Getting hurt at work on Halloween

One of the most interesting cases I saw from a few years ago involved a worker who was hurt at their office while hanging pumpkin decorations for an office party at Halloween.

In general, if a party is not mandatory and you get hurt at the party, you do not get workers' compensation benefits.  If it is mandatory then you do get benefits.

In this case, the worker was organizing the party for the office and we argued it was more like a birthday celebration than a company picnic or something like that.  The case eventually settled.

For your purposes, you should probably just enjoy any party that you can and like anything else in life be careful.  I certainly wouldn't miss a party because it wasn't covered by workers' compensation.  If you do get hurt then let a lawyer who knows what they are talking about do a real analysis of your case to determine if you are entitled to benefits.

Some ways we determine mandatory versus not are:

Statement that you have to attend from the boss.

Loss of pay if you aren't there or other repercussions.

Being asked to show up because clients will be there.

Work issues being discussed (e.g. a presentation before a cocktail hour)

It's not always black and white and like our case described above, sometimes there are shades of gray.  Moral of the story is to not give up on a case just because someone tells you that you don't have one.

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.

Severance agreements and workers' compensation rights

Severance agreements sometimes state that by signing the agreement the worker is giving up all rights to pursue a workers’ compensation claim. Giving up these rights would be a serious detriment to the employee. The law recognizes this and says that you can’t simply sign away your workers’ compensation rights in a severance agreement.

The only way these rights can be signed away in a severance agreement is if it’s approved by an arbitrator at the Illinois Workers’ Compensation Commission. This isn’t usually the case, so if you’ve signed a severance agreement and are worried that you lost the ability to claim workers’ compensation, talk to an attorney. You can probably still file a claim.

As a general rule of thumb, it’s a good idea to have any agreement reviewed by an attorney before signing. So even though the clause we’re talking about here isn’t enforceable (meaning even if you sign it they can’t hold you to it), it’s better to be safe than sorry, in our opinion.

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 workers' compensation settlement lies

A very seriously injured worker came to us recently for help.  He had been jerked around with his pay, approval of treatment, payment of bills and which doctors he could or couldn't see.

He hadn't called a lawyer before because in his own words, "The adjuster was just so nice to me and said that this is how it is in Illinois.  She also told me the best advice I'd I've get is to not hire an attorney because settlement amounts are set no matter what the lawyer does."

I almost fell out of my chair when I heard the last part.  I've seen workers get screwed, but never have I seen an adjuster flat out lie about what is or isn't available when the case ends.

The fact of the matter is that no case is worth a set amount except for when you have a body part that is amputated and you make a full return to work.   Otherwise there is a range of what your case is worth. 

For our very nice caller, his range was between $60,000.00 on the low end and $350,000.00 on the high end.  Most cases aren't that drastic, but every case has a wide range of what it "could" be worth.

Attorneys in Illinois get 20% of what they recover.  If you aren't represented, most adjusters knock 20% off the top of any offer they make.  Their performance is judged by how much money they save.  Our performance (and pay) is judged by how much money we can get for you.  Who do you think is going to look out for you?

We ask that our clients be honest in every aspect of their case.  It's a shame that insurance adjusters can't do the same.

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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Never been to Illinois? You still might have a case here

Under Illinois workers' compensation law, you can bring a case in Illinois if you were hurt here, physically in Illinois when hired or your principle place of business is in Illinois.  And if you can bring a case here you should do so as Illinois has the strongest workers' compensation laws in the country.  In fact if you get hurt in a place like Indiana or Texas, you probably wouldn't even be able to find an attorney to help you.

Some companies like United Airlines are based out of Chicago.  Their union has contracted with them so their employees can bring any work injury case in Illinois.  A handful of other companies have done the same.  This is a huge benefit for these employees.  It also means that their first trip to Illinois someday might be for a workers' compensation hearing.  Good for United.

Even if you don't live here, but bring the case in IL, you can still see whatever doctor you want in your area.  Illinois doesn't limit the length of time a doctor can have you off work or the amount of benefits you can receive.

We will see insurance companies telling workers where the case has to be filed.  Obviously those people have a motivation that is the opposite of yours.  Often you have more than one place where you can bring the claim.  You are best served by seeking the advice of someone who is independent to find out your options.

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 a FCE?

If you have a serious injury, at some point you will likely be scheduled for a functional capacity evaluation (FCE).  It's typically a test ordered by a doctor right before they are going to discharge you from their care.  It is used to detail what restrictions you need when you return to work.

If you are an injured teacher or sit at a desk all day, a FCE probably isn't needed.  But if you are a laborer, flight attendant, mechanic, etc. and you can't lift, bend, stand or move like you used to, then a FCE is a great tool to determine what exactly you can do.

The beauty of a FCE is that it can objectively measure if you are being honest about your limitations.  You don't realize it, but during the test they will have you do the same thing over and over, but in different ways.  So part of the test measures your abilities and part of it measures your honesty.  If you are honest, the test will work out for you.  If you exaggerate what is wrong, you could screw up the whole case.

At the end of the exam you likely will be sore, tired (it usually lasts a couple hours) and will have a real idea of what you can and can't do.  As attorneys we love these tests because they lend great credibility to what our clients tell 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.

When do TTD benefits begin in Illinois?

A reader who got hurt while working construction in Aurora asks:

I recently was hurt on the job and my doctor has me off work for a month.  The adjuster said that I don't get paid for the first three days I miss.  That's so unfair.  I need that money.  Can anything be done>

Surprise, surprise, the adjuster isn't telling the whole truth.  Under Illinois workers' compensation law, when you are off work for a work injury, you don't get TTD benefits until you hit the 4th day.  However, once you are off for 14 days, those first three days are also to get paid, even if it's not 14 days in a row.

Another thing to be aware of is that even if you don't usually work weekends, if the doctor has you off on Friday and Monday, that is actually four days for Illinois workers comp TTD purposes.

For this reader, they are clearly going to be off more than 14 days.  It appears the dis-honest adjuster (and not all of them are that way) is trying to frustrate the worker in to ignoring his doctor and going back to work too soon.  That saves them money, but likely will lead to a worse injury and a bigger problem.  The sad part is that if he does try to go back to work and it gets worse, they'll probably try to say he shouldn't get benefits because he didn't listen to his doctor.

Ahh, the games people play.  Fortunately this is a game you can win if you know what you are doing.

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.

"Reasonable and related" medical expenses must be covered

If you have a work injury, you are entitled to coverage for all reasonable and related medical bills. Coverage is 100%. There don’t have to pay any co-pays or anything out of pocket.

So what does reasonable and related mean?

A reasonable medical expense is generally one that is recommended by a doctor and one that would probably be recommended by other doctors, as well. The key is to not just have your doctor suggest something but to get it documented, like in the form of a prescription.

Even things that seem unconventional, or extra, can be covered. Examples include gym memberships, special mattresses or pillows, massages, etc. If your doctor believes these things will aid your recovery and help your condition improve, then there’s a good chance they will be covered by workers’ comp.

We don’t promote stretching the truth or looking for a windfall. If there is a treatment out there that a doctor reasonably believes will help you recover, we believe you deserve the option to pursue it.

The second requirement is that the treatment is related to your injury. If you are seeing the same doctor for more than one injury or condition, just know that only the treatment and bills related to your work injury are covered. Often, doctors end up lumping things together in the same bill or statement.

One last thing: If you do end up paying anything out of pocket, keep your receipts. Your attorney should do what they can to get you reimbursed as soon as possible.

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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No compensation for work party injury, unless attendance was required

 

If you get hurt at a work picnic or holiday party, you’re probably not eligible for workers’ compensation. It’s generally seen as outside the boundaries of a compensable work injury.

The exception is if you were required to be at the event. If so, you may have a good argument for benefits – medical coverage, lost wages, etc. If you simply felt obligated to be there, that’s probably not enough.

As you may suspect, there are gray areas. If the purpose of the event was to entertain or speak with clients, you may be able to argue for workers’ compensation benefits.

Aside from workers’ compensation, there may be another potential claim in the case of a work party injury: if you were injured because of someone’s negligence. If your employer was negligent in maintaining their property and you were injured, you may have a personal injury lawsuit. The same thing is true if the party or event was at a restaurant or hotel. You may have a personal injury case against them, 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.

 

Having trouble with a settlement? Now is the best time of year to settle.

If you have a workers' compensation case in Illinois, October is the best month of the year to try and settle your case.  Why?  Because insurance adjusters get rated and compensated based on how many files they have closed at the end of the year.

So starting around now and in to November, they will often make their best offer because they are thinking about themselves, not about your case.  It's not their money so while an extra $5,000 is huge for you, it doesn't usually mean much to them.

If you have an active case with your lawyer that has been waiting for months to settle, push them to call the adjuster or other attorney to try to work things out.  Many insurance companies are scheduling "settlement days" at the Illinois Workers' Compensation Commission over the next couple of weeks.  Ask your lawyer to find out if the company fighting your case is going to be there. 

You will never find them more motivated to resolve your case than now (or this time next year).

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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Step #2: Notify your employer

Step #1, always, is to get medical attention for your injury. Step #2 is to notify your employer. You only have 45 days to do this or it can hurt your chances of getting benefits under workers’ compensation.

We hear from people who did not report their injuries and wish they had. The reasons for not reporting an injury range from thinking the injury isn’t serious enough, to fear of getting fired, and general misinformation about workers’ compensation.

The reality is that a minor injury can worsen, and if you reported it by the deadline, you’re in a better position. If you fail to report it and then lose your job, you have even bigger problems. It is illegal for an employer to fire you for pursuing a workers’ compensation claim, and in Illinois there are laws to protect you.

Your employer is supposed to fill out a specific form. Many do not. Some companies have their own forms in place, as well. In many small companies, all of this is overlooked. Because you are required to notify your employer, we suggest putting something in writing, even if it’s an informal note. Make sure to keep a copy. The goal is to ensure that your employer can’t claim that you never told them.

Think long term. While at the moment it may seem like just a couple of doctor appointments and a few missed days, you can end up needing surgery and missing months of work. If you are approved for benefits under workers’ compensation, you can get your medical bills covered and even get checks for a portion of your wages until you recover.

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.

Can a heart attack be a work injury?

Illinois law says that workers who suffer a job-related injury are entitled to benefits (medical coverage, payment for lost wages, etc.) But what is meant by “job related?” If you are a construction worker and you fall from a ladder at the job site, the link is fairly obvious. But what if you have a heart attack on the job? Simply being at work at the time of the injury is not enough to be covered under workers’ compensation.

The difference is whether your job caused or contributed to your injury. If you can show this, you should be covered. In cases like heart attacks, the cause may be extreme work conditions, such as very hot or very cold weather, heavy lifting, long hours, etc. The problem is that there are a lot of other things that can cause a heart attack.

That said, we’ve seen many cases where a worker is able to prove that their job caused their heart attack and obtain full benefits. There are even cases where the heart attack occurred at home, after work hours, and the worker was still covered under workers’ comp.

The bottom line is that even if you have other factors that tend to contribute to heart attacks, if your job was a contributing factor, you can still get benefits. The key is to work with an experienced attorney, as well as a cardiologist, who can evaluate your entire situation.

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.

Carpal Tunnel Syndrome - not just a repetitive stress injury

Carpal Tunnel Syndrome is injury to the nerve that goes from your forearm to your hand. Common symptoms are tingling, pain, and clumsiness handling objects. The pain or discomfort may be limited to your wrist, or it may travel up the arm, even to the shoulder.

Most people associate carpal tunnel with typing or other types of repetitive motion – grasping motion with the hands, bending of the wrist, etc. However, carpal tunnel isn’t just a repetitive stress injury.  It can be caused by one-time injuries, such as trauma to the hand or neck.

In many cases, a trauma to the hand, wrist, arm, neck, etc., can aggravate a carpal tunnel issue. So even if you weren’t in pain or having issues with your wrists, a sudden injury could cause symptoms of Carpal Tunnel Syndrome to surface.

Under Illinois law, injured workers are eligible for workers’ compensation benefits when a job aggravates or accelerates a pre-existing condition. If you had only mild carpal tunnel, or if you had it under control at the time, and you then suffered a hand injury at work causing your carpal tunnel syndrome to worsen or flare up, you would still be covered.

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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Does your lawyer still have passion?

A Chicago workers compensation attorney (not someone we ever recommended) just quit the practice after 22 years of representing clients.  Apparently he is leaving the law practice altogether and going in to a different line of work.  This has happened with a few other successful attorneys in the last few years, most of which had a big volume of clients.  For a couple (not this most recent one), we saw their performance really slack before they threw in the towel.

There is no one test to see if your lawyer has lost his/her passion for helping clients, but here are a few warning signs:

1. Phone calls not promptly returned.

2. They yell at you.

3. They don't follow through on what they say they are going to do.

4. For no good reason the case is just dragging on.

5. They seem to take a really high number of vacations.

6. They talk down to you.

7. If you ask for an explanation of something they refuse.

These can all be bad signs.  If it's happening to you, it may be time to switch lawyers which is usually easy unless a big settlement offer has been made or you have already switched once before.  Better yet, think of things when interviewing a lawyer 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.

How not to prove permanent disability in Illinois work comp

This was featured in IICLE which is a case law summary service which is very valuable for lawyers.  The moral of the story is that you should get real medical treatment if you are having physical problems, not just pop pills for years.  It also shows that the best doctor to discuss your medical condition is your treating physician, not a hired gun.

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In Weaver v. Decatur Overhead Door, No. 98 WC 17022, 2010 WL 896172, 10 I.W.C.C. 0183 (Feb. 23, 2010), the Commission affirmed an arbitrator’s decision finding the petitioner failed to prove a permanent and total disability. The Commission affirmed the award for a 50 percent loss to the person as a whole. The injury occurred on February 21, 2007. The Commission had affirmed a prior arbitration decision following a 19(b) hearing. In this case the arbitrator found the petitioner’s failed-back syndrome was causally related to his accident.

The arbitrator found the petitioner offered a substantial number of physical complaints in his testimony but failed to present convincing evidence that he was disabled to the extent claimed. The arbitrator reviewed the evidence from physicians who had seen the petitioner since the trial in 1999. One of the physicians recommended use of a spinal cord stimulator. The petitioner told another physician he was not interested in this procedure. The arbitrator felt that if the petitioner had the level of pain described at trial it seemed inconsistent that he would not agree to use of a spinal cord stimulator.

Another physician who examined the petitioner on a referral from the petitioner’s treating physician did not feel that the petitioner would respond to any further surgical management. This physician commented that there were significant secondary gain issues and a psychological component to the patient’s pain syndrome.

A physician who examined the petitioner at the request of his attorney was of the opinion the petitioner was permanently and totally disabled.

The respondent’s examining physician testified the petitioner had positive physical exam findings and neurological deficits consistent with the subjective complaints and surgical history. This physician found three out of five positive Waddell signs indicating there was an exaggeration of symptoms and observed that other physicians commented on positive Waddell signs. This physician found the petitioner at maximum medical improvement and felt he was capable of employment at the sedentary, light work level. He supported his opinion on the facts that (1) the petitioner did not need assistive devices to walk, (2) was not bedridden, (3) his pain was managed well, and (4) the petitioner’s activity level and upper body strength. He felt the patient was over-reporting his subjective complaints. The arbitrator found the examination and testimony of this physician credible.

The arbitrator also found the petitioner’s treating physician had done little for the petitioner aside from continuing to prescribe pain medications. In the treating physician’s deposition, taken in 2004, he admitted he had not examined the petitioner’s back since 1999. The arbitrator also observed the doctor’s notes showed the petitioner had called in for refills of narcotic medication while moving his mother-in-law from a hurricane area. The arbitrator found the records demonstrated the petitioner’s pain was well controlled.

Vocational counselors also testified. One reviewed medical records and felt the petitioner was unemployable. This counselor never met with the petitioner and did not test or evaluate him. A second counselor evaluated the petitioner at the request of his attorney in 1999 and gave conflicting opinions. He also evaluated the petitioner at the request of the respondent in 2005 and felt there were employment opportunities with reduced earnings. He testified that his 1999 opinion was based on restrictions from the treating doctor and that his 2005 opinion was based on the opinions of the examining physician.

The respondent retained another rehabilitation counselor who testified to home-based work in which her company specializes. She described the work as telephone customer service survey work. The employer allows a choice of the hours they work and the use of flex time, as well as the provision of training and accommodation for restrictions. She sent various letters to the petitioner and his attorney about this line of work and received no responses. She sent a letter to his attorney advising it was assumed the petitioner was not interested in pursuing employment. She received a letter from the attorney that the petitioner was having the documents reviewed by a vocational counselor. She then sent the attorney an employment application which was never returned. She testified in her deposition that the employment was still available in an entry level position with no physical or job skills requirements. The petitioner admitted he did not contact her about the position and simply informed her he was not interested. The arbitrator found no medical evidence that the petitioner was incapable of performing this type of work.

The arbitrator also found the petitioner offered no evidence of any effort made to find employment or evidence to refute the testimony of the counselor who described the customer service survey work. Accordingly, the arbitrator found the petitioner failed to prove a permanent and total disability and awarded a 50 percent loss to the person as a whole.

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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Vocational rehabilitation in Illinois work comp: Don't lie

A reader asks:

Currently I am on workmens comp for a back injury and leg injury and have been receiving ttd.I have an attorney on this case but need some clarification from someone else about this matter.The insurance company has assigned a work rehab company to me to find employment. My place of employment has done a involuntary terminated my job. My question is when I am applying for jobs and the section for leaving last place of employment I put down injured on job,workmens
comp injury or involuntary termination due to injury my rehab company insist that I cannot put those reasons down  but lie and write down looking for a less strenuous position or changing jobs. Also when putting down a salary do not put one in and don't put in a traveling distance. If I don't follow there rules they report to the insurance carrier that I am not cooperating with them by because I don't want to lie on applications.What is case law about falsifying job application?

This is a simple one.  Never, ever lie.  You cooperate in any way you can with finding a new job, but you don't lie on an application or in an interview.  If you do, it helps the insurance company, but not you and it's wrong.   What happens when down the road you love this new job and then get fired  because they found out about the lie?  You are screwed, that's what happens.

If you go to trial at the Illinois Workers' Compensation Commission over this issue, I don't believe that any Arbitrator is going to punish an injured worker who refuses to lie.  If you show up a mess to an interview or act unprofessional that is one thing.  But not lying about having been hurt is something completely different.  And quite honestly, it can help sell you.  e.g. "I have been out of work for a year because I had a job injury.  It's killing me because I've worked all of my life and love to do so.  I'm just chomping at the bit to get back."  That is the type of advice of voc rehab counselor should be giving.

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.

 

 

Don't ever quit your job with a work injury

A client of ours wants to quit their job because they can't stand their boss.  While we understand their position, the reality is that if they can stick it out, they should.

While you will never lose your right to medical care by quitting, if you have any restrictions and quit, you could jeopardize your ability to get TTD benefits.  The employer can simply say that they would have had a job for you had you not left.

When it comes time to settle your case, the value of your claim can be affected by whether or not you are working, especially if you have a big injury.   In fact, quiting your job could end up costing you somewhere in the six figures.

Of course some times you have to do what you have to do.  But if you can ride it out until the end of the case, you should do so.  If there is a new job opportunity available elsewhere you should at least talk to your lawyer before telling the boss where to stick his job.   It's part of thinking long term, not just for the now.

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.