told his attorney he wanted to go trial and his lawyer said no because he "doesn't want to hurt his relationship with the defense attorney."

Yikes!

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 laws- what a difference a day makes

Under Illinois workers' compensation law, if you can no longer return to your old job due to permanent restrictions and suffer a loss of what you can now earn, you might be entitled to wage differential benefits.   That allows you to receive 2/3 the difference of what you would currently have been making under the old job compared to what you can make now.

So let's say that you were an electrician who made $35 an hour when you blew out your knee and now would have been making $40 an hour.  Instead you can only earn $10.00 an hour as a security guard.  Based on a 40 hour work week, it's a difference of $1,200 a week, 2/3 of which is $800.

For accidents that happened prior to February 1, 2006, there was a maximum cap based on the permanent partial disability rate at the time of your injury.  In plain English that means that no matter how big your wage loss, the most you could get compensated if you could do any work is $591.77.  The Workers' Compensation Act was amended to change this rule.  For accidents after February 1, 2006 your maximum pay rate for a wage differential loss became 100% of the state average weekly wage.

So if you were hurt on January 31, 2006, the most you could receive for your loss is $591.77 a week.  If you were hurt on February 2, 2006 you would get up to $822.20 a week.

In the example above it would result in a difference of more than $10,000.00 a year.  Yes, it's crazy what difference a day can make.

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.

Calling all nurses. Are you getting ripped off on your wages?

We only handle work injury cases, but like any other (good) work comp firm, we work hand in hand with labor lawyers when problems come up.   Recently a great wage and overtime attorney we work with mentioned a problem that has been happening to a lot of hospital nurses and others.  So . . . .

If you are in a job where you work a normal day plus a lunch break and don't get paid for your lunch break, let us know if:

1. You are working through your break, but not getting paid for it; or

2. You are eating in a lunch room or nurse's station, but regularly interrupted by patients, doctors, etc.; or

3. You just don't get a work break because of the work load.

If this is happening to you (and apparently it's the way business is done at a lot of hospitals) it is illegal.  If you or anyone you know would like to discuss this situation please call us at (312) 346-5578 and we will put you in touch with a labor lawyer.

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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Falls in parking lots and Illinois workers' compensation

In general, accidents on the way to work or home after work are not covered under Illinois workers' compensation law.  In other words, if you are riding the train or driving in your car and get in to an accident, you can't successfully file a claim (note there is a big exception to this rule which would be a whole other post so call us if this has happened to you).

When you arrive to work or leave at the end of the day and are in the parking lot, however, you can technically be considered to be working.  If you have an accident from a slip and fall or anything else, you might be able to make a workers' compensation claim.

There are two key points to consider:

First, does the employer provide the parking lot for the employees?  If they restrict where you can park (e.g. an employee designated lot) then an injury from a fall is probably a case.  On the other hand, if it's a big public lot and you can park wherever you want, you are probably at no increased risk to that of the general public.  If so then the chances of prevailing are tougher.

The second point is do they maintain the parking lot?  If they own it and have to clean it or are responsible for the upkeep of the lot (even if they just contribute to it through rent payment) then accidents will probably be held to be work injuries.

This is all a very generalized statement of the law.  It's also important to know that any accident that is personal to you would not be covered.  In other words if you slam your hand in the car door that will never be an Illinois workers comp claim unless something about the job made that happen.  Most of the cases we are able to succeed on involve slipping on something icy or wet.

Does this sound confusing?  It can be.  If you have questions about parking lot accidents do not hesitate to contact us.

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.

Three signs you don't have the best Illinois workers' compensation attorney

A recent streak of calls presented a bunch of red flags to us.  So in the hope that it will help someone out, here are three warning signs when it comes to hiring an attorney for an Illinois work injury.

Don't let the lawyer direct your medical care: If you want a recommendation of a good doctor then ask your lawyer; if your lawyer has an opinion about a doctor or your treatment they can offer it.  But we are lawyers, not doctors.  I get calls once a week from doctors that want me to send my clients to them and offer to send their patients to me.  It loses me a lot of money to turn that down, but we do because it is un-ethical.  If your doctor wants you to work with a certain lawyer or your lawyer wants you with a certain doctor then it just smells wrong.

What other areas of law does your lawyer handle: We typically suggest you get someone that does nothing but workers comp.  That said, personal injury, social security and employment law are natural extensions of workers comp.  On the other hand, if your attorney is also taking on divorce, criminal defense, estate planning, immigration, etc. it should make you wonder how much they really know about workers compensation laws in Illinois.

Are they assigning a brand new attorney to your file?:  Every lawyer has to start somewhere, but do you want them starting their career on your case?  I wouldn't, especially if it's a tough one.  We had a recent call where a law firm assigned a case of a steel worker with a herniated disc to an attorney who was admitted to practice law in November.  Saying that a senior partner will supervise the file is a load of crap in our opinion.  They certainly aren't on the phone when you have questions and they aren't on the phone or in court with the young lawyer.  If the attorney on your case hasn't been doing workers comp for at least seven years we think you are short changing yourself.

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.