Injured while working on a U.S. government contract overseas?

Employees working for private companies under U.S. government contracts overseas are entitled to their own form of workers’ compensation. Most employees in the U.S. fall under an individual state’s laws, but it’s different for those working in Iraq, Afghanistan and other foreign countries where the U.S. has a presence. These employees, although working for private companies, fall under the broad category of national defense or security.

The most common examples are those working on U.S. military bases abroad. The law also includes employees working on infrastructure projects for the U.S., such as building roads and schools in war-torn areas, as well as those working for “morale” or “welfare” organizations such as the USO or American Red Cross.

What this all means is that if you are an employee in one of these categories, and you get hurt on the job, then you are entitled to certain benefits under a federal law called the Defense Base Act. This law promises injured workers coverage of medical bills, payment for lost wages, ongoing compensation for permanent injury, and death benefits for families of workers who suffer fatal work injuries.  We don’t handle these cases in house, but through the network I’ve created of like-minded, hard working attorneys, I do know firms that can help with these claims.

Virtually all government contracts require employers to have Defense Base Act insurance for their employees. The employer’s insurance company pays out benefits. If you are injured doing one of the jobs that fall under this law, then you have to file a claim for benefits with the insurer. There are some strict deadlines. You generally only have one year from the date of your injury to file a claim. There are some exceptions, so check with an attorney. Also, the law requires you to notify your employer of an injury within 30 days. There is a specific form for doing this. In many cases, an injury can and should be reported immediately so medical care can be provided.

The law includes coverage of medical bills. However, there is a restriction on the number of doctors you can see. You are allowed to choose your own doctor but only once. Any referrals to specialists or physical therapy from that one doctor are allowed, but you can’t choose another primary doctor. This is meant to prevent workers from shopping around for a doctor who gives them the diagnosis they’re looking for. On the flip side, don’t let the insurance company trick you into choosing their doctor as your one choice. You don’t want a doctor who is in bed with the insurance company.

You don’t have to navigate this alone. We don’t suggest dealing with the insurance company without an attorney. The insurance company’s best interests are not the same as yours, so even if they seem nice and helpful, they can’t possibly be on your side. They make money by denying claims and turning down requests for medical treatment.

The good news is that you can hire an attorney who has a lot of experience in Defense Base Act cases, who knows how the insurance companies work and who knows the best way to ensure you’re getting all of your benefits. What’s even better is that the insurance company is the one paying for your attorney. If you have questions about whether your job and injury fit within the Defense Base Act, or if you need help finding a lawyer who is known for their success in handling these cases, whether it’s for you or a loved one, feel free to give us a call.  We will do whatever we can to point you in the right direction.

 

Frustrated with the insurance company? You're not alone

Communicating with the insurance company is arguably one of the worst parts of a workers’ compensation case. Your job caused your injury, and Illinois law specifically says that you get benefits to help you get healthy and back to work, but the insurance company seems to be working against you. Why is it so hard?

Employers pay the insurance company to cover their employees if they are injured on the job. This coverage includes a few different benefits, such as wage loss payments and coverage of medical bills. You can also get a settlement at the end of your claim if your injury is serious and/or permanent. The problem is that the insurance company makes money by refusing to pay you these things. Their interests are exactly the opposite of yours.

The trouble often starts with getting them to call you back or to answer your questions. Then you call back a few weeks later and someone new is assigned to your case. This happens over and over again because of the high turnover at these companies. Then, they make promises and pretend they care, just to turn around and deny medical treatment that you need in order to recover.

It sounds like it should be illegal, and some of it can be, but a lot of this continues to happen. Many injured workers don’t know that they’re been messed with. It’s probably the first time they’ve ever dealt with workers’ compensation insurance, so how would they know? The insurance company counts on this to make money. They also count on the fact that you will get frustrated and give up, that you won’t hire a lawyer and that you’ll never really know all of what you’re entitled to. All of this is to say that the insurance company isn’t there to help you. They’re not on your side.

One of the best things you can do for your case, in our opinion, is to hire an experienced lawyer and focus instead on your health. Dealing with the insurance company causes a lot of unnecessary stress and takes a lot of energy. When you formally file a case with a lawyer, we can file trial motions that will correct their bad behavior. If you aren’t getting your benefits, or your medical treatment isn’t approved, we can deal with them. We know their tricks and how they handle claims.

If you’re getting no answer from the insurance company, or you feel like they’re stringing you along, you’re not alone. Talk to an experienced attorney who handles these cases all the time. Having an attorney also makes a difference when it comes to negotiating a settlement of your claim. In our experience, it makes you much more likely to get a fair amount. If you go it alone, you’re giving the insurance company too much power. 

We’re happy to be the ones you talk to, but I’m not writing this post to get business.  I’m writing it because it’s the truth.  So if we or an attorney in our state wide network isn’t right for you, find someone experienced who is.

How long does it take to get to trial after a 19(b) petition is filed?

Under Illinois workers’ compensation law, there is no set answer to this question, but I can tell you that it doesn’t or rather shouldn’t take a year and a half.

That’s how long it had been for a recent caller to my office and there was no indication that she’d be going to trial any time soon.  I could see online via the Illinois Workers’ Compensation Commission website that a 19(b) trial motion had been filed, but that was way back in 2013. 

A 19(b) is what’s known as a petition for immediate hearing.  Basically, it allows your lawyer to get your case ready for trial and have an Arbitrator decide a dispute.  It’s not the end to your case, but rather a way of determining if you in fact did sustain a work related injury or whether or not you are entitled to benefits.  The most common scenario is when your doctor says you can’t work and an independent medical examination (IME) says you are fine.

To get ready for a trial in this scenario usually requires your attorney to gather all of your medical records and take a deposition of your doctor and the IME doctor.  That’s mostly it.  On average that should take three months or so and usually it shouldn’t drag past six months.  That’s hard to take if you have no money coming in, but not as hard to take as 18 months would be.

So why was my caller waiting so long?  In her case, the firm she hired is rather lazy by reputation and tends to take every case that comes through the door, no matter the quality.  When you have a couple thousand cases, you can’t help everyone and what ends up happening at firms like this one is that the tough cases get the shaft.

I’ve heard of other firms that take cases in all parts in Illinois, but refuse to actually travel to the hearing locations for a trial.  In other words, the best work comp firm in Chicago is of no use to you if your case is being heard in Springfield and they won’t go there for you.

Still other firms don’t want to spend the money to go to trial.  Taking a deposition of a doctor or two can cost a couple of thousand dollars.  That is money that is supposed to be paid by the attorney and then reimbursed to them at the end of the case.  Some younger firms can’t afford to do this.  Other times your case isn’t that strong or doesn’t have a ton of value so they don’t want to spend the money to make a trial happen.  My take on that is then they shouldn’t have taken your case to being with.

Whatever the reason, you have every right to ask your attorney for a firm and realistic time table as to when you will be able to testify. If they tell you it could take years, they are simply lying to you.

 

Deciding to report a work injury to your employer

Some injured workers hesitate to tell their employers about their job injuries; others willingly tell their employer but are uncomfortable asking about workers’ compensation. We understand that it might be an awkward conversation, but we think this comes from some misunderstandings about the way workers’ compensation works and why it’s there in the first place.

Workers’ compensation does not come out of your employer’s pocket. Most employers are required by law in Illinois to carry workers’ compensation insurance for all of their employees. This means that their insurance company pays for any work injuries. When you file a claim to collect benefits, you are more involved with the insurance company than with your employer. If you hire an attorney to help you, he or she will be dealing directly with the insurance company, not your employer.

It’s also helpful to understand why workers’ compensation even exists. The system is meant to help both sides. Employers benefit from workers’ compensation because it protects them from lawsuits. Employees are not allowed to sue their employer for a work injury, and in return, they get to file for workers’ compensation benefits. It’s how the system works. There’s some give and take, and it’s fairly routine.

The law actually requires you to notify your employer in order to get benefits. If you don’t give notice within 45 days of your injury, then the insurance company can try to deny your benefits. If your employer asks you not to report your injury as a work injury, they’re asking you to lie. Don’t take that risk. If you lie to your doctor about how you got hurt, and it goes through your group health insurance rather than your employer’s workers’ compensation insurance, you could be guilty of insurance fraud.

Illinois is considered a worker-friendly state when it comes to work injuries. Employees are entitled to payment for all of their medical bills. There shouldn’t be any out-of-pocket expenses. Also, if you can’t work, you can collect 2/3 of your average weekly wage until you can return to your job. Don’t risk losing these benefits. Notify your employer of your injury, make sure you see your doctor and tell him or her exactly what happened, and get a free consultation with an Illinois workers’ compensation attorney who can answer your questions.

Ten things to know about Illinois workers' compensation law

There’s a good post on this at our sister site at http://www.findgreatlawyers.com/10-facts-illinois-workers-compensation-law/ that I would encourage you to read.  It’s a real good starting point for someone that simply wants to educate themselves on Illinois work comp law.

What I would add to this list is:

  1. The law is always changing, so it’s really important to have an attorney who is handling these cases day in and day out in your corner.  Avoid general practice lawyers.
  2. Nurse case managers are not your friend.  They are there to interfere with your medical care and limit what is spent on getting you healthy.  But …
  3. … You can boot them from your case at any time, even if you gave them permission to be on your case.  It’s often the first thing we do.
  4. Your case can’t be closed without you either waiting too long to file it (via an application for adjustment of claim) or if you settle the case via a contract. I can’t believe the number of people that call me and say the insurance adjuster told them the case was closed. That’s not their call.
  5. Never give a recorded statement. It’s not for your benefit and as the saying goes, anything you say can and will be used against you.  Most of our clients have nothing to hide (we wouldn’t take them on if we knew they were lying), but even then you don’t want your words to be twisted and used against you.  Let your lawyer do the talking.
  6. The most common question we get is, “What is my case worth?”  The answer is that it depends on your ultimate recovery, your wages, any disputed facts and many other things. We’ll tell you if we know, but any lawyer that gives you that answer soon after you’ve been hurt is a b.s. artist and is just going to give you an inflated number with the hopes that you will hire them.
  7. These cases are not lawsuits.  They are claims for benefits just like health insurance.  You aren’t suing anyone.
  8. The second most common question we get is, “How long will this last?”  The answer is that it will take as long as it takes for you to get healthy and back to work, assuming that will happen.  We encourage people not to settle early because once you do, the case is closed forever.
  9. It is legal for the insurance company to have someone conduct video surveillance on you.  It happens a lot if there is a serious or long term injury.  If you are being honest you have nothing to worry about and the reality is that most surveillance attempts are a waste of time and money.
  10. Not only do you not have to pay anything up front to hire a work comp lawyer in Illinois, but you should not pay for any of the expenses up front either.  That’s on the attorney to pay for and if they won’t they are the wrong lawyer for you.  But do know that the expenses on most cases are under $200 and I can only recall one case ever where I’ve seen them going over $10,000.  There are no filing fees to bring a case so if you hire an attorney they should file your claim right away.

As always, if you have any questions you are welcome to call us – it’s free and confidential – at (312) 346-5578 or fill out our contact form and we’ll call you.

 

Can I appeal the arbitrator's decision?

If your workers’ compensation case goes to trial, and the arbitrator rules against you, then you can appeal. If you’ve gotten to this point in your case, then you probably know that workers’ compensation cases are different from lawsuits. An arbitrator, who is similar to a judge, oversees the trials of injured workers and makes a ruling based on the evidence.

There are a couple of things to keep in mind if you are considering an appeal. Don’t delay. There is only a certain window of time in which you can appeal a decision by an arbitrator. Also, stick with your attorney. In an appeal, the law does not allow new evidence or witnesses. The attorney handling the appeal is stuck with all the same pieces from the original trial. For this reason, a new attorney is not likely to agree to handle your appeal, especially if there were problems with the way the trial was handled in the first place.

Another thing to know, and another reason why it can be hard to find an attorney for your appeal, is that winning on appeal is unlikely. It’s not impossible, but the success rate is fairly low. It’s just not good business for a lawyer to pick up a case at this point in the process. Your original lawyer might be hesitant to appeal, but if you believe the outcome is wrong, you should insist on it. They’re likely your only shot.

This situation underscores the importance of hiring a good attorney. Not only will it help you win in the first place, but you aren’t stuck with a bad attorney for your appeal, if you need to go down that road. When looking for a workers’ compensation attorney, find someone who has a lot of experience representing injured employees. Make sure they’ve been successful, too.

If you are questioning whether you hired the right attorney, know that you can get a second opinion. You are allowed to switch attorneys. And if it’s in your best interest, then do so without delay. The longer you wait the harder it can become. Your attorney can have a significant affect on the outcome of your case. In our experience, for example, your settlement amount is likely to be higher if you have an experienced attorney negotiating with the insurer.

If you have questions about appealing your case, feel free to give us a call.

When will my workers' compensation case go to trial?

Your attorney should take the time to explain the process and timeline of a typical Illinois workers’ compensation claim. While no two claims are exactly the same, there are deadlines and rules that apply in most cases. Typically, workers’ compensation cases settle without going to trial. But that’s not to say you and your attorney shouldn’t be thinking about trial and preparing for that potential outcome.

After you file your claim, your case will be assigned to a hearing location and an arbitrator who will act as the judge, overseeing the progress of your case and hearing any disputes that are brought before him or her. Your case will be scheduled for a routine status hearing every three months. At this hearing your attorney and a representative of the insurance company will appear before the arbitrator, at the hearing site, and give any relevant updates. At this hearing, either side can formally request a trial. Or, more typically, the parties agree to continue the case for another three months.

The status hearings can go on like this for three years before an arbitrator has to push for a resolution of the case. In the meantime, your attorney and the insurance company will be in charge of moving things along. A big factor in how quickly a case gets resolved is your health. A claim cannot – and should not – end until you are recovered. The legal term is “maximum medical improvement,” and it means you’re as recovered as you are going to get. Once this happens, it makes sense to end the claim.

As we mentioned, most cases end in settlement, with the insurance company paying the injured worker a lump sum for any permanent injury they have suffered. In exchange, the injured worker agrees to give up any future medical coverage for that injury. If an agreement cannot be reached, then you can go to trial and the arbitrator can decide. If there is ever a dispute during your treatment and recovery, you can request an immediate hearing. Your attorney should not hesitate to request one of these if your benefits have been denied or stopped. 

Whether it’s trial or settlement, it’s impossible to predict how long it will take to get to that final step in your claim. A lot depends on your injury and recovery. It can take a couple of years. But what’s certain is that your attorney should be willing to take your case to trial if it’s in your best interest, and he or she should pursue your case aggressively. Workers’ compensation attorneys typically handle a high volume of cases, but that does not make it ok for them to drag their feet on any one of them. You should expect to be kept informed along the way.

What is a hearing site? Will I have to go there?

A hearing site is basically a courthouse for workers’ compensation cases. Work injuries are resolved through a claims process rather than an injury lawsuit, so you won’t be appearing in court. The hearing site is where any disputes will be heard, where your attorney will go for periodic status hearings, and where your trial will take place if you end up going to trial instead of settling.

After you file a claim, which is done by filing out an Application for Adjustment of Claim and submitting it to the Illinois Workers’ Compensation Commission, your case will be assigned to a hearing site and an arbitrator, who acts as a judge. You may or may not have to be present for a status hearing; you will have to be there if you go to trial or if there’s an emergency hearing.

Most employers are required to carry workers’ compensation insurance to pay benefits to employees hurt on the job. These benefits include medical bill payments and checks for part of the income you lose while you are potentially unable to work because of your injury.

There are hearing sites all over the state. Yours will typically be the hearing site closest to where your injury happened. Often, this is close to your main place of work. However, if you were injured out of state (you can still get Illinois workers’ compensation), the hearing site will probably be the location closest to your home here in Illinois.

There are some situations in which a worker does not live or routinely work in Illinois, yet still qualifies for Illinois workers’ compensation benefits. This can be the case if the employee was hired in Illinois. In that case, the hearing site will probably be a location that is considered convenient for everyone involved.

There are status hearings every three months on workers’ compensation cases. Your case will be on the arbitrator’s calendar and that day they will hear whether there is any progress on the case or if it will be continued for another three months. Either side can request that a trial date be set. The arbitrator monitors cases this way for up to three years, at which point they will push for resolution in the case. Until that time, your attorney will work with the insurance company to try and reach an agreement on settlement.

If there is ever an “emergency” in your claim, such as a refusal to pay benefits, or a sudden stop to your benefits, your attorney can request what’s called a 19(b) hearing, which is an expedited process. This will take place at the hearing site, with you and your attorney present.

Most claims settle. But that can’t happen until the worker is at “maximum medical improvement,” which means their treatment and recovery is complete. It doesn’t mean they are 100%, but rather that they are as good as they’re going to get. At this point, it makes sense for the two sides to settle. If an agreement can’t be reached, your attorney can go to trial to argue for fair compensation. There are pros and cons to settling a claim, so never make that call without the advice of a solid worker’ compensation attorney.

Illinois work comp: The importance of a witness

Illinois workers’ compensation law is a “no-fault” law.  That means you don’t have to prove that anyone was negligent in order to get benefits.  You can’t win a case if you were goofing off, but you can even if you were partially at fault for an injury (e.g. you fell asleep at the wheel while driving the company van and got injured).

As a result, in many cases you do not need a witness to prevail for benefits.  That said, it never hurts to have one.  For example, if you did get hurt when you fell asleep at the wheel, if an anonymous tipster tells your employer that you had been drinking, you will have a hard time winning your case.  But if a co-worker was with you the whole time and can testify that you didn’t drink a drop then you should be fine.

When a witness becomes really important is when you get in to a “he-said, she-said” sort of situation.  A while back a worker called us and said that her arm was injured while working at an office in Waukegan when a co-worker forcibly grabbed her.  She does have a real, medically documented injury, but benefits were denied.  The reason the insurance company is fighting her is the alleged assaulter denies ever even touching her, much less squeezing her arm.

So in order to win she has to go trial and the Arbitrator will have to believe that this did in fact happen.  There is no other witness, so it comes down to how credible each of them is.  And the injured worker theoretically has a motivation to lie, so unless their story is very believable and/or the other party is not believable at all (and they might have a motivation to lie too) then it’s a very hard case.

What I always tell people is that the first thing you should do after an accident is get medical attention.  Of course there is nothing more important than your health.  After that, you need to make sure to report your accident to your employer.  I then encourage people to start keeping a journal that documents what happened, when it happened, who saw it and then tracks your medical progress.  It’s good for you in case some day your memory needs to be refreshed at a trial and it’s good for your lawyer too in getting a full understanding and history of what happened.  If it wasn’t witnessed, your detailed description can enhance your credibility.

Even in a repetitive trauma injury situation like getting carpal tunnel from excessive typing, it’s a good idea to log how often you typed and who could verify this.

Of course, some accidents aren’t witnessed and if that’s the case then you go with what you have.  In those situations though, reporting what happened right away and being consistent with your doctor in telling them what happened will strengthen your credibility. 

With this caller, we declined to get involved because she didn’t sound credible to me.  I asked her why she didn’t file a police report for battery and there wasn’t a real good response.  Had she gone to the police, that investigation would have served as a possible additional witness.  My personal opinion is that it didn’t happen and given that honesty is our #1 feature in a client, we took a pass on representing her or referring her to a lawyer in our network. 

 

The scariest thing on Halloween for injured Illinois workers

Today is Halloween.  If you are an injured worker, you shouldn’t be scared of ghosts, goblins, witches or even an over-abundance of trick-or-treaters coming to your door.  No, the scariest thing to you or any other injured worker in Illinois should be a nurse case manager.

Their title sounds innocent enough and they aren’t all trying to ruin your case, but many of them will do things that they shouldn’t be doing.  The worst offense is that they’ll try to talk to your doctors and convince your doctor that the treatment plan is wrong for you and that another (cheaper) course of action should be taken.

Another frightening thing they will do is try and convince your doctor that you should be working even when your physician has said you should be off of work.

Of course when they do these things it puts your health at risk.  Let’s say your doctor says you can’t return to work because your normal job requires you to regularly lift 50 pounds or more and you have a herniated disc in your back.  So the nurse case manager talks to your doctor and says, “Is it ok if he goes back to work as long as he doesn’t have to do any lifting at all?”  The doctor says yes because that sounds reasonable, but you know that type of job doesn’t exist at your company.  So you go back to work and try not to lift anything, but then your boss is asking for help and calling you a wuss if you refuse.  So you try to help and then make your injury ten times worse when if you had just rested a couple of weeks you would have been 100%.

These nurses do other frightening things like trying to schedule your appointments around your schedule or even telling you that they need to let them in to the exam room with the doctor, even if you are disrobed!!

What’s really frightening is many of these nurse case managers will act as if you have no say in the matter and that they are doing this all with your best interests in mind.  Of course they are really just concerned about the bottom line of the insurance company and saving them money.  They aren’t thinking about your health.

Beyond that, you do have a say in the matter.  Many of these case managers will discourage you from hiring a lawyer because they know that the second we get on the case, we are going to prevent them from abusing you.  The first thing a good attorney will do is standup for their client and that’s something that should exist throughout a case.  Unless we give permission otherwise, they are not supposed to do anything other than request copies of medical records and bills.  All the other stuff is nonsense and abusive and we typically put a stop to it right away.  We certainly wouldn’t want them in the exam room with you or talking directly to your doctor.

So be scared, but not too scared. Just as I used to tell my kids when they were young that there was nothing to worry about at night when the lights were off, you don’t have to worry about this interference in your case.  That is you don’t have to worry as long as you know your rights.  And enforce them.

 

This is the best time of year to settle your Illinois workers' compensation case

Fair or not, sometimes Illinois workers’ compensation law is a game.  You are looking at your case based on how it affects your life because, after all, it’s your life and health that is being messed with when you get hurt while working.

But from the insurance company standpoint, specifically the adjuster who usually is in charge of settling your case, they are looking out for their own financial well being.  For many of them, that means getting a bonus based on the number of cases that they close by the end of the year.

A lot of insurance company workers don’t get paid based on how good of a job they do, but instead based on how many files they are able to move.  So while they won’t just give you whatever you want, they are thinking of themselves this time of year, so if there is a case they can settle, they will.

In the insurance industry (and I know this from my former days as a defense attorney) there is a saying that there is no good file other than a closed file.  When your case is open that means they are paying lawyer or nurse case managers or investigators and possibly more medical bills.  Insurance companies like fixed numbers, not the possibility of having to pay more. 

So what happens is that the insurance adjuster will set what is called a reserve on your case.  That in plain English is the most that they expect to spend on your claim.  If they stay below the reserve number, they can usually close a case without having to get the approval of a supervisor.  And if they close your file and a bunch of others, that’s more money in their pocket for Christmas presents or a trip or whatever. 

Beyond that, they are really getting pressure at this time of year from their supervisors to move files because they supervisors also get compensated this way.  So we’ll see a lot of “settlement days” this time of year where they’ll meet with attorneys en masse and try to work out a lot of cases.

Now you don’t want to even think about settling if you are still under medical care or not working due to an injury. But if your back to work and don’t need to see the doctor again, your attorney should really be pushing for a settlement and be aggressive about it.

Come spring time, the insurance company will not be as anxious to get rid of you.  They’ll settle if it makes sense, but at this time of the year, they’ll practically beg you to do it.

I remember once long ago an adjuster telling me that she’d settle for what I asked for – which was more than the case was worth – but only if I promised to have the contracts approved before the end of the year.  That was really the first time I realized how the business really works and I’ve seen it many times since.

So if you do want a settlement, remember, there is no better time of year than now to make it happen.

 

A new insurance company lie in Illinois

I have a good friend that is a workers’ compensation lawyer in Florida.  I have referred him cases and the ones that he’s able to take on he does a great job with them.  The problem is that he has to turn down a lot of clients because in many cases he can only get them a settlement from the insurance company if they are willing to quit their job.  It sounds pretty illegal to me and it would never happen in Illinois, but it does prevent him from taking some cases on.  Of course it’s the workers that end up getting screwed over in the end.

I say it could never happen in Illinois because if the insurance company doesn’t want to offer a settlement we can force one by going to arbitration.

But recently a caller to my office told me that the insurance company told him that any payment for permanent partial disability to him would have to come with a resignation and if he didn’t provide one he’d get nothing.

That is a total lie.  They might not voluntarily pay anything, but again we can easily get him compensated by filing a trial motion. 

Nothing in Illinois law requires you to resign.  Ever.  They wanted my caller to do that because he is fairly old and had a major injury that does not allow him to return to his old job.  If he were to resign it would greatly reduce the amount of money that the insurance company would have to pay him.

So essentially he was lied to in order to save some money.  That’s a pretty immoral thing to do, but it’s the type of nonsense that you see all of the time.  It just happens that this is the first time I’ve heard this angle.

Like with any other workers’ compensation claim in Illinois, you have to realize that the insurance company has a competing interest to what’s best for you.  That doesn’t mean you are always going to get in to a battle or go to trial.  It does mean that you are going to look out for yourself and not take legal advice from someone with a competing interest from you.

And overall, if they are saying something that sounds ridiculous, they are probably just throwing a dart against the wall and hoping that it sticks. 

Do I Need a Lawyer if I'm Injured at Work?

A reader contacted us and wanted to know if she needed an attorney.  The insurance company assigned her a nurse case manager to her claim.  That person told her a lawyer isn’t needed.  Her co-workers are telling her she’s crazy if she tries to go at this alone and that the nurse case manager is trying to screw her over.

So who is right?

I’d say that they both are, but that’s a bit misleading.  The nurse case manager is never going to tell you that you need an attorney.  She has a conflict of interest as she works for the insurance company.  Their goal is to limit what they have to pay for your care.  So she’ll never you say you need a lawyer because if they are breaking the law or taking away benefits you are entitled to, they don’t want you to know that you could do better.

That said, there are certainly times an attorney won’t make much of a difference.  This is especially true with minor injuries that heal quickly.  It could also be true in cases where there is an amputation, but no job or wage loss.  It could even be true in a death case if all the benefits are being paid, but with both amputations and death cases, if there is no dispute, the lawyer fee is limited to $100 so there would be no reason not to get help.

But in general the co-workers are correct.  Things don’t always get out of hand in these cases, but if they do and you aren’t already represented, it will greatly delay your ability to get in to court to get a fair hearing.

Most people I talk to that don’t get a lawyer make that decision because they don’t want to pay the 20% fee when the case is ready to settle.  The problem is that there’s no guarantee you will even get a settlement offer and when you do, it’s most likely to be a low ball offer.  This is especially true since the law on settlements changed in 2011 with the introduction of AMA guidelines being a factor in these cases.  Those guidelines have caused many offers to be woefully low.

But the biggest benefit you’ll get from having an attorney, or at least if you have one that really looks out for you, is that you’ll not get taken advantage of along the way.  Most people don’t know that the nurse case manager isn’t supposed to talk to your doctor, cancel your appointments or in any way interfere with your treatment.  Some people don’t know that they shouldn’t give a recorded statement.  Others will end up paying co-pays with their doctors or out of pocket expenses.  If you are being sent for an IME you should know what to expect.  Once you settle your case, it closes out your medical rights forever for that injury.  A good attorney will make sure that your future needs are looked out for.  If you settle without taking in to consideration any future Medicare or social security issues, you might end up owing the government a bunch of money.

I could go on and on, but the point is that you don’t know what you don’t know.  And that is the biggest benefit for having an attorney.  I talk to people every month who want to re-open a case because they’ve realized that they should have had representation.  But once the case is done, it’s done forever.

 

I’d say that they both are, but that’s a bit misleading.  The nurse case manager is never going to tell you that you need an attorney.  She has a conflict of interest as she works for the insurance company.  Their goal is to limit what they have to pay for your care.  So she’ll never you say you need a lawyer because if they are breaking the law or taking away benefits you are entitled to, they don’t want you to know that you could do better.

That said, there are certainly times an attorney won’t make much of a difference.  This is especially true with minor injuries that heal quickly.  It could also be true in cases where there is an amputation, but no job or wage loss.  It could even be true in a death case if all the benefits are being paid, but with both amputations and death cases, if there is no dispute, the lawyer fee is limited to $100 so there would be no reason not to get help.

But in general the co-workers are correct.  Things don’t always get out of hand in these cases, but if they do and you aren’t already represented, it will greatly delay your ability to get in to court to get a fair hearing.

Most people I talk to that don’t get a lawyer make that decision because they don’t want to pay the 20% fee when the case is ready to settle.  The problem is that there’s no guarantee you will even get a settlement offer and when you do, it’s most likely to be a low ball offer.  This is especially true since the law on settlements changed in 2011 with the introduction of AMA guidelines being a factor in these cases.  Those guidelines have caused many offers to be woefully low.

But the biggest benefit you’ll get from having an attorney, or at least if you have one that really looks out for you, is that you’ll not get taken advantage of along the way.  Most people don’t know that the nurse case manager isn’t supposed to talk to your doctor, cancel your appointments or in any way interfere with your treatment.  Some people don’t know that they shouldn’t give a recorded statement.  Others will end up paying co-pays with their doctors or out of pocket expenses.  If you are being sent for an IME you should know what to expect.  Once you settle your case, it closes out your medical rights forever for that injury.  A good attorney will make sure that your future needs are looked out for.  If you settle without taking in to consideration any future Medicare or social security issues, you might end up owing the government a bunch of money.

I could go on and on, but the point is that you don’t know what you don’t know.  And that is the biggest benefit for having an attorney.  I talk to people every month who want to re-open a case because they’ve realized that they should have had representation.  But once the case is done, it’s done forever.

What if my employer doesn't have workers' compensation insurance?

Illinois law requires most employers to carry workers’ compensation insurance. It’s estimated that more than 90% of Illinois employees are covered. When a worker gets hurt on the job, the employer’s insurance company pays out benefits to that worker.

The law specifically says that employers must insure all employees who work in Illinois, as well as those who are hired in Illinois or injured here. Employers who work for themselves and have no employees do not need to get workers’ compensation insurance, but if they have just one employee, even if it’s a part-time employee, the law applies and they must carry insurance. Employees are covered by Illinois workers’ compensation law the minute they get hired. There is no waiting period.

Employees generally aren’t allowed to sue their employers for negligence after a work injury, even if it was the employer’s fault. That’s just the way the law works. It’s a trade-off. Employers are protected from lawsuits and employees are given benefits without having to prove fault or go through the litigation process. However, if an employer knowingly fails to carry insurance for its employees, then an injured employee may be able to sue their employer in court.

You can search online to see if your employer has coverage, although your employer is supposed to post this information in a place where employees can easily see it. Employers who break the law and fail to get insurance can be fined up to $500 per day. Employees who report employers for non-compliance are allowed to remain anonymous. 

If your employer tells you that you can’t file a claim because they don’t have insurance, don’t take that as the final answer. Find out if they really do have insurance. Similarly, if your employer tells you that you don’t qualify for workers’ compensation, look into it for yourself. We talk to people whose employers seem to do anything they can to keep them from filing a claim. They do this to save money but it can really hurt your health and your ability to continue to work and be financially independent. Don’t get intimidated.

There are some rare exceptions, but the general rule is that employers have to carry insurance coverage for their Illinois employees. If you suffer an injury, the benefits you’re entitled to under Illinois law can make a big difference. Not only can you get coverage of 100% of your medical expenses, including doctor visits, tests, prescriptions, and even surgery, but you can collect 2/3 of your average weekly wage if you can’t work because of your injury. If you have questions, don’t hesitate to give us a call.

When to report a work accident to your employer

In Illinois, employees are entitled to certain benefits if they get injured on the job. For any injury that arises out of your employment you should be eligible for payment of 100% of your medical expenses and payment of a portion of your lost wages if you are unable to work while you recover. In order to get these benefits, you have to follow a few rules.

One of the initial rules you need to be aware of is employer notification. The law says that you must notify your employer of a job injury within 45 days. If you fail to do this, your claim for benefits could be denied and you might miss out on the compensation you need, even if you have a legitimate work injury. That said, if you think you have already missed the deadline, don’t give up. Check with an experienced Illinois work injury attorney as soon as possible.

Ideally, you should notify your employer much sooner than 45 days. It doesn’t have to be complicated. You can just tell your supervisor that you got hurt and include the when and where. Your notice is considered sufficient if it gives them enough information to look into it further. However, like most things, it’s safest to put it in writing. Don’t forget to include the date.

The problem with delaying on this is that the more time that passes, the harder it is to prove that your job caused the injury. And the connection to your job is what will get you benefits. For example, if you come back after a long weekend and tell your boss “I hurt my back at work last week” they might be suspicious that you actually hurt yourself at home over the weekend. 

Don’t trust that your employer, or their insurance company that is paying out the benefits, is going to give you the benefit of the doubt. Even if you have a good relationship with your employer, they’ll most likely jump at the chance to deny your claim. The insurance company makes money when they don’t pay, and their priority is their bottom line.

For most work accidents, the date of injury is clear. It’s the date on which you had the accident. For repetitive trauma injuries, on the other hand, the date of injury is less clear. The law says that you have 45 days from the date on which you realized that your injury was caused by your work. So this could be the day that you see your doctor for the pain in your hand and wrist and they tell you that it’s carpal tunnel syndrome and most likely caused by your work. Again, as soon as you know you have a work injury, let your employer know.

Some employers require you to fill out an accident report after something happens. Make sure you follow this, because you don’t want to get fired or face other consequences from your employer. However, your claim for workers’ compensation is not at risk if you fail to do so. The law requires you to notify your employer but does not require you to fill out an employer’s accident report in order to get benefits. Don’t let your employer convince you otherwise.

There’s no real risk in reporting your injury ASAP, but there’s a lot to lose if you wait too long. The law’s 45-day rule is a good guideline, but sooner is usually better. If you have questions before reporting your injury or concerns about your employer’s reaction, it’s confidential and free to talk to an attorney first.

When the company doctor says there's nothing wrong with you

One of the more frustrating situations we see in workers’ compensation law is when someone has a legitimate injury but is told they’re completely fine. The worker might be hearing this from their boss, or their employer’s insurance company, or even from a doctor affiliated with their employer. Why would they do this? Because injured workers cost them money.

Some employers have a rule that an injured worker has to be seen at a particular doctor’s office or a company clinic. Obviously, that doctor is going to be a bit biased toward the company. They know that it’s in the company’s best interest if you aren’t hurt because then they won’t have to pay workers’ compensation benefits.

You can imagine how frustrating this is to an employee who gets hurt on the job. It’s frustrating for us, too. Our job is to look out for injured workers and their rights, and these types of situations are the exact opposite: employers looking out for only themselves and their bottom line.

The good news is that you don’t have to continue to see the company doctor or go to the company clinic. States have different rules on this, and in Illinois injured employees are allowed to choose their own doctor. Go to a doctor you know and trust, or one that has been recommended by a reliable source.

Your doctor’s opinion on how you were injured, why you were injured, what treatment is best and what you need in order to recover, are central to your workers’ compensation case. Your doctor’s credibility is extremely important. A doctor who is essentially a hired gun of the employer is not going to have the final say, as long as you have a trustworthy doctor in your corner.

Along these same lines, don’t use your lawyer’s hired gun either. Don’t let your attorney direct your medical care or send you to some doctor they send all their clients to. Sure, it might get you a favorable report, but in the long run it will hurt your case. The people who are a part of the local workers’ compensation law community, including the arbitrator who is essentially the judge in your case, will know exactly what’s going on. And the result is that they won’t trust the doctor’s opinion and they might not trust you, either.

Your health should be your first priority. If you know something isn’t right, don’t get discouraged if you get brushed off by the company doctor. Go get a second opinion. And if you are worried about pursuing a claim and what it entails, talk to an experienced lawyer about your concerns. A free consultation is a good place to start, and it’s completely confidential.

When should you see a doctor after you are hurt at work?

A recent caller to my office was somewhat freaking out.  She had hurt herself while working on a Saturday, but as of the following Tuesday she hadn’t gone to a doctor or the emergency room.  She was hoping that her foot would start to feel better and like many of the people that we talk to, she wanted to just keep working and not have to deal with it. That is an understandable position and usually the sign of a hard working client.

Now that she realizes her problem is getting worse, she wants to see a doctor.  But a friend of hers told her that if you don’t go to get medical help within 24 hours of your injury, you aren’t allowed to get workers’ compensation benefits.

Allegedly that is the law in some other state, but it’s not the law in Illinois.  There is no time limit as to how quickly you have to see a physician, but I will say that the longer you wait, the harder it is to prove your condition is related to the original accident.

The reason behind this is that if you are on a witness stand some day and tell the Arbitrator that you hurt your back in April, but didn’t see a doctor until October, he/she will look at you with skepticism.  All of the Arbitrators are experienced and know how painful a back injury can be.  So if you say that you were able to go six months without any medical intervention, it will raise suspicions that something happened in between that really caused your trouble.  This doesn’t end your chances at a case, but certainly can hurt them.

I hate going to the doctor and other than bugging a buddy that’s an ER doc for advice, I usually just try to figure things out on my own.  So that makes me somewhat of a hypocrite because my advice to you is to never try and tough out an injury that is bothering you for more than a couple of days.  Perhaps the pain will go away, but it’s also possible your delay in treatment will cause you to get much worse.  If you go to the doctor, worst case scenario is that you waste an hour or so of your life because you get better right away.  Best case scenario is your injury doesn’t get out of hand and any potential case doesn’t end up in litigation because you created a potential defense.  Doesn’t it make more sense to just get checked out?

The other lesson from this phone call is that you should not take legal advice from friends that are not attorneys.  They likely have your best interests at heart, but don’t always know what they are talking about.  In this situation, the friend didn’t know that the laws are different from one state to another.  Many other times people confuse what the law actually is because they are going off something that they heard or improperly comparing their experience to yours.  So ask a lawyer.  We’ll always talk to you for free and so will many other firms.

What to expect after a work injury in Illinois.

A serious work injury is impossible to predict, and if it happens to you, it can seem like there are a million unknowns. What happens from the time of your injury, legally speaking, can differ based on your particular circumstances, but there is a general timeline of a typical workers’ compensation claim.

Work injury. A slip and fall, or something more serious, is usually the start of a workers’ compensation case. Whether it’s a sudden injury or something that develops over time, you shouldn’t just wait it out. One of the best things you can do, aside from seeking medical treatment, is to be proactive about your claim for benefits. Gather all the information you can.

Medical treatment. If your injury is sudden and severe, medical treatment is a given. But even if it seems like you might be able to work through it, go see a doctor if there’s any doubt. An injury can worsen quickly. If you wait, things might get worse. You could put your health, and a potential claim for benefits, at risk.

Notification deadline. You have to notify your employer of your work injury within 45 days of the date of the injury. If your condition or injury doesn’t have a specific date on which it occurred, then your deadline is 45 days from the date you knew your injury was work related.

Talk to an attorney. There’s no such thing as doing this too soon, especially if your injury is serious. If you’re unsure of whether you need legal help, at least get a free consultation and get all of your questions answered.

File a claim for benefits. You might start getting benefits regardless, but make sure to get this paperwork filed in case a problem comes up down the road and you need to request a hearing with an arbitrator. The form is called an Application for Adjustment of Claim and is filed with the Illinois Workers’ Compensation Commission.

Your arbitrator. Every claim is assigned to an arbitrator, who acts like a judge in your case. They will put your case on their docket regularly for status hearings to monitor any progress. If there is a dispute in your case, the arbitrator will make a decision after a hearing. They’ll also oversee your trial if you have one.

Your benefits. Ideally, you should start getting benefits fairly quickly. Temporary Total Disability benefits are available four days after you get hurt and you can expect TTD checks every two weeks. These are if you are unable to work. Your medical benefits should start right away, and you should be covered 100%. This includes doctor visits, medication, tests and even surgery.

Status call. These usually happen every three months to monitor the progress of your claim. If your case is moving along normally, then nothing much will happen and your case will be put on the calendar for another three months. If you want a trial, your attorney can request one at your status hearing.

Hearings on a dispute. As we mentioned, your attorney can request a hearing if there is a dispute in your case. A common reason is because benefits aren’t being paid. Your attorney will argue that you are entitled to benefits and hopefully the insurance company will be forced to pay.

Settlement. The majority of workers’ compensation claims in Illinois settle at the end. This means that you receive a lump sum in exchange for ending your case (no more benefits in the future). It’s important to understand what rights you are giving up in a settlement. It’s also important to go through this process with an attorney who understands the value of your case. You won’t get a second chance.

Trial. If a settlement agreement can’t be reached, the case can go to trial. Attorneys for both sides will present their cases, and the arbitrator will make a final decision. Make sure your attorney is willing to take your case this far if it’s necessary in order to get you a fair outcome.

Lawyers aren’t always good at explaining the big picture to clients or letting them know what to expect step by step. We try our best to give straightforward information to people. We hope this answers your questions, but if it doesn’t, just give us a call.

You must be a partner with your lawyer

 

Not only should you be a partner with your lawyer, but you should be the most active participant in your case.  Consider this e-mail that I got from an outstanding workers’ compensation lawyer in Chicago.

I filed a case for this guy in June.  It was a low rate case, but he claimed to have a herniated disc and was not getting paid.  I motioned the case up for a 19(b) hearing and notified the claimant to meet me in Wheaton.  On the day before the hearing, I spoke with him and confirmed that he would be there.  The next day, he did not show up, nor did he respond to my many phone messages and emails.  I wasted an entire half day waiting for him (to say nothing of the prep time, etc) and my opposing counsel had 4 witnesses present for the hearing to testify about their accident defense.  He never did respond.  I filed a motion to withdraw as counsel which was granted.

When the lawyer says it’s a low rate case, that means the injured worker wasn’t earning very much money.   That will effect how much the case is worth.  So he was clearly busting his butt for the client, but not going to get a huge financial return out of it if he won.  That’s ok, unless your client doesn’t care about their case at all.  I understand why the attorney was upset.  He got a case ready for trial in less than three months and the client doesn’t even bother to respond to a call.

Beyond that, it’s very disrespectful to the other attorney.  We aren’t worried about being friends with them, but if you tell them you are going to trial and that you’ve prepared your client, it makes you as a lawyer look bad.  That could impact future clients or cases.

I talk a lot about being honest with your attorney. I’m very straight forward with anyone that contacts me about how I’ve created a network of great lawyers that I work with on cases to try and get the best result possible for you.  We are also extremely direct and honest when you call and ask us questions.  Any attorney we’d refer you to can not promise a result, but can show a great track record of success and customer service.

All that anyone can ask in return is that you be honest and work with us to make your case a success.

Now I’m sure most of you would say that you’d never not show up for court if a trial was scheduled.  I’ve been handling these cases for 17 years and it’s the first time I’ve ever heard of this happening  But I still encourage you to be actively involved in your case.  That doesn’t mean that you let it dominate your thoughts and life.  But instead, no matter who you hire, ask them what you can do to help or what information they need.  Every time you go to the doctor, e-mail what happened and make sure to send them your off work slips.  If you go back on light duty to work and are experiencing issues with your boss, communicate with us.  But when you stay silent, it’s the sure fire way to harm your case because knowledge is power when it comes to handling these claims.  If we don’t hear anything from you we assume all is well.

 

How much do you weigh?

When I was young, I was taught never to ask a woman how old she is or how much do you weigh.  I teach those lessons to my children now.  But while I’m working, I ask those types of questions all of the time.
 
I’m not trying to be rude, but rather it’s very relevant for properly analyzing a workers’ compensation and figuring out if it’s compensable and how much it might be worth.
 
If you are diagnosed with carpal tunnel syndrome, we wouldn’t be doing our job if we didn’t ask you how much you weigh.  Obesity is a knows cause of carpal tunnel. That doesn’t mean if you are overweight that you have no case, but it does mean that we are trying to be prepared for any possible defenses that we might have to fight.  Any good work comp lawyer would also ask you if you are diabetic or pregnant as those are two known risk factors as well.  You could have all three of these issues and still win your case.  But most cases aren’t perfect and have some possible defense.  Your attorney needs to be prepared to respond to those defenses.  If the first time they learn that you are diabetic is when you are on the witness stand then they haven’t done their job.
 
Knowing your age is important too.  First off, we can’t formally file a claim without listing your date of birth.  That’s a requirement for the Application for Adjustment of Claim that must be filed with the State of Illinois.  Beyond that, knowing how old you are plays a role in determining what your case is worth, especially if you are not going to be able to return to your old job and have a loss of future wages as a result.  Knowing your age allows to get a proper range of what your case may be worth.
 
To be fair, I’ve never heard someone respond that they were offended by these questions.  Of course, I ask the weight question in a delicate, polite way and explain why I am asking.  So hopefully my grandmother, who taught me the importance of being polite and NEVER asking a woman her weight or age, is proud of me still, knowing that I have a good reason for asking.
 
For you as a client, you should be nervous if your attorney isn’t asking questions about you.  They should get to know you and your case, otherwise how are they going to have a full picture of what you are going through and be able to best represent you?

Hot off the Illinois Workers' Compensation Commission Presses

 

We have four new Arbitrators and we lost one as Arbitrator Brandon Zanotti resigned in order to become a State’s Attorney.  Below are the biographies of the new Arbitrators per the IWCC.  Somewhat odd in that three of the four are more insurance company oriented per their background.  But until we see them in action as Arbitrators, we of course can have no real opinion on them.  Best of luck to them all.

Governor  Pat  Quinn  appointed four  new  arbitrators to  the  Commission:

Maria  Bocanegra is  an  attorney  at  Katz Friedman,  specializing  in  workers’  compensation.  She  previously  worked  as  a  judicial  assistant  to  the  Honorable  David  Furman  and  as  a  case administrator  for  the  United  States  Bankruptcy Court  in  the  District  of  Colorado. Ms.Bocanegra  was  also  appointed  to  the  Illinois  Department  of  Labor’s Labor  Advisory  Board  in  2013. She  holds  a  J.D.  from  DePaul  University  and  a  B.A.  from  Quincy  College.

Stephen  Friedman is  currently  a  Managing Partner  of  Rusin,  Maciorowski  &  Friedman,  Ltd., specializing  in  workers’  compensation defense. Previously,  he  was  an  associate  and a partner  at  Rooks,  Pitts  and  Poust  practicing  workers’ compensation  and  personal  injury  defense. He  earned  both  a  J.D.  and  a  B.A.  from  the  University  of  Illinois.

Steven  Fruth is  currently  a  trial  attorney  at  the  Chicago  Transit  Authority.    Previously,  he  served  as  a  Circuit  Judge  in  the  Circuit  Court  of  Cook  County  and  as  the  Staff  Counsel  at  Allstate  Insurance  Company.    He  holds  a  J.D.  from  the  John  Marshall  Law  School  and  a  B.A.  from  Southern  Illinois  University.

Michael  Nowak  is  an  attorney  at  Becker,  Paulson,  Hoerner  &  Thompson,  P.C.,  focusing  primarily  on  workers’  compensation  law.    Previously,  he  was  a  partner  in  his  own  firm,  representing  injured  workers.    Mr.  Nowak  has  served  as  an  arbitrator  for  the  St.  Clair  County  Arbitration  Center  as  well  as  a  member  of  the  Judicial  Nominating  Committee  for  the  U.S.  District  Court,  Southern  District  of  Illinois.    He  holds  a  J.D.  from  Northern  Illinois  University  and  a  B.A.  from  Eastern  Illinois  University.

Please  join  us  in  welcoming  these  new arbitrators to  the  Commission.

 

The basics of Illinois workers' compensation law: Your benefits

Illinois law says that workers who suffer a job-related injury or illness are entitled to benefits. Sometimes, workers have to go after these benefits themselves (ideally, with an attorney), and other times benefits are awarded fairly routinely. A denial of benefits is not the final word – an arbitrator will make the decision in a disputed case.

Many companies in Illinois are required to carry workers’ compensation insurance. The employer’s insurance company should pay the following benefits, according to Illinois law:

Medical: All reasonable and related medical expenses should be covered 100%, with no out-of-pocket costs or co-pays. This includes prescription medication, diagnostic tests, treatment, surgery and even physical therapy. Your medical benefits generally continue until you reach what’s called maximum medical improvement, which basically means you are as good as you are going to get.

Lost wages: If you have to miss work while you recover, whether it’s a few weeks or many months, or even more, you are entitled to get paid for a portion of what you would have been making if you were still working. These benefits, which are equal to 2/3 of your average weekly wage, should be paid out regularly. If they stop, or if you are denied, you can request a hearing in front of an arbitrator.

Settlement: When a claim comes to an end, the insurer might make a settlement offer. This is a lump sum that is meant to compensate the worker for the permanency of their injury. In exchange, the worker gives up his or her right to future medical benefits for that injury. Not all cases end in settlement, but many do. If your case ends with a trial, the outcome could be different, with future medical benefits available.

Death benefits: When a worker is killed on the job, his or her surviving spouse, minor children and other dependents are eligible for death benefits.

Other: The law also considers how difficult it can be to re-enter the workforce. You might be eligible for job re-training if your injury makes it so that you can’t return to your old career.

In order to have the best shot at getting your benefits, file a claim as soon as possible. Technically, you have three years from the date of the accident to file a claim for benefits, or two years from the last payment of benefits, whichever is later. But sooner is better. Also, the law says that you must notify your employer of your injury within 45 days.

Don’t let your boss or the insurance company tell you that you aren’t eligible for benefits. Always check with an attorney. An initial consultation should be free.
 

Why is nothing happening in my case?

Delay, in the legal system, is an unfortunate reality in some cases. But there should always be a reason for it, not just the fact that your lawyer is lazy or the insurance company is waiting to see if you’ll just go away. If there’s been a delay in your case, find out why. If you haven’t heard from your lawyer in a while and you don’t know the status of your claim, you should check in. It’s completely reasonable expect a prompt response.

Potential reasons for a delay in your case:

The insurance company is denying benefits. If the insurance company can find a way to deny your claim, they will. Once that happens, the ball is in your court. Many times, the injured worker can successfully get their claim approved by asking for a hearing in front of an arbitrator. Don’t do this without an experienced attorney who knows how to make your case and understands the strategies used by the insurance company. Note that you won’t get this hearing automatically; you have to submit a petition.

You are still in the middle of your medical treatment. If you are still injured and still going through treatment or therapy for your injury, then not much will be changing in your case. You should continue to get benefits, but your claim won’t settle until you are as good as you’re going to get. This is called maximum medical improvement, or MMI.

The insurance company is delaying settlement. If your medical treatment is complete, you might be waiting for a settlement offer from the insurance company. The insurance company doesn’t have to offer you a settlement. Many times they do, because they want to close your case and ensure that you won’t come back later asking for more benefits. However, it’s not unheard of for an insurance company to ignore you and hope you give up and go away. Your attorney should be doing what they can to move things along.

You need a new lawyer. If you aren’t getting benefits and your attorney has not petitioned for a hearing or given you a good reason why they haven’t, then it’s time to have a serious conversation. If you have trouble getting in touch with your lawyer and can’t even set up a face-to-face meeting, it might be a sign that your case is being ignored. You can always get a second opinion, and in some cases, switching attorneys is the only way to solve the problem. The sooner you switch, the better off you’ll be.

 Don’t sit around and wonder what’s going on in your case or stress about a lack of benefits. Call your attorney or set up a meeting so you can get your questions answered.

 

What a good lawyer can do for you

If you are feeling hesitant about hiring a lawyer, you aren’t the first. We talk to people all the time who are unsure of whether they really need legal help. The thing is, hiring a lawyer isn’t that big of a deal, and it can make a world of difference if you’ve been injured at work.

The immediate benefit you’ll get is answers to your questions from someone who knows what they’re doing and who has helped hundreds of injured workers before (make sure this is true of anyone you hire). All of the lawyers we work with share our philosophy of giving clients honest and straightforward answers.

Next, your lawyer will make sure your case is on track. There are deadlines to be aware of, and it’s your lawyer’s job to make sure those deadlines are met. Have you notified your employer? Filed a formal claim requesting benefits? Are you nearing the statute of limitations, after which you are no longer allowed to make a claim at all?

Your lawyer, if they have the experience we’re talking about, will know how the insurance company operates. They’ll know their common delay tactics, how they might attempt to deny your claim and what to expect from them when it’s time for settlement or even trial.

And speaking of trial, your attorney shouldn’t be afraid to go there if necessary. Many, many cases settle, with the injured worker taking a lump sum in exchange for ending their claim. But if the other side isn’t giving you what you’re entitled to, a good lawyer will have the experience and desire to take your case to trial (with your approval, of course).

And finally, a good lawyer will communicate with you throughout all of these steps. Their fee is set by law and is lower than the fees for most other types of injury cases. And you shouldn’t have to pay a fee on your regular benefits payments, only when your lawyer has to work to get you past benefits or a settlement, or a win at trial.

It’s fairly likely that your lawyer will have handled cases similar to yours, which puts you ahead of the game. Honestly, we can’t think of any good reason to not hire an attorney, unless your injury is minor. In our experience, workers who hire attorneys end up with larger settlements than those who go it alone.
 

Is your workers' compensation lawyer hurting you?

A Chicago work comp defense attorney I am friendly with shared the following snippet from an e-mail she got from a lawyer on a case she is defending:


Petitioner is recommended surgery and yes you will pay it because I will visit justice upon your client.  While you consider this email and remain aghast at its utter bravado I'll retire to east bank club pool to savor another impending victory over your firm.

For lack of a better term, the lawyer representing this injured worker appears to be an utter douche bag.  I had never heard of him so I looked him up and noticed that he’s only been licensed to practice for less than three years and has his own firm.  That leads me to believe that he was never properly trained on how to handle a case or communicate like a professional.  That’s not to say that a younger lawyer can’t successfully handle a case, but in this matter he’s doing it in a way that will not only harm the current client, but future clients.
 
If we represent you, our job is to look out for you and not be buddies with the defense law firm.  But pissing them off by acting like a jerk is not going to make them suddenly turn reasonable.  Think of your own life experiences.  When someone puts you on the defensive with their actions, it makes you defensive right back to them.  The last thing that will happen in this case is for the insurance company to roll over and pay for a surgery because someone is acting arrogant.  In fact, if it’s a close call it will be the motivation needed for them to deny the case altogether.
 
And this doesn’t just hurt the current client who appears to be badly injured, it will hurt his future clients.  This e-mail is being passed around because it’s so ridiculous.  As a result the lawyer is going to get a bad reputation.  So the next time he has a case with this defense firm or anyone else that has seen it, they are going to have a biased view of the case and the innocent worker is going to suffer.
 
Clients want lawyers that show they are fighting for them, but this type of letter is actually harming them. There are so many better ways to write this, mainly to lay out the supporting evidence, file a trial motion and petition for penalties (which actually requires the insurance company to respond to you with their reasons for denying the case) and follow up with a phone call.  Attaching a medical report that supports your position would help too.  That’s actual toughness because it shows that you have a strong case and will go to court with evidence that will punish them for not doing what they are supposed to do under the law.
 
I’ll give this younger attorney a pass personally.  Maybe he was having a bad day or maybe he just doesn’t know any better.  But he looks like an ass and certainly is not anyone I’d recommend to represent anyone that I cared about.
 
As a client you can protect yourself by simply asking your attorney to cc you (or blind carbon copy) on any correspondence that they are sending.  They should feel great about this because it can prove to you that they are actually trying to get stuff done on your case.  And if they don’t want to do it, it may be a sign that they are doing nothing at all.

The risks of your employment might not be obvious

If someone asked you to name the health risks of being a cashier, you’d probably name the physical injuries that can come from standing for long periods of time, or using a cash register all day long, or repeatedly bagging customer purchases.

The fact that a cashier might be at risk for an injury caused by an out-of-control vehicle smashing into the store probably doesn’t come to mind. But that’s what happened in a recent workers’ compensation case. The question was whether the cashier had suffered a work injury under Illinois workers’ compensation law and would be entitled to benefits.

The legal issue is whether the injury was related to her job as cashier. The rule is that injuries that could happen just as easily to any member of the general public at any time don’t count as work injuries (for purposes of getting workers’ compensation). So was the cashier at greater risk for getting hit by a runaway car because of her job?

The cashier won her case and it was determined that she was at a greater risk than members of the general public for that type of injury. The reason was because she was required to stand in the front of the store for most of her time at work and the front wall of the store was a large glass window. 

These cases tend to be very fact specific. While the law is important, it really comes down to the situation of each injury and each employee. Examples where employees were not eligible for benefits include falling on gravel in the parking lot, tripping for no apparent reason, and bending over to pick something up. In these cases, no compensation was awarded because the arbitrator or commission determined that the employee was at no greater risk than the general public when it came to their specific injuries. That said, there are situations in which these cases would be compensable. A single detail can make a big difference.

The bottom line is that you can’t rely on the general rule when determining whether workers’ compensation should be awarded in a particular case. There are so many exceptions and nuances. Honestly, it’s what makes our job interesting. And it’s also one reason why the help of a good Illinois attorney can turn your case around.

 

Nurse's fall at work not covered, but cop covered for fall at home

These cases aren’t related, but they’re interesting to look at side by side. When you consider the basic facts of each, the outcomes seem unfair. Why is a nurse who falls in the hallway at the hospital not covered by workers’ compensation, but a police officer who falls at his own home is?

The reason is because an injury has to be related to the individual’s work in order to make them eligible for workers’ compensation benefits. Specifically, Illinois law says that the injury has to arise out of and in the course of one’s employment. The effect is that not every injury at work is considered a work injury. And on the flip side, you don’t necessarily have to be at your place of work in order for an injury to count.

So, an underlying connection to your work is more important than the location, which is at the core of both of these cases.

The police officer was at home on his lunch break, and when he was walking back out to his squad car, he slipped on snow and ice. What makes his injury a workers’ compensation injury is the fact that he was on duty at the time. He was permitted to have lunch at home. He was wearing his radio, and he would have had to respond to a call for assistance if needed. So, he was still in the course of his employment when he fell, even though he was in front of his own house.

The nurse fell in the hallway at the hospital and injured her knee. She testified that the floor had a defect – that it was not flat and caused her to fall. However, she could not provide evidence of any floor defect, so her benefits were denied. Even though she was in her place of employment, simply tripping and falling is not enough to get compensation under the law. You have to prove that something unique to your employment caused your injury; and she could not do that. In other words, her fall did not specifically arise out of her employment.

These cases illustrate some of the underlying concepts of workers’ compensation law. But more importantly, they go to show that you can’t always predict whether something will be a considered a work injury, making you eligible for payment of medical bills, wage loss checks and other important benefits.
 

Illinois Work Comp - How Many IME's Can They Send You To?

A very frustrated worker contacted me recently.  She didn’t need an attorney as she actually had a quite good one in her corner already – not my office and not someone in my statewide network of law firms, but still a firm I like and respect.  This lawyer had taken her case to trial and won.  There was a dispute as to whether or not she needed a back surgery and if so, was it related to a job injury.
 
The issue at the trial was who did the Arbitrator find more credible; the IME doctor that saw her once for about 10 minutes and said no surgery was needed and any injury wasn’t work related or the treating orthopedic doctor that has seen her over 15 times and believes a surgery is needed due to a job accident.
 
Just reading that last sentence, you’d realize that in most cases the treating doctor’s opinion will be given a lot of weight.  That doesn’t guarantee a win, but if your lawyer is willing to go trial and do the work necessary, you usually have a great chance at winning and that’s what happened in this case. It’s not unusual for Illinois workers’ compensation at all.
 
So here we are three years or so after the trial and she’s had her surgery.  Her doctor says she can’t return to her old job. The insurance company sent her back to the same doctor for another IME, this time to address whether or not she needs any work restrictions.  Surprise, surprise, he says she is fine.
 
The caller was understandably upset because she sees no reason that this doctor should be able to see her again.  As good as Illinois workers comp law is for injured workers, it’s not perfect.  The reality is that this is a new case issue, so the insurance company does have a right to send her back to the IME.  It’s a joke of course because we know if this goes back to trial she’s going to win again, but they are entitled to fight it if they want.  If anything, it gives them some leverage in negotiating a settlement.
 
For longer term injuries, it’s not unusual to go to more than one IME.  There is no law as to how many they can send you to, but generally speaking, it can’t be done for pure harassment.  The IME has to serve a purpose that hasn’t already been addressed.  For example, you may see their hack, er, I mean IME doctor and he could ask you to come back after you have a MRI.  If a long time has passed, they might see you to report on progress that you’ve made since the first visit.
 
And in cases like this one, if there is generally a new issue at hand such as whether or not you need work restrictions, they can send you back for an exam.  They are wasting their money and your time, but it’s within their rights.
 
My advice is to go to the exam, don’t embellish your symptoms answer their questions and go from there.  Most of the reports I read are based more on your medical records than anything else, although it’s not uncommon for them to observe you in the parking lot and compare how you move there to how you move in their office.  If you have a good treating doctor and attorney in your corner, things will work out fine.  And that’s true whether you have to go to one of these exam or five.

Your doctor says you're ready to go back to work, but you disagree

Unfortunately, the insurance company isn’t going to take your word for it. In order to continue to get temporary total disability benefits, you’re going to need your doctor to agree that you are unable to return to your job. That’s the law in Illinois.

If you legitimately feel as though your doctor is wrong, we believe you. You know your body best. But the law has to draw the line somewhere or everyone would go around saying they can’t work. If your doctor can’t be convinced, you’re in a tough spot.

The best way to avoid a problem like this is to value your relationship with your doctor from the beginning. Your goal is that you want your doctor to trust you and believe you and genuinely want to help you. So being a good patient is a good start. This includes being honest about how you were injured and how you’re feeling. Keep your doctor posted if your pain or condition changes. If they don’t feel you are being honest, they might not believe you when you say you are still in pain.

If you’ve already gotten to the point where you have a disagreement with your doctor about your readiness to return to work, make sure to let them know that you disagree. You might be able to get them to agree to a few weeks of light duty work as a trial run. Maybe there is some rehabilitation you can do first to get you ready to go back. Make sure you ask what you can do if you feel pain while working in the future.

Your doctor may have seen patients in the past who have tried to take advantage of workers’ compensation system. Let them know that you aren’t one of them, that you want to return to work but that you are worried that it’s not time (as long as this is the truth, of course).

In the end, you might just have to go back to work and give it a try. Maybe you’ll be pleasantly surprised, or maybe you’ll get re-injured. But if you don’t try, your other option is to sit at home and not get paid. We wish we could give good news all the time, but our philosophy is to be honest about what you’re facing and then help you figure out how to make it better.
 

Illinois workers' compensation tip: Know your arbitrator

You don’t have to personally know your arbitrator, but your attorney ideally should.

In an Illinois workers’ compensation case, a judge doesn’t oversee hearings and trials. Instead, an arbitrator is in charge. They act just like a judge – deciding disputes, holding status hearings to check on the progress of a case and presiding over trials. It’s just a different system with different players.

The rule of thumb about knowing the arbitrator is similar to that of knowing the judge. If your attorney knows the tendencies of the person making the major decisions in your case, then they can tailor their argument to give you the best shot. Knowing the arbitrator helps an attorney make decisions about strategy, such as whether to go to trial. An attorney can’t know the arbitrators without dealing with them often. Look for an attorney who handles cases day in and day out, and focuses their entire law practice on workers’ compensation.

Along these same lines, when your attorney appears before an arbitrator often, that arbitrator develops an opinion of your attorney. Hopefully it’s a positive one. If they have a good working relationship, and each respects the other, then it can have a positive effect on your case. We’re not saying that anything unethical is going on. It’s quite the opposite. An attorney who knows what they’re doing, works hard for their clients and respects the arbitrator has an advantage simply because arbitrator has a positive opinion of them. You want this type of lawyer presenting your case.

Work injury cases don’t start with a lawsuit, nor do they play out in a typical courtroom. Instead, Illinois law has created a system in which injured workers file claims for benefits, which are then paid (hopefully) by their employer’s insurance company.

The system protects employers from lawsuits. An injured worker does not even have the option of filing a lawsuit; a claim for benefits is their only recourse. For the injured worker, the intended benefit is compensation, regardless of fault, without having to file a lawsuit. It doesn’t always work like it should, especially for the injured workers, but it’s what we have. You can give yourself a leg up by hiring a well-respected attorney who focuses in this area of law.
 

Determining the accident date for a repetitive stress injury

It’s important to know the date of your Illinois work injury in order to receive workers’ compensation. It determines when benefits begin, allows the insurance company to verify your injury and tells them whether you filed a claim within the deadline.

For an injury caused by a specific incident such as a slip and fall, the date of accident is obvious. For an injury that is caused over time, such as a repetitive stress injury, that date can be hard to pinpoint.

The rule, when it comes to accident dates for repetitive stress injuries, is the date on which your injury was apparent and you were aware (or a reasonable person would have been aware) that it was related to your job. This could be the date you see a doctor about arm pain and he or she asks you about your job and diagnoses you with carpal tunnel syndrome, for example.

Telling your doctor what your job entails is important after an injury. If the insurance company tries to argue that your injury was not caused by work, your doctor’s opinion that it was caused by work will be very important.

Carpal Tunnel Syndrome is a common example of a repetitive stress injury, but it can be any injury caused by repeating the same motion over and over again. It can be assembly line work, typing, lifting, pushing or pulling, etc.

Illinois law gives you three years from the date of accident to file a claim for benefits. Or, if you have received some form of benefits, then the deadline can be two years from the last payment of those benefits. Whichever of these dates is later, that is your deadline. You also have 45 days to notify your employer of a work injury in order to be eligible for benefits. That 45 days also starts on the date of injury.

If you have questions about the date of your work injury, or any other questions about getting benefits in Illinois, talk to an experienced work injury attorney. Illinois law provides injured workers with disability benefits payments, coverage of 100% of their related medical expenses, and many workers end up with a settlement if their injury is permanent.
 

What filing an Illinois workers' compensation case is not

At least once a week I talk to someone who has never talked to an attorney before, at least not to hire them potentially.
 
Some of these callers hate that they had to pick up the phone and seek my help.  They hate it so much that they let themselves get taken advantage of and abused by insurance companies and nurse case managers who are messing with their medical treatment following a work injury.
 
I recently talked to one nice guy who got illegally fired after a work injury and had his benefits cut off without cause at all.  But before he would hire a lawyer he said he wanted to talk to his priest to make sure it’s ok.
 
Lobbyists and others have done a great job of painting the legal industry in a terrible light.  And to be honest, many of my peers have made law firms as a whole look terrible.  So I understand why lots of people have a terrible perception of our industry.
 
Most of those that are hesitant don’t want to get an attorney because in their mind they are “not the suing type.”  Well, I have good news for them.
 
First off a claim for workers’ compensation benefits in Illinois is not a lawsuit.  It is simply a claim for getting an employee benefit that you are entitled to and no different than filing a claim for your health insurance company to pay the hospital bill if your appendix ruptures.  When you hire us we are never filing a lawsuit against your employer or anyone else.
 
Beyond that, there is no “suing type” at least not in reality.  We only represent honest people with honest claims.  If we thought that a client was faking an injury we wouldn’t help them.   If we sign you up and catch you lying, we’ll withdraw from your case.
 
But if you are like most of the people we meet that bring claims in that you are a hard worker who had an accident while working and sustained an injury, we want to protect you and make sure that you get the benefits allowed by law which will allow you to get healthy and financially survive.
 
There is nothing immoral about hiring an attorney when you are being honest.  What’s immoral is how some of these insurance companies and IME doctors will screw you at a moment’s notice in order to avoid having to do what they are supposed to under the law.
 
And the truth is that this isn’t unique to work comp.  Any car accident lawyer I know, for example, wouldn’t take a b.s. case either.  But the good news for you is that if you don’t want to sue anyone, you don’t have to, as work comp is not a lawsuit.
 
If you have any questions about Illinois law and want a no cost, no commitment consultation, just call me any time at 312-346-5578 and we’ll try to point you in the right direction.

By Michael Helfand

Do I have to take a drug test after a work injury?

The law says that you have to take an employer’s drug test if you are injured on the job. If you don’t, your workers’ compensation claim can be denied. Employers are supposed to have uniform policies in place and not selectively require drug tests for only those who get hurt. Generally speaking, however, there isn’t much leeway in refusing a drug test after a work accident. What you can do, is present a good case (if you test positive) that the drug or alcohol was not the cause of your injury.

If you test positive for drugs or alcohol, the law creates a presumption that intoxication or the influence of drugs was the cause of your injury, which means you can’t get workers’ compensation benefits. However, the presumption is rebuttable, meaning that your lawyer’s job is to prove that intoxication was not the cause of your work accident or injury. If he or she is successful, you should be able to get benefits.

This law is unfortunate for workers who get hurt because their job poses a legitimate risk and not because they smoked pot over the weekend. A good attorney can win such a case, but it will take more time than it should, unfortunately, and it can delay treatment and recovery.

It makes sense that you wouldn’t get benefits if you were wasted and that was the reason for your injury, but the law takes it even further by requiring the test and giving it significant weight. Allowing the insurance company to deny your claim until you prove your case is a disservice to legitimately injured workers.

An important aspect of this law is that the intoxication has to be so great that it’s said to be a “departure from employment.” This is what puts the accident outside of the reach of workers’ compensation coverage. In other words, you were not technically doing your job.

Insurance companies aren’t going to let a case like this slip by. They want to deny your claim and this law gives them a solid basis to do so if your drug test comes back positive. Your best course of action is hiring an attorney who has been successful in winning these cases.
 

How do you get a copy of an IME report?

A recent called to our office was wondering if their lawyer was doing their job correctly.

 

This worker had an IME performed at a doctor’s office in Chicago back in January.  His treating doctor was recommending a spinal fusion and the IME was taking place to see if that was necessary or not.  No medical benefits were approved until this report became available.

 

So here we are in June and the report has never been received.  The worker called the IME office and asked for a copy because, you know, it’s a medical report about him.  They told him that they could not turn it over to him since the report was prepared at the request of the insurance company.  They wouldn’t even tell them what it says.

 

The doctor’s office for the IME is within their right to not send a copy of the report to worker, even as awful as that sounds.  Performing these exams is a financial windfall for them and they don’t want to upset the insurance company.

 

But that doesn’t mean the worker should get screwed over as is happening in this case.  Here is what the lawyer should do:

 

  1. Issue a subpoena to the doctor’s office for a copy of the report and any notes related to the exam.  Sometimes these hack doctors won’t prepare a report if they know it’s going to be bad for their client.  They’ll call them up and say that they agree with the treating doctor and will tell the insurance adjuster or defense lawyer that they just won’t prepare a report because that way it can’t be used against them.  So we subpoena the notes and really the whole file in order to uncover every stone possible.
  2. File a trial motion for an immediate hearing. This will force defense counsel to either turn over the report or go to trial without it.  There is a legal precedent in Illinois that says if you went to an IME exam and the defense attorney doesn’t offer evidence about what the IME doctor thought, the Arbitrator can reasonably infer that the doctor’s opinion was in your favor.

 

The bottom line is that situations like this call for aggressive lawyering.  The current attorney told his client that he didn’t want to go to trial because “it will probably get delayed by an appeal anyway.”  That’s ridiculous and lazy.  If you aren’t willing to go to trial as an attorney then there is really no point being involved at all.  Sure you avoid arbitration hearings if you can get a good result for your client otherwise, but you never give up on that option altogether.

 

If there is a silver lining, it’s that this worker has a solvable problem.  It’s just a shame that he had to wait so long in pain while his representation sits on their hands.

We Are Non-Lawyerly

A caller to my office paid me a really nice compliment.  She told me that I wasn’t very “lawyerly” and I very much appreciated that.
 
What she meant is that I write and talk like what a real human being, not the stuffy image that many attorneys are perceived to be like.
 
Truth be told, most Illinois work comp lawyers I know (and attorneys in general) act pretty normal.  Even the bad ones.  But we do come across some who think that having a law degree is a license to treat people like dirt, talk down to them, yell at them, etc.  Most of these idiots are lawyers who hate what they do for a living, but don’t know how to do anything else professionally or don’t have the courage to try.  They are mostly miserable and I feel sorry for them.
 
I’d sooner find something else to do than be miserable every day at work. The network I’ve created around Illinois that allows us to refer you to the best work comp attorney for your area when needed is made up of lawyers that care about their clients and if you knew them outside of needing their legal help, you’d like them personally.  And you’ll like them when they are working for you because you’ll see that they care about getting a good result for you.
 
There is a lot of perception versus reality out there.  If you’ve sought out legal help and talked to some a-hole or heard of someone that did, I apologize on behalf of the entire professions.  But just as there are mostly good cops, teachers, real estate agents, laborers or anything else, it’s the bad ones that help form your opinions.
 
So I guess what I’m trying to say is that whether your are contacting us or another law firm for help with your case, don’t be hesitant or worried about how to talk to a lawyer or anything else.  If an attorney can’t talk to you like a human being then they aren’t right for you any way.  For better or worse, there are more than 80,000 of us in Illinois.  The right one for you is out there somewhere.
 
Finally, when it comes to work injuries, you should never lay out a penny from your own pocket and that includes having just a no commitment consultation.  If they try to charge you then you should say no thanks and move on.
 

Don't let your employer talk you into getting back to work too soon

One of the frustrating things about workers’ compensation cases is that the employer’s interests are often at odds with the injured employee’s interests. For example, your employer would like you to get back to work as soon as possible. If you’re injured, it’s in your best interest to wait until you are healed and physically ready to handle the demands of your job. Otherwise, you could get hurt again or never make a full recovery.

Some employers have been known to pressure workers into coming back to work before they are ready. If your employer is pushing you to return to work, or threatening to fire you if you can’t come back right away, it’s a red flag and you should proceed with caution. This is especially true if they pressure you to get a release from your doctor so that you can return to work. Even if they promise that you won’t have to do your full duties, don’t do it.

As much as you might want to return to work and normal life, getting a release to return to work before you are physically able to do so can damage your workers’ compensation claim. In the worst cases, the worker returns to work only to get fired. At this point, they are no longer getting temporary total disability benefits (payment for lost wages while they recover), but they don’t have a paycheck at all and aren’t in great physical condition when it comes to getting another job.

Getting a full release from your doctor, or having your doctor say that you have reached maximum medical improvement, is great if it’s true. If not, it hurts your ability to get further medical treatment covered by workers’ compensation. Further, it can decrease the value of your case. At the end of a claim, many workers will get a settlement if their injury is permanent. But if your doctor has signed off that you are all better, the employer and their insurance company are going to argue that there isn’t any permanent disability.

The bottom line is that a release to full duty work should not happen until you are actually ready or full duty work. Being ready means that you have exhausted your treatment and either you are completely healed or you are as good as you are going to get. If you are unsure of whether it’s time for full duty work, talk to an Illinois workers’ compensation attorney about the implications and the other options you might have.
 

By Michael Helfand

Five reasons you'll lose your workers' compensation case

Based on our experience, here are some circumstances that are difficult to overcome in a workers’ compensation case. Not always impossible, but difficult.

  1. You lack credibility. Credibility is arguably one of the most important factors in a workers’ compensation claim. Not only yours, but that of your doctor and lawyer as well (see below). If you are honest, you will be credible. The circumstances surrounding your injury, your level of pain, your ability to work or not … all of these things are at the core of your case and if no one believes you, it’s going to be tough. You need your doctor on your side. If your case ends up in front of an arbitrator, their opinion of you will matter a lot. For example, if you’ve filed half a dozen claims in the past, that won’t look good.
  2. Your doctor lacks credibility. Your doctor might recommend surgery, or say you can’t work, or require work restrictions if you can work. The insurance company is going to disagree, because these things cost them money. If there is a dispute, you’re more likely to win if your doctor has a good reputation.
  3. Your lawyer doesn’t know what they’re doing (or lacks credibility). If your case is disputed, you’ll need a lawyer who has significant experience arguing cases in front of an arbitrator. They should be familiar with the arbitrator assigned to your case. They should focus mostly on work injury cases. These things create credibility. (Tip: don’t hire a lawyer suggested by your doctor – this makes them both look bad.)
  4. There was no “increased risk” associated with your injury. Unfortunately, just because your injury happens at work doesn’t mean it qualifies for workers’ compensation. If it is an injury that could have happened just as easily to anyone in the general public, then it’s not considered a work injury for purposes of workers’ compensation. For example, if you have a foot injury because you stand at work all day, that might not be enough. A lot of people stand all day at work. You’ll have to prove that your job created an increased risk of that injury.
     
  5. Your injury didn’t happen in the course of your employment. Your injury might seem work related to you, but the law might disagree. You aren’t in the course of your employment while you are driving to work in the morning, although there are exceptions. The point here is that if the circumstances of your injury are in a gray area, the insurance company is going to argue that it wasn’t a work injury, and you might have an uphill battle. The best thing you can do is hire a lawyer who knows how to prove your case and ensure that you get benefits.

 If any of these apply to you, we aren’t suggesting you give up. The facts vary from case to case and what ruins one case might not ruin another.

By Michael Helfand

Can I see any doctor I want for my work injury?

Generally speaking, yes. In Illinois, you get to choose the doctor you see for your work injury.

It’s not a good idea to go to a doctor recommended by your attorney. Your doctor’s opinion on how you were injured, what type of treatment is reasonable and whether you are ready to return to work are extremely important in a workers’ compensation case. If it looks like your attorney and your doctor are in bed together, it weakens your case and makes your doctor look a lot less credible.

Another thing to keep in mind is the type of doctor you’re seeing. Again, his or her medical opinion will be important, so you want someone with credibility. Often, this means a specialist of some sort. Their specialty should be relevant to your injury and treatment.

Your employer or the insurance company has to pay for 100% of your medical care in Illinois, as long as it is reasonable and related to your work injury. Your medical treatment needs to be seen as reasonable. Some providers on the cusp include chiropractors and those doing experimental medicine. A referral to a specialist might be better. You can get this from your general practice or family doctor.

If coverage is unclear because of the type of treatment you’re seeking, you can try to get the insurance company to agree to the treatment ahead of time. This can save time and delay and a lot of trouble later on. Even if the treatment might seem outside of the box, the insurance company might agree to it because it helps their bottom line. For example, naturopathic care is probably going to be cheaper than having surgery.

As a reminder, the most important aspect in all of this is to look out for your health first and foremost. Be honest with your doctor. Don’t ignore pain or downplay it. If it looks like you’ve been dishonest with your doctor, you’ll lose precious credibility, especially if it comes out in front of the arbitrator.
 

Medical expenses - modifications to vehicle or home

Two recent Illinois workers’ compensation cases address the issue of modification of a vehicle or home after a disability caused by a work accident. In both of these cases, the workers won their arguments that they should be awarded the costs of their respective modifications. In the first case, a pre-existing condition didn’t prevent worker from getting the vehicle he needed, and in the other, it didn’t matter that the recommendation for home modifications came from a physical therapist rather than a doctor.

In the first case, the employer was ordered to provide the injured worker with a handicapped-accessible van that accommodated his needs, as well as training to teach him how to use the vehicle. The twist in this case was that the worker had the pre-existing condition of muscular dystrophy. In fact, his pre-existing condition already required the use of a modified van.

The other side argued that the worker’s need for the van was due to his pre-existing condition, and also that he already had access to other benefit programs to provide him with a van, but these arguments didn’t work. The Illinois Workers’ Compensation Commission said that the worker was entitled to the modified van because he was found to be “permanently and totally disabled” after his work injury. In other words, the need for the van was in part due to the work injury.

In the other case, the injured worker was arguing for payment for the costs of modifications to his home. The arbitrator and the commission denied the cost of those modifications because they were recommended by a physical therapist rather than a doctor. The court disagreed, deciding that a physician’s prescription is not a requirement. The law in Illinois doesn’t say that a doctor needs to give an opinion or even testify when it comes to awarding benefits like these. The worker just needs to provide evidence that the award is reasonable and necessary, according to this case.

The law says that injured workers in Illinois are entitled to coverage of all reasonable and related medical expenses. This doesn’t only cover strictly medical things like prescription drugs and surgery. We’ve seen cases with all types of treatment that get approved. Some get approved without a fight; many are disputed but we are able to get them for our client after arguing the case to an arbitrator; sometimes, the treatment is just too unrelated or non-traditional. It often comes down to the opinion of your doctor and the experience of your attorney. Don’t assume you aren’t covered.
 

By Michael Helfand

What the insurance company doesn't want you to know

Your employer’s workers’ compensation insurer is often who you deal with after a work injury, and they are the ones paying your benefits, or not paying in many cases. Here are some things that they don’t want you to know…

 1. You don’t have to talk to them or give a recorded statement. They want you to say something that will hurt your claim. Tell that them you won’t give a recorded statement. Your safest bet is to hire an attorney – someone who knows the games insurance companies play – who will talk to them for you. This way you don’t run the risk of inadvertently hurting your claim.

 2. You should hire a lawyer. They’ll make you think it’s not necessary, that everything is very routine and that they’ll look out for you. It’s a scam. They know that if you have an attorney they’ll have to pay more on your claim. If you don’t have an attorney, they know they can take advantage of you, such as offering you an extremely low settlement offer because you have no idea what your claim is actually worth.

 3. If you accept a settlement, you give up your right to any future medical coverage. Settling a claim can be beneficial to both sides. As an injured worker, you can get a lump sum payment without going to trial. But if you are facing more medical treatment, such as a potential surgery in the future, be careful. When you sign a settlement, you agree that you won’t ask them for any more medical coverage. If you go to trial, you can leave this option open.

 4. They’re not denying your claim for a good reason. Sometimes, their reason for denying benefits is a long shot, but they’re really just hoping you get frustrated and go away.

 5. They’re in it to make money. The number one way they do this is to pay you less than fair value on your claim. That is their goal. They may pretend like they care about you, but they answer to their stockholders and making a profit is what they really aim to do.

 It sounds bad, but all hope is not lost. If you are aware of these things, it will be much harder for them to take advantage of you. Let us know if you have any questions about what the insurance company has told you. It may not be the whole story.

By Michael Helfand

Is my lawyer going to talk to my employer?

The idea of having your lawyer call your boss is uncomfortable to many people, and we hear this fear a lot from our clients. Most people like their job and don’t want to cause any drama. We get that. Even if you hate your job, you don’t want to make things worse by making your employer angry. We get that, too. In the majority of cases, we never talk to your employer.

The law requires your attorney to send a copy of your claim to your employer (a routine document called an Application for Adjustment to Claim), but that’s it. Your privacy is important. Your lawyer should respect that. In most of the cases we handle, the employer has workers’ compensation insurance that handles the cases of injured employees. We almost always work directly with the insurance company and their lawyers on getting your benefits and dealing with any disputes that arise.

If you are injured in the course of your employment, Illinois law says that you get 100% coverage of any medical bills that are reasonable and related to your injury. In addition, you get disability payments that cover a 2/3 of your lost income if you can’t work. Other benefits might be available, as well, such as a settlement at the end of your case. The point is that these are important benefits if you are unable to continue to work.

Don’t avoid a claim because you are worried about getting a lawyer involved. And don’t avoid hiring a lawyer based on fear of them talking to your boss. Having a lawyer can make your case go faster and prevent you from getting taken advantage of by the insurance company. If you’re still worried, then talk to the attorney about your concerns. They should understand your hesitation and share your goal of making your claim as smooth as possible and not creating a situation that would jeopardize your future with your employer.
 

The danger of giving a recorded statement

If you’re injured at work, your employer’s insurance company will probably be involved. Most employers carry workers’ compensation insurance, so that when an employee is injured and entitled to benefits, it’s the insurer who pays out those benefits.

The insurance company might contact you. It can seem routine and fairly innocent, when in fact it’s a critical moment that could make or break your case.

If the insurance company asks you to give a recorded statement, you should decline. Just say no. Don’t let them bully you into it, either. They want a recorded statement for one main reason, which is to use it against you. They want you to say something that they can use to deny your claim and refuse to pay you benefits.

How could it hurt your case? You might say something that brings into question whether your injury was work related (a requirement to qualify for benefits) or related to something outside of your job. This is just one example of a way that you could inadvertently hurt your case.  It’s exactly what the insurance company is hoping you will do.

The best way to prevent this is to get a lawyer who will handle all contact from the insurance company. There are no hourly fees or upfront costs when hiring a workers’ compensation lawyer in Illinois. If they win a bunch of money for you, they get paid from that, at the end of your case. Otherwise, they walk you through your claim and help you avoid pitfalls, such as talking to the insurance adjuster. The insurance company might not stop at trying to get a statement. They might use surveillance to try and catch you doing something you shouldn’t be doing considering your injury. They might try and come to your doctor appointments or talk to your doctor and try to influence your course of treatment.

The insurance company presents itself as helpful and on your side. It’s not the reality of the situation. Their interest is to spend as little money as possible on you. You, on the other hand, should be interested in getting all of the benefits that the law says you get. Your priorities are regaining full health and avoiding debt.
 

Is your injury a can of worms?

Workers’ compensation is a system that was set up to help workers who suffer a work-related injury. Illinois law says an injury is considered work related if it arises out of and in the course of your employment. You don’t necessarily have to be at your work location or doing your exact work duties, but a connection to your job is required in order to qualify for benefits.

Many times, it’s not as simple as a single incident that causes an isolated injury. Workers’ compensation cases often get messy if there are pre-existing injuries, secondary conditions and other complications. It can seem like a can of worms. You hurt your back at work while lifting something heavy, but you already had an old back injury from a car accident ten years ago, and then while you’re recovering you develop a separate yet related injury to another part of your body. Or maybe you develop hypertension as a result, or suffer a complication from back surgery.

The law in Illinois says that pre-existing conditions and secondary injuries do not disqualify you from receiving workers’ compensation benefits. You get benefits if your job causes your injury. And you also get benefits if your job makes an old injury worse. So in the example with the existing back injury from a car accident, you can still get your treatment covered if you re-injure your back or aggravate your injury with something that happened on the job.

The same is true of a secondary injury. A surgery complication, or hypertension, or any other injury that comes up will not disqualify you. If it’s related, that secondary injury will be covered. If it’s a completely unrelated injury, it might not be covered but it shouldn’t hurt you, either.

All of these layers can be confusing. And the insurance company that pays workers’ compensation benefits isn’t going to ensure that you get everything you’re entitled to; that doesn’t help their bottom line. You have to look out for yourself. Don’t let your employer or their insurer tell you that something isn’t covered or that you don’t qualify. Get that information from an experienced attorney whose job it is to get you all the benefits provided under Illinois workers’ compensation law, regardless of pre-existing injuries and other complicated circumstances.
 

By Michael Helfand

Does your employer have to carry workers' compensation insurance?

We were contacted by a really nice guy who had a very serious neck injury on the job.  He reported the accident to his employer just like he should.  He received prompt medical care and told the doctor he got hurt at work which is what he should do too.  But then he was told by his boss that they weren’t required to carry workers’ compensation insurance so he’s out of luck.
 
We are checking in to whether or not the company does have insurance, but I can tell you that they lied to him.  Any company that has even one employee or is going to be doing any business in Illinois (this would include someone who gets hurt at the airport on a layover) has to carry workers’ compensation insurance. This is true if you have just one employee that works an hour a week or thousands of workers.  The only exception is for some farmers and Chicago policemen.
 
If an employer doesn’t carry insurance they can be personally liable for your medical bills.  It’s also a class 4 felony which could lead to jail time as well as the business being shut down.
 
This employer is a scumbag who is trying to screw over a good worker.
 
Other companies we have seen have told workers that they are independent contractors when they really aren’t (this doesn’t get them off the hook for having to carry insurance that will compensate you and pay your medical bills).  Some have illegally tried to get their staff to sign a document waiving their right to work comp benefits.  Those contracts are not enforceable in Illinois.  Others that have locations in multiple states have attempted to get their employees to agree that they can only bring a case in a certain state.  That’s not enforceable in Illinois either.
 
Bringing a work comp claim is not a lawsuit.  It’s a claim for benefits and shady tactics should not and can not stop you from having those rights.
 
So don’t be tricked or bullied in to thinking that you don’t have the ability to bring a case.  There are certain legal requirements needed to get benefits approved, but you don’t lose your rights just because your employer didn’t feel like getting insurance.  Remember, it’s a felony if they don’t have it.  That is how serious we take this and how serious they should too.

By Michael Helfand

We love fighting for injured workers

Even though the law in Illinois clearly says that individuals with work-related injuries are entitled to payment of their medical bills and checks for lost wages, the truth is that it’s not enough. On the other side are big insurance companies that constantly, and expertly, work against you to prevent you from collecting benefits. Our lawyers have worked on both sides – for insurance companies and individual workers – and seen it for themselves. The system is unfair.

We much prefer to fight for injured employees who desperately need money to support themselves and their families. Not the insurance companies who try to take that all away. There is very little job satisfaction that comes with saving a few bucks for a multi-billion-dollar corporation, all at the expense of real people.

That said there is some benefit to be gained from working for an insurance company in the past. We know how they operate. We can apply that information to the cases of our clients and protect you from their underhanded attempts to ruin your claim. We know which cases they’re likely to use surveillance on, what they’ll ask you on the phone to try and get you to say something harmful to your case, and how they’ll try to get involved with your medical treatment so they can try to steer it in a direction that benefits their bottom line.

Our goals are the opposite. We understand you need to get better, get back to work if possible, and remain financially stable during the entire ordeal. You might be supporting a family or dealing with additional pressures in your life. If you get hurt working for your employer, you are entitled to get help with your recovery.

The reality is that you need an experienced lawyer in order to be on equal footing with the insurance company. Specifically, it’s an advantage at times to have a lawyer who has worked for the insurance companies or who has been doing workers’ compensation law long enough to know the game.

At the end of the day though, helping a regular person is way more rewarding than help a faceless corporation screw someone over.
 

By Michael Helfand

Volunteers don't get workers' compensation in Illinois

Workers’ compensation, which pays you certain benefits if you are hurt on the job, is only for employees. The law in Illinois does not extend the right to benefits to volunteers. Even if you have a regular volunteering position or you volunteer a significant number of hours, you aren’t an employee. If you volunteer at a hospital and slip and fall on a wet floor, which is a fairly common injury for hospital workers, you simply don’t have the same options as an employee.

Sometimes the person or entity you volunteer for will offer to pay your medical bills if you were hurt while doing work for them. This is a kind gesture, but it doesn’t put them on the hook for anything further. It doesn’t mean they are admitting that they are responsible. And it doesn’t mean that you can file a claim for workers’ compensation if you end up having extensive medical bills.

The same rule applies to independent contractors: Only employees get workers’ compensation in Illinois. Volunteers, independent contractors or other non-employees who get hurt while doing work on someone else’s property have the option of a personal injury lawsuit. You have to prove negligence of some sort in order to hold the property owner or manager responsible for your injury and any financial loss (medical bills, lost earnings, etc.). The dispute is handled through the courts.

A claim for workers’ compensation is different from a lawsuit in that fault doesn’t matter. You don’t have to prove negligence, and if the injury was your fault, that doesn’t matter. You just have to show that your injury was caused by your work. Also, you don’t go to court. It’s a claim for benefits against an insurance company (most employers carry workers’ compensation insurance in Illinois).

The benefits available under workers’ compensation include payment of 100% medical bills, checks for 2/3 of your average weekly wage during the time that you are unable to work, and possible lump sum payment at the end of your claim.

Whether you are a volunteer with a potential injury lawsuit or an employee with a workers’ compensation claim, an experienced Illinois attorney can help you navigate the right type of legal action. The type of attorney we would recommend depends on which type of case you have. If you have a work injury, we suggest hiring someone who exclusively handles work injuries, and the same is true for a negligence lawsuit.
 

By Michael Helfand

Illinois work comp: when to take settlement offer

We always caution injured workers to be smart when it comes to taking a settlement offer from the insurance company. Usually, our warning is that the offer is probably too low and that the insurer is taking advantage. A recent call we received was a good reminder that sometimes the offer is good and if you don’t take it, you could end up regretting it.

An injured worker called us because he wasn’t happy with the settlement offer he received from the insurance company for $325,000. You’re probably thinking that sounds like a pretty good offer. We thought so too. And as we talked to him further, we realized that it was actually a great offer, and one that he should accept quickly.

It takes a lot of experience to evaluate a settlement offer and know whether a client should be advised to accept or whether he or she should go to trial. Once you’ve done this dozens or even hundreds of times, you develop a good grasp of how the insurance companies work, how trial can be used to increase a recovery, and how much a case should be worth. You should never accept or decline a settlement offer without consulting with someone who knows how to value a case.

In the case of the worker who called us, our experience told us that he might lose at trial because the insurance company had a possible defense, which is that he may not have given his employer notice within the required 45 days. This could make his case worth $0 if he goes to trial. That’s quite a risk. Sometimes, going to trial is the only way to get the full value of your case. There’s always the risk that you could lose, and you have to weigh it against the potential reward.

The lesson here is that you need the right lawyer to properly evaluate your case. You need someone who knows the arbitrator and can tell you how that arbitrator is likely to decide such a case. In some instances, a settlement offer can be pulled. It’s not common, but it can happen. The guy who called us may have come close to ruining his case. Hopefully, he gets a good lawyer on his side right away.
 

By Michael Helfand

How social media can affect your workers' compensation case

Your attorney might recommend taking a break from social media while you deal with your work injury. Insurance companies routinely hire private investigators to look into claimants to make sure they’re telling the truth. They want to verify that you are actually hurt, that you’re as hurt as you say you are and that your injury is really work related. More accurately, they want to catch you lying or ignoring your doctor’s orders.

In the old days, it was harder for a private investigator to find out what people were up to behind closed doors or while out of town. Now, they have access to your life in a way they never did before. They can go on Facebook or Twitter and see how you spent your weekend and read what you’re saying about your life, including your work injury. It’s a big thing we caution our clients about. It doesn’t happen in every case, but if your injury is serious, it could happen to you.

If you’re caught doing something you shouldn’t be able to do with your injury or that your doctor said you can’t do, then your benefits will likely be at risk. The insurance company is doing all this to look for a reason to cancel or deny your benefits. It might cost them some money to hire these investigators, but it saves them much more in the benefits they don’t have to pay.

These investigators follow you in real life too, not just online. The best way to protect yourself and your benefits is to be honest with your doctor, follow your doctor’s recommendations, and don’t push yourself to do yard work or heavy lifting if you shouldn’t be doing that. And don’t use your time off work for anything that would look suspicious, like golfing or even playing baseball with your kid.

It’s frustrating that you worry about all of this on top of dealing with the fact that you are hurt. The financial strains and physical recovery are stress enough. But the reality is that the insurance company might be checking up on you, so you have to be honest and careful. If the insurance company is disputing your injury in any way, the fastest way to get back on track is to get the help of an attorney who goes up against insurance companies every day on behalf of injured workers.

By Michael Helfand

Don't let the insurance company minimize your injury

They’ll do it, and not accidentally. Downplaying injuries is a common insurance company tactic. They’re trying to reduce your benefits, which saves them money. It can be incredibly frustrating and infuriating if you get seriously hurt at work and the insurance company calls it a minor strain.

Minor injuries cost the insurance company less money. Your treatment is shorter and less extensive. With a minor injury, you’re more likely to make a full recovery, or at least that’s what they’ll argue. Their goal, with any case, is to pay as little in benefits as they can manage, and then close your file as soon as possible.

This might sound extreme, but we’ve seen it a million times in Illinois workers’ compensation cases. The best thing you can do is make sure your injury isn’t minimized at the beginning of your case. It will lead you down this road where the insurer is brushing you off and trying to make your claim go away. They get away with this all the time and workers with serious injuries end up with much less than they’re entitled to.

One reason why the insurance companies get away with this is because they are good at acting like they’re helping you. The insurance adjuster might call you at home to see how your treatment or recovery is going. It seems like they’re on your side. Many workers are relieved that the process seems to be going so smoothly. But in reality, it’s a sign that it’s going the way they want it to, which is the opposite of how you want it to go.

The best way to avoid falling into this trap is to hire an experienced attorney. An Illinois workers’ compensation attorney who knows what they’re doing won’t let them take advantage of you. They’ll fight for you, making sure you get all the benefits and treatment you need. Also, the mere fact that you have an attorney will change how the insurance company handles your claim. In our experience, you are much more likely to get a fair settlement offer if you are represented by a lawyer, especially one with a good reputation. Your lawyer should still negotiate to get you the best settlement possible, of course. The point is that without an attorney, any offer you get is pretty much guaranteed to be very low.

Pay attention to the way the insurance company lists your injury. If it’s not right, don’t assume that it’s just a typo or that it’s just how the system works. If you think something is wrong, there’s still time to get help from a work injury attorney in most cases.
 

By Michael Helfand

Do I have to let the insurance company see all my medical records?

In some workers’ compensation cases in Illinois, your employer’s insurance company might want more involvement in your medical care than you are comfortable with. Any benefits you get after a work injury are going to be paid by the insurer. Legitimately, they need to see your medical records related to the work injury in order to understand the reason for your claim. However, they are going to try to use this information to deny your claim if they can, which is why you need to be careful.

In order to give the insurer access to your medical records, they will ask you to sign an authorization. Medical records are of course private, and this authorization tells medical providers that you are allowing the insurer to look at your records. You won’t get very far if you refuse to sign the authorization. It’s a necessary step in the process of getting benefits. But, you don’t have to sign it as-is. Many authorizations are very broad. You can try to limit the scope of the authorization, to cover records for a set time period, such as the date of your work accident and after. You also can try to limit the length of the authorization.

Something else to look out for is whether the authorization allows the insurance company to actually speak with your doctor without you being present or without your consent. If you give them this kind of access to your doctor, it can give them a lot of influence over your treatment, work restrictions, the doctor’s opinion on the cause of injury (work or outside of work), etc. It’s in the employer’s interest to get you back to work, so they might influence your doctor to release you back to work, for example. Then the insurance company doesn’t have to pay you benefits for not being able to work.

A similar strategy used by the insurance company is sending a nurse case manager to your appointments. In Illinois, you do not have to let them into the exam room with you, and we can’t think of any good reason why you would want to.

The safest way to deal with the insurance company is to put the whole situation in the hands of your lawyer. An experienced Illinois workers’ compensation attorney knows how the insurance company operates and can protect you against tactics like these.

By Michael Helfand
 

What to say to your employer about a work related injury

If your injury was sudden and severe, your employer is probably aware of the incident. Perhaps an accident report was filled out. If your injury developed over time or your employer is not yet aware that you are hurt, you’re probably wondering what you need to do.

If you suffer a work-related injury in Illinois, you are entitled to workers’ compensation benefits. In order to start the process, you need to inform your employer of your injury. They should then tell their insurance carrier, who actually pays the benefits.

The law says that you must notify your employer of a work injury within 45 days. It’s a good idea to do this as soon as possible, however, so that there is no dispute about when the injury occurred or whether it occurred at all. If you delay, it can cause suspicion and lead your employer to deny benefits and claim that your injury didn’t happen at work. It’s also a good idea to notify your employer in writing. You want to avoid any question about when or whether proper notice was given. If your injury develops slowly over time, notify your employer as soon as you realize that you have an injury and that it’s job related.

Also, you should file a formal claim for benefits. This is a document that you file with the Illinois Workers’ Compensation Commission, not directly with your employer. You may start getting benefits before filing a claim, but it’s recommended that you file one anyway. If your benefits are denied outright, or there is some other problem down the road, you’ll be in a better position to get a hearing in front of the arbitrator (similar to a judge). 

Your employer is not allowed to fire you for going after your benefits. You have a right to do so, and they can’t get in the way. If they fire you in retaliation for filing a claim, you can sue them for any financial loss you suffer. Other damages might be available, as well.

If your employer is disputing the extent of the injury or whether an injury even exists, it’s a good idea to talk to an experienced Illinois workers’ compensation attorney to make sure you don’t lose out on benefits. If you are honest with your doctor and work with a reputable attorney, you have a good chance of the benefits to which you’re entitled.

By Michael Helfand
 

If you are an injured college athlete, we want to speak with you

We have long believed that the way college athletes are treated makes them employees under the law.  The University has a “right of control” over you in that they and the NCAA have limited your ability to earn outside income, tell you where to go, what to do and if they don’t like how you are doing it, even if you have great grades, they can fire you by taking away your scholarship.
 
The National Labor Relations Board seems to agree with me in that they are allowing Northwestern University football players to unionize.
 
If athletes are really employees then they are entitled to workers’ compensation benefits and protection too.  That means no more worrying about who will pay for your surgery if you get injured.  That means that if you lose your scholarship because you are too hurt to play, you should be compensated.  And if you suffer any permanent injury, just like any other worker, you are entitled to a settlement for the extent of your injuries.
 
We are looking to talk to any college athlete who has been hurt while participating in their sport, preferably in the last three years.  You must either go to an Illinois school or have been injured while playing in Illinois.  So if a basketball player from New York got hurt in a game at DePaul or Bradley or anywhere else in IL, we can help them too.  And if you go to college here, but got hurt somewhere else, we can protect your rights as well.
 
Call us at (312) 346-5578 or click the contact us link above if you’d like to discuss the possibilities.  There is no cost to you and we only get paid if we are successful.  Please note that there are time limits for pursuing these cases and any delay could cause you to lose your rights forever.

By Michael Helfand

Illinois workers' compensation covers out-of-state employees

You don’t have to live or work in Illinois in order to get Illinois workers’ compensation benefits. Most people don’t know this, since common sense might say that you have to be here to get benefits here. It’s not a free for all. You do have to have some connection to Illinois, but it’s less of a connection than you might think.

There are several situations in which someone not living or working in Illinois can file for Illinois workers’ compensation. One is if you are working out of state for an Illinois company. If your employer is based here, you can file here. Another situation is if you were hired here. If you were interviewed and hired in Illinois, you are eligible for workers’ compensation here even if you’ve never been back here since. Obviously, if you work in Illinois and get hurt in Illinois, you are eligible, as well.

Just to clarify, eligibility depends on more than just the location of your injury or employer. In order to qualify as a work injury under the law, the injury must be related to your work and happen while you are on the job. You also have to be an employee (not an independent contractor) and you have to file a claim within the time limit. The statute of limitations on work injury claims is three years from the date of the injury, or in the case of an injury that develops over time, three years from the date you knew or should have known that you were injured and that the injury was work related. If you have received benefits before (sometimes this happens without a formal claim being filed), then you have two years from your last benefits payment to file a claim.

The number of employees who are told they are not eligible to file a claim or get benefits is much greater than it should be. In many cases where a boss discourages a claim or the insurer denies a claim, the employee is in fact entitled to benefits. The worst part is that some employees take the word of their employer or the insurance company as the final answer.

If you are having trouble getting benefits, because you work out of state or for any other reason, an experienced Illinois workers’ compensation attorney is going to be able to give you the best advice. The insurance company needs to look out for its bottom line, which is helped by not paying benefits. And a friend or neighbor offering advice, or sharing their work injury experience, means well but hasn’t seen outcomes in hundreds of cases.
 

By Michael Helfand

 

When your boss tells you to lie

I’d estimate that about 10 times a year someone calls me with a very similar sounding story.
 
The gist is that they got hurt at work, but their boss or supervisor tells them to tell the doctor that they got hurt at home.  It usually comes with some sort of promise that “I’ll take care of your bills” or something like that.
 
It’s almost always b.s. and designed to screw you over.
 
Whether or not your case gets covered under the Illinois Workers’ Compensation Act depends on a lot of things.  At the top of the list has to do with what you told your medical providers.  If your history of how you were injured changes a lot or you say it didn’t happen at work, that will be held against you.
 
In the very least, you will be made to look like a liar on the witness stand and that will really impact your credibility.
 
We find that supervisors usually say this nonsense for two reasons: 1. They get a bonus if there are no work injuries. 2. They are an owner and worry about their insurance rates going up.
 
Whatever the reason is, their instruction isn’t them looking out for you.  It’s them looking out for them and their best interests.  When you have $30,000 in medical bills and no way to pay them, they won’t care about your problems at all because it’s your problem, not theirs, even if they created it.
 
The bottom line is that honesty is always the best policy and you should not let anyone persuade you to lie.  If you do, you could ruin your case.  That may not be a big deal if you have a minor injury.  But if you have the type of case that is going to cause you to miss time from work or have significant medical bills, you could end up creating your own financial ruin.
 
Remember, bringing an Illinois workers’ compensation claim is not a lawsuit.  You are not suing your company.  You are making a claim for benefits that is no different than asking for health insurance or any other employee right.  You aren’t going to get rich off of your case, but you could go bankrupt if you lie.

By Michael Helfand

Five things every client should ask their work injury attorney

The title of this post actually should be “Five things every client should ask their future work injury attorney” because you shouldn’t hire an attorney without asking these things first.

 

  1. Do you focus your practice on workers’ compensation? The answer should be yes. In our opinion, an attorney who handles the same kind of case day in and day out is going to have a better grasp on the process, the strategies and have key relationships in the relevant legal community. They should know the arbitrators, insurance companies, etc. They also should have some experience with your type of injury. The more closely their experience matches your needs, the better off you’ll be.
  2. How will we communicate, and how often? This might seem small, but it’s big. If you are in touch with your attorney and know what to expect, you will understand what’s happening in each step of your claim, and you can be confident that you will know when something important happens. It’s also helpful to know how quickly to expect a response when you reach out, whether it’s over the phone or by email.
  3. What is your fee? What about the costs of my case? Attorney fees in workers’ comp cases are set at 20%, by law. It’s a contingency fee, which means that it’s paid out at the end of your case and is based on what you recover in the end. However, make sure this fee isn’t coming out of your weekly benefits checks. The only time this should happen is if your attorney has to go to a hearing and fight for past benefits that you’re owed. Also, your attorney should cover all the costs of your case upfront and not expect you to pay for your doctor’s deposition or anything else.
  4. What is the best strategy for my type of injury and situation? They should be upfront and honest about their approach, and they should not be making huge promises. Anything that sounds too good to be true is worth looking at more closely. Your attorney should take the time to explain things in a way that makes sense. 
  1. How can I help my case? Hopefully, this will be a welcome question. When a client and attorney are on the same page, things can go more smoothly, not to mention more quickly. Your attorney likely will have some suggestions, such as following your doctor’s orders and treatment recommendations, not talking to the insurance company, etc.

 You should ask any other questions that help you determine whether you want to hire a particular attorney. Not everything can be measured objectively, and a lawyer who seems like a good match in terms of experience can feel different in person. Most initial consultations are free. They’re a great way to get answers to these and other questions.

 

You got hurt at work - now what?

If your injury was serious, you probably received emergency medical attention. If you didn’t, or if you are feeling pain after the fact, your priority should be seeing your doctor. Even if you’ve put it off, make that appointment as soon as possible. Next, learn about the benefits you can get under Illinois workers’ compensation law. Your employer likely has workers’ compensation insurance, which exists to pay medical bills and lost wages for employees who get hurt on the job.

Your medical bills should be covered 100%. If you can’t work, you can get temporary total disability payments, also called TTD. These start after you’ve missed four days of work, and you can expect a check every two weeks. The amount of the check is 2/3 of your average weekly wage. If you need help knowing what your average weekly wage is, talk to an attorney. There are other benefits if your injury prevents you from ever working again or forces you to work for less pay permanently.

Don’t rely on the insurance company to fully inform you of your rights and available benefits. Ideally, you shouldn’t talk to them at all but rather have a lawyer do that for you. Experienced Illinois workers’ compensation lawyers are familiar with the tactics the insurance companies use to try and save money by denying claims and withholding benefits. For example, they might ask you to give a statement, or even ask to talk to your doctor. What they’re trying to do is find a way to argue that your injury isn’t covered – that’s it’s not a work injury or that you don’t qualify for some other reason. You might accidentally say something that hurts your case.

Other things you should know are that you have 45 days to notify your employer of a work injury, and three years from the date of injury to file a claim (only two years in some cases). Claims are filed with the Illinois workers’ compensation commission. You might receive benefits without filing a claim, but do so anyway. It could help if there’s a problem later.

Be clear with your doctor about how you’re feeling and what caused your injury. Their opinion matters a lot. Also, listen to your doctor’s warnings and don’t do things that they say you shouldn’t do. The insurance company would love to catch you shoveling snow in order to say that you don’t really have a back injury.

Getting medical attention, notifying your employer and filing a claim are the first things you should do, along with getting a free initial consultation with an experienced Illinois work injury attorney.
 

By Michael Helfand

Timeline of an Illinois workers' compensation case

The process for filing a claim and getting benefits after an Illinois work injury is different from the process of filing a lawsuit after a non-work injury. Here is what you can expect in a typical case:

Injury. This often happens because of an accident at work. A slip and fall, a machine injury, a car accident on the job, lifting something heavy, etc. The majority of work injuries are sudden, although some, like carpal tunnel or other repetitive stress injuries, develop over time.

Medical treatment. After a work accident, or as soon as you realize you are injured, you should see a doctor. Generally speaking, you get to choose which doctor you see. Immediate medical attention is good for your overall health and also for your benefits claim.

Notify employer. You have 45 days to notify your employer of a work injury. If your injury occurs over time, and you do not have an exact date of injury, then your date of injury is the day you knew or should have known that you had a work injury.

Hire attorney. It’s a good idea to hire an attorney at the beginning of your case, especially if your injury is serious or permanent. Although it’s never too late if you realize later on that you want legal help.

File a claim. Claims in Illinois are made by filling out a form called an Application for Adjustment of Claim and filing it with the Illinois Workers’ Compensation Commission. Most claims are filed at the main offices in downtown Chicago. You have three years from the date of your injury to file a claim.

Get assigned to an arbitrator. Once your claim is filed, the commission will assign an arbitrator (similar to a judge) to your case. They will follow the progress of your claim and hold hearings if there is a dispute. They’ll also oversee your trial if you have one. Your arbitrator will be at a hearing site, most likely the site closest to where you were injured.

Start getting benefits. Benefits should start fairly quickly. You are eligible for TTD four days after you get hurt. You can expect TTD checks every two weeks. Medical benefits should start right away. You should be covered for 100% of all reasonable treatment, including medications, ER visits, doctor appointments, physical therapy and surgery.

Status hearings. Your arbitrator will have your case on the calendar every three months for a status update. Your attorney can request a hearing or trial at that time, or simply put the case on the calendar for another few months.

Other hearings. Your attorney can request a hearing if there is a dispute, especially if you are not receiving benefits. At the hearing, your attorney will tell the arbitrator why you are entitled to benefits and ask that you be paid all the past benefits you are owed.

Settlement and end of claim. Many claims settle. This is where the insurance company agrees to pay you a certain amount and you agree to close your claim. This souldn’t happen until your recovery is over and you’re as good as you’re going to get. It’s recommended that you walk through the settlement process with an experienced attorney who knows how insurance companies work. It’s your best bet for getting a fair settlement.

Trial if necessary. If your claim does not settle, it can go to trial. Your attorney and the insurance company will present their sides and the arbitrator will rule on your case.

By Michael Helfand

What is included, and not included, in a work injury attorney's fee

Workers’ compensation attorneys charge a contingency fee, which means that they only get paid if they’re successful in getting you a settlement or a recovery after trial. This means that you don’t have to pay an attorney out of pocket. It also means that pretty much everyone can afford to hire an attorney to fight for benefits or negotiate a good settlement.

The bottom line is that Illinois law limits workers’ compensation attorney fees to 20%. This is 20% of what your attorney is able to get at the end of your case. It’s significantly less than the fee earned by attorneys in typical personal injury cases, which are usually around 33% of the final award or settlement.

All of your attorney’s hours are included in this fee, so there is no hourly rate. The fee should be paid out of the end settlement or recovery in your case. Most work injury attorneys – and all of the ones we recommend – do not take a fee from the regular checks you get for lost wages or from the money you get for medical bills. You should keep the full amount of these benefits.

The only time when a fee should be taken from benefits is when your attorney has to fight for unpaid benefits by requesting a hearing, gathering evidence and arguing your case in front of an arbitrator. If you win and receive a lump sum for past benefits that you are owed, your attorney’s fee will come from that amount. If you lose, there is no fee.

Not included in your attorney’s fee are the costs of your case. For example, your attorney will have to pay your doctor for his time in giving a deposition. In our opinion, clients should not have to pay for small things like stamps, copies and other office expenses. Either way, your attorney should cover all costs until the end of the case.

Sometimes, people have to switch attorneys during their claim, after they have signed a fee agreement with the first attorney. It’s important to know that this will not increase the amount you have to pay in attorney’s fees. The past and current attorneys will share the fee, and it’s up to them to figure out who gets what. It won’t cost you more than 20%.

Most workers’ compensation cases settle. Insurance companies are known to treat workers differently if they are not represented by an attorney, offering very low amounts or avoiding negotiations altogether. In our experience, having a good attorney means a higher settlement amount.

Your attorney should always be upfront and honest with you about costs and fees associated with your case. If you don’t understand how fees are calculated, ask. If you are wondering about the costs of your case, you can ask any time, not just at the end. 
 

By Michael Helfand

Chicago workers' compensation lawyer (allegedly) behaving badly

I don’t know this guy or if what he’s accused of is true, but I do know that he had a lot of cases and has been licensed to practice law since 1979.  Assuming what he’s alleged to do is true, it’s criminal, awful and shocking.  He surely couldn’t have built a law firm by being dishonest or stealing from clients, so something must have changed in his life if he did this.  Whatever it is, please note that most lawyers don’t do this and if you are concerned about something like this then you can take action.  FYI, he has been suspended from practicing law pending the outcome of the investigation.  So if he is/was your attorney, you need to look for new representation.

BEFORE THE HEARING BOARD

OF THE

ILLINOIS ATTORNEY REGISTRATION

AND

DISCIPLINARY COMMISSION

In the Matter of:

JORDAN LEE MARGOLIS,

Attorney-Respondent,

No.3124731.

Commission No. 2013PR00070

FILED --- February 10, 2014

FIRST AMENDED COMPLAINT

Jerome Larkin, Administrator of the Attorney Registration and Disciplinary Commission, by his attorney, Marita C. Sullivan, pursuant to Supreme Court Rule 753(b), complains of Respondent, Jordan Lee Margolis, who was licensed to practice law in Illinois on November 5, 1979, and alleges that Respondent has engaged in the following conduct which subjects Respondent to discipline pursuant to Supreme Court Rule 770: 

COUNT I
(Conversion of Les Johnson's settlement proceeds)

1. On or about December 12, 2004, Les Johnson ("Johnson") was injured while working for the William Wrigley Company ("Wrigley") when he fell, twisting his right knee.

2. On or about May 19, 2005, Johnson met with Respondent concerning a possible workers' compensation claim against Wrigley. At that time, Respondent and Johnson agreed that Respondent would pursue a workers' compensation claim on behalf of Johnson. Respondent and Johnson agreed that Respondent's receipt of a fee would be 20% of any recovery.

3. On or about May 29, 2012, Johnson agreed to settle his claims against Wrigley in return for the payment of $375,000 ("Johnson settlement"). Under the terms of the settlement agreement, Respondent was to receive $56,019.60 in attorney's fees from the $375,000 settlement, and after other deductions, Johnson was to receive $318,440.40.

4. In or about early June 2012, Respondent received M & I Bank of Mayville check number 27072206, which had been made payable to Johnson and Respondent in the amount of $375,000, and which represented the Johnson settlement funds. On or about June 4, 2012, Respondent, or someone acting at his direction, deposited the check into an account Respondent maintained at MB Financial Bank that ended in the last four digits 0704 ("MB account"). The MB account was a corporate business checking account, and was used by Respondent as the depository of property belonging to clients or third persons. The MB account was not a client trust account.

5. As of December 24, 2012, Respondent had disbursed only $20,190.80 of the Johnson settlement to Johnson from the MB account. As of that date, Respondent had still not distributed $297,440.23 to Johnson of the $318,440.40 Johnson was to receive from the Johnson settlement funds, and Respondent should still have been holding $297,440.23 on behalf of Johnson.

6. As of December 24, 2012, the balance in Respondent's MB account was $809.37, and Respondent had used $297,440.23 of the Johnson settlement proceeds by issuing checks and making withdrawals for his own business or personal purposes.

7. At no time did Johnson authorize Respondent to use for Respondent's own business or personal purposes any portion of the $318,440.40 Johnson was to receive from the Johnson settlement funds.

8. Between June 2012 and April 2013, Johnson spoke to Respondent several times requesting distribution of his settlement proceeds. In response to Johnson's inquiries, Respondent told Johnson that he would soon distribute the Johnson settlement proceeds to Johnson, but Respondent never did so. Respondent's statements to Johnson that he would soon distribute the Johnson settlement proceeds to Johnson were false, and Respondent knew that they were false.

9. As of May 22, 2013, the date the Inquiry Board voted to file this complaint against Respondent, Respondent had not disbursed the remaining Johnson settlement funds to Johnson.

10. By reason of the conduct described above, Respondent has engaged in the following misconduct:

a. failing to hold property of clients or third persons that is in a lawyer's possession in connection with a representation separate from the lawyer's own property, by converting those funds to his own use and causing the balance in his account to fall below the amount then belonging to clients and/or third parties or otherwise failing to preserve those funds separate from his property, and placing client funds in his business checking account instead of a client trust account, in violation of Rule 1.15(a) of the Illinois Rules of Professional Conduct;

b. upon receiving funds in which a client or third person has an interest, failing to promptly notify the client or third person, and failing to promptly deliver to the client or third person any funds or other property that the client or third person is entitled to receive, and upon request by the client or third person, failing to promptly render a full accounting regarding such property, in violation of Rule 1.15(d) of the Illinois Rules of Professional Conduct; and

c. conduct involving dishonesty, fraud, deceit or misrepresentation, by converting client and/or third party funds to his own use and causing the balance in his client trust account to fall below the amount then belonging to clients and/or third parties, and making dishonest statements relating to those funds, in violation of Rule 8.4(c) of the Illinois Rules of Professional Conduct.

COUNT II
(Conversion of settlement proceeds and misrepresentations 
in the Estate of Loretta Gainey wrongful death matter
)
 

11. On or about August 5, 2005, John White, M.D. ("White"), performed thyroidectomy surgery on Loretta Gainey ("Gainey") at Sherman Hospital ("Sherman"). Immediately after the surgery, Gainey had an expanding hematoma of the neck at the surgical site and respiratory distress. Gainey died on June 1, 2006.

12. In or about June 2006, Gainey's husband, Jeffrey Gainey, met with Respondent concerning a possible wrongful death action against White, Sherman, and the other medical providers involved in Gainey's surgery and care. At that time, Respondent and Jeffrey Gainey agreed that Respondent would represent Jeffrey Gainey, as special administrator of the estate of Gainey, in matters relating to Gainey's death. Respondent and Jeffrey Gainey agreed that Respondent's receipt of a fee would be contingent upon obtaining a recovery for Gainey's estate, and would be 1/3 of any recovery.

13. Between August 5, 2005, the date of Gainey's surgery, and June 1, 2006, the date of Gainey's death, Gainey received medical treatment which was paid by Jeffrey Gainey's health insurance carrier, Blue Cross Blue Shield of Illinois ("Blue Cross"), and for which Blue Cross asserted a lien of $421,736. On or about August 4, 2006, Blue Cross sent Respondent a letter notifying Respondent of its lien of $421,736 in connection with Gainey's medical treatment. Respondent received the letter shortly after it was sent.

14. On or about December 29, 2006, Respondent filed suit on behalf of Gainey's estate against White, Sherman, and the other medical providers involved in Gainey's care. The Clerk of the Circuit Court of Cook County received the matter and docketed it as Jeffrey Gainey, Individually and as Special Administrator of the Estate of Loretta Gainey, Deceased, v. Sherman Hospital, Apiwat Ford, M.D., John White, M.D., Midwest Surgery SC, Glenn Batiller, M.D., Renukadevi Garla, M.D. and United Anesthesia Associates, S.C., 06 L 13612.

15. On or about November 23, 2010, Respondent and Greg Mollerud ("Mollerud"), a corporate reimbursement representative at Blue Cross, agreed that Blue Cross would reduce the amount of its lien, which by that date amounted to $465,630.66, in connection with Gainey's medical treatment, and would accept $250,000 from any settlement reached in the Gainey matter as full satisfaction of Blue Cross' claimed amount. On that date, Mollerud sent Respondent a letter confirming Respondent and Mollerud's agreement, and Respondent received the letter shortly after it was sent.

16. In or about December 2010, Jeffrey Gainey agreed to settle the claims of Gainey's estate against the defendants in case number 06 L 13612 in return for the payment of $2,400,000 ("Gainey settlement").

17. On or about December 8, 2010, Chicago Hospital Risk Pooling, Sherman's insurance carrier, wire transferred $2,400,000, which represented the Gainey settlement funds, into an account Respondent maintained at MB Financial Bank that ended in the last four digits 0704 ("MB account"). The MB account was a corporate business checking account, and was used by Respondent as the depository of property belonging to clients or third persons. The MB account was not a client trust account. Shortly after receipt of the wire transfer, Respondent, or someone acting at his direction, made disbursements from the Gainey settlement proceeds, except Respondent held back $250,000 in order to pay Blue Cross the amount it had agreed to accept in satisfaction of the lien it asserted in connection with Gainey's medical treatment.

18. Between November 30, 2010, and December 5, 2012, Mollerud telephoned Respondent on 27 occasions, and sent Respondent six letters, inquiring when Blue Cross would receive its $250,000 payment from the Gainey settlement. In response to Mollerud's inquiries, Respondent, or someone acting at his direction, told Mollerud that a matter relating to case number 06 L 13612 prevented Respondent from distributing the $250,000 owed to Blue Cross.

19. Statements to Mollerud that a matter relating to case number 06 L 13612 prevented Respondent from distributing the $250,000 owed to Blue Cross, made by Respondent and those acting at his direction, were misleading, and Respondent knew they were misleading. There was no matter preventing Respondent from distributing to Blue Cross the money it was owed, and by making those statements, Respondent, and those acting at his direction, intended to mislead Mollerud into believing that Respondent could not pay the money due Blue Cross from the Gainey settlement funds.

20. As of December 24, 2012, Respondent had not disbursed any money to Blue Cross from the Gainey settlement in payment of its lien. As of that date, Respondent should still have been holding $250,000 on behalf of Blue Cross from the Gainey settlement proceeds.

21. As of December 24, 2012, the balance in Respondent's MB account was $809.37, and Respondent had used $249,190.63 of the Gainey settlement proceeds by issuing checks and making withdrawals for his own business or personal purposes.

22. At no time did Jeffrey Gainey, Mollerud, or anyone at Blue Cross authorize Respondent to use for Respondent's own business or personal purposes the $250,000 due Blue Cross from the Gainey settlement proceeds.

23. As of May 22, 2013, the date the Inquiry Board voted to file this complaint against Respondent, he had not paid Blue Cross its $250,000 lien from the Gainey settlement proceeds.

24. By reason of the conduct described above, Respondent has engaged in the following misconduct:

a. failing to hold property of clients or third persons that is in a lawyer's possession in connection with a representation separate from the lawyer's own property, by converting those funds to his own use and causing the balance in his account to fall below the amount then belonging to clients and/or third parties or otherwise failing to preserve those funds separate from his property, and placing client funds in his business checking account instead of a client trust account, in violation of Rule 1.15(a) of the Illinois Rules of Professional Conduct;

b. upon receiving funds in which a client or third person has an interest, failing to promptly notify the client or third person, and failing to promptly deliver to the client or third person any funds or other property that the client or third person is entitled to receive, and upon request by the client or third person, failing to promptly render a full accounting regarding such property, in violation of Rule 1.15(d) of the Illinois Rules of Professional Conduct; and

c. conduct involving dishonesty, fraud, deceit or misrepresentation, by converting client and/or third party funds to his own use and causing the balance in his client trust account to fall below the amount then belonging to clients and/or third parties, and making dishonest statements relating to those funds, in violation of Rule 8.4(c) of the Illinois Rules of Professional Conduct.

COUNT III
(Conversion of settlement proceeds, forgery, and misrepresentations to Angelo Rosaschi)

25. On or about January 31, 2009, Angelo Rosaschi ("Rosaschi") was injured while working for The Home Depot ("Home Depot") when he struck his head in a stairwell and suffered a closed head injury and three herniated cervical discs.

26. On or about August 9, 2009, Rosaschi met with Respondent concerning a possible workers' compensation claim against Home Depot. At that time, Respondent and Rosaschi agreed that Respondent would pursue a workers' compensation claim on behalf of Rosaschi. Respondent and Rosaschi agreed that Respondent's receipt of a fee would be 20% of any recovery.

27. On or about November 10, 2011, Rosaschi agreed to settle his claims against Home Depot in return for the payment of $266,506 ("Rosaschi settlement").

28. On or about November 15, 2011, Respondent received Chase Bank check number 65162556, which had been made payable to Rosaschi in the amount of $15,000, and which represented a portion of the Rosaschi settlement funds. On or about November 15, 2011, Respondent, or someone acting at his direction, affixed the purported signature of Rosaschi on the back of check number 65162556 and deposited it into an account Respondent maintained at MB Financial Bank that ended in the last four digits 0704 ("MB account"). The MB account was a corporate business checking account, and was used by Respondent as the depository of property belonging to clients or third persons. The MB account was not a client trust account.

29. On or about November 21, 2011, Respondent received Chase Bank check numbers 65164990, 65165007, and 65165009 in connection with the Rosaschi settlement. Check numbers 65164990 and 65165007 had been made payable Rosaschi in the amount of $191,045.96 and $6,506 respectively, and represented a portion of the Rosaschi settlement funds. Check number 65165009 was made payable to Respondent in the amount of $53,954.04, and represented Respondent's attorney fees for the Rosaschi matter. On or about November 21, 2011, Respondent, or someone acting at his direction, affixed the purported signature of Rosaschi on the back of check numbers 65164990 and 65165007 and deposited the checks into Respondent's MB account. On that same date Respondent, or someone acting at his direction, deposited check number 65165009 into Respondent's MB account.

30. At no time did Rosaschi authorize Respondent, or anyone acting at his direction, to affix his endorsement to any check in connection with the Rosaschi settlement.

31. On or about February 8, 2012, Respondent, or someone acting at his direction, sent Rosaschi a letter with a check payable to Rosaschi in the amount of $12,000, representing a partial distribution of Rosaschi's settlement. In the letter Respondent, or someone acting at his direction, also stated that "[w]e will reconcile matters when the main check is received."

32. The statement to Rosaschi that "[w]e will reconcile matters when the main check is received," made by Respondent or someone acting at his direction, was misleading, and Respondent knew it was misleading. By making that statement, Respondent, or someone acting at his direction, intended to mislead Rosaschi into believing that Respondent had not yet received all of the Rosaschi settlement funds.

33. As of February 22, 2012, Respondent had disbursed only $24,107.75 to Rosaschi from the Rosaschi settlement. As of that date, and after payment of Respondent's attorney's fees and other costs and expenses, Respondent should still have been holding $188,144.21 on behalf of Rosaschi from the Rosaschi settlement proceeds.

34. As of February 22, 2012, the balance in Respondent's MB account was $5981.69, and Respondent had used $182,162.52 of the Rosaschi settlement proceeds by issuing checks and making withdrawals for his own business or personal purposes.

35. At no time did Rosaschi authorize Respondent to use for Respondent's own business or personal purposes any portion of the amounts due Rosaschi from his settlement funds.

36. By reason of the conduct described above, Respondent has engaged in the following misconduct:

a. failing to hold property of clients or third persons that is in a lawyer's possession in connection with a representation separate from the lawyer's own property, by converting those funds to his own use and causing the balance in his account to fall below the amount then belonging to clients and/or third parties or otherwise failing to preserve those funds separate from his property, and placing client funds in his business checking account instead of a client trust account, in violation of Rule 1.15(a) of the Illinois Rules of Professional Conduct;

b. upon receiving funds in which a client or third person has an interest, failing to promptly notify the client or third person, and failing to promptly deliver to the client or third person any funds or other property that the client or third person is entitled to receive, and upon request by the client or third person, failing to promptly render a full accounting regarding such property, in violation of Rule 1.15(d) of the Illinois Rules of Professional Conduct; and

c. conduct involving dishonesty, fraud, deceit or misrepresentation, by converting client and/or third party funds to his own use and causing the balance in his client trust account to fall below the amount then belonging to clients and/or third parties, and making dishonest statements relating to those funds, and signing his client's name without authority, in violation of Rule 8.4(c) of the Illinois Rules of Professional Conduct.

COUNT IV
(Conversion of settlement proceeds, forgery, and misrepresentations to Sherry Tobias-Rontos)

37. On or about October 6, 2006, Sherry Tobias-Rontos ("Tobias-Rontos") was injured while working for the City of Chicago ("the City") when she hurt her back while lifting boxes. On or about August 15, 2007, Tobias-Rontos was again injured while working for the City when a chair rolled over her right foot. On or about September 4, 2007, Tobias-Rontos was again injured while working for the City when she hurt her hands and arms while lifting boxes.

38. In or about October, 2008, Tobias-Rontos met with Respondent concerning possible workers' compensation claims against the City. At that time, Respondent and Tobias-Rontos agreed that Respondent would pursue workers' compensation claims on behalf of Tobias-Rontos. Respondent and Tobias-Rontos agreed that Respondent's receipt of a fee would be 20% of any recovery.

39. In or about May 2012, Tobias-Rontos agreed to settle all of her claims against the City in return for the payment of $130,000 ("Tobias-Rontos settlement"). Under the terms of the settlement agreement, after the payment of attorney's fees and after other deductions, Tobias-Rontos was to receive $103,225.

40. When Tobias-Rontos agreed to settle all of her claims against the City, as described in paragraph 39 above, she specifically told Respondent that she wanted to review all settlement papers relating to her claims. On or about June 4, 2012, Respondent, or someone acting at his direction, affixed the purported signature of Tobias-Rontos on the settlement papers resolving her claims against the City without permitting Tobias-Rontos to first review the settlement papers and without Tobias-Rontos' authorization to sign her name.

41. On or about July 16, 2012, Respondent received Old National Bank check numbers 013512 and 013513, which had been made payable to Tobias-Rontos and Respondent in the amounts of $95,000 and 35,000 respectively, and which represented the Tobias-Rontos settlement funds. On or about July 18, 2012, Respondent, or someone acting at his direction, affixed the purported signature of Tobias-Rontos on the back of check numbers 013512 and 013513 and deposited the checks into an account Respondent maintained at MB Financial Bank that ended in the last four digits 0704 ("MB account"). The MB account was a corporate business checking account, and was used by Respondent as the depository of property belonging to clients or third persons. The MB account was not a client trust account.

42. At no time did Tobias-Rontos authorize Respondent, or anyone acting at his direction, to affix her endorsement to any document in connection with the Tobias-Rontos settlement.

43. As of December 24, 2012, Respondent had not disbursed any money to Tobias-Rontos from the Tobias-Rontos settlement. As of that date, Respondent should still have been holding $103,225 on behalf of Tobias-Rontos from the Tobias-Rontos settlement proceeds.

44. As of December 24, 2012, the balance in Respondent's MB account was $809.37, and Respondent had used $102,415.63 of the Tobias-Rontos settlement proceeds by issuing checks and making withdrawals for his own business or personal purposes.

45. At no time did Tobias-Rontos authorize Respondent to use for Respondent's own business or personal purposes any portion of the amounts due Tobias-Rontos from her settlement funds.

46. Between October 2012 and May 2013, Tobias-Rontos contacted Respondent's firm on several occasions to find out when she would receive her settlement proceeds. During that time period, Respondent, or someone acting at his direction, told Tobias-Rontos that she would receive her funds shortly. Respondent's statements to Tobias-Rontos that he would soon distribute the Tobias-Rontos settlement proceeds to Tobias-Rontos were false, and Respondent knew that they were false.

47. As of May 22, 2013, the date the Inquiry Board voted to file this complaint against Respondent, he had not disbursed any of the Tobias-Rontos settlement funds to Tobias-Rontos.

48. By reason of the conduct described above, Respondent has engaged in the following misconduct:

a. failing to hold property of clients or third persons that is in a lawyer's possession in connection with a representation separate from the lawyer's own property, by converting those funds to his own use and causing the balance in his account to fall below the amount then belonging to clients and/or third parties or otherwise failing to preserve those funds separate from his property, and placing client funds in his business checking account instead of a client trust account, in violation of Rule 1.15(a) of the Illinois Rules of Professional Conduct;

b. upon receiving funds in which a client or third person has an interest, failing to promptly notify the client or third person, and failing to promptly deliver to the client or third person any funds or other property that the client or third person is entitled to receive, and upon request by the client or third person, failing to promptly render a full accounting regarding such property, in violation of Rule 1.15(d) of the Illinois Rules of Professional Conduct;

c. failure to keep a client reasonably informed about the status of a matter and promptly comply with reasonable requests for information, in violation of Rule 1.4 of the Illinois Rules of Professional Conduct; and

d. conduct involving dishonesty, fraud, deceit or misrepresentation, by converting client and/or third party funds to his own use and causing the balance in his client trust account to fall below the amount then belonging to clients and/or third parties, and making dishonest statements relating to those funds, and signing his client's name without authority, in violation of Rule 8.4(c) of the Illinois Rules of Professional Conduct.

COUNT V
(Conversion of settlement proceeds, forgery, and misrepresentations to Lisa Hardin)

48. On or about December 22, 2009, Lisa Hardin ("Hardin") was injured when a vehicle driven by Monica McGee-Saulsberry ("McGee-Saulsberry") struck Hardin's vehicle.

50. On or about May 20, 2010, Hardin met with Respondent concerning a possible personal injury action against McGee-Saulsberry. At that time, Respondent and Hardin agreed that Respondent would pursue a personal injury action on behalf of Hardin. Respondent and Hardin agreed that Respondent's receipt of a fee would be contingent upon obtaining a recovery for Hardin, and would be 1/3 of any recovery.

51. In or about December 2011, State Farm Insurance Company, McGee-Saulsberry and Hardin's insurance carrier, agreed to settle Hardin and Respondent claims for a total of $100,000 ("Hardin settlement"). Respondent and Hardin agreed that after the payment of Respondent's attorney's fees in the amount of $33,333.33 and deductions for costs, Hardin was to receive $66,563.08.

52. On or about December 20, 2011, Respondent received State Farm check number 101389313J, which had been made payable to Hardin and Respondent in the amount of $50,000, and which represented a portion of the Hardin settlement funds. On or about December 27, 2011, Respondent, or someone acting at his direction, affixed the purported signature of Hardin on the back of check number 101389313J and deposited the check into an account Respondent maintained at MB Financial Bank that ended in the last four digits 0704 ("MB account"). The MB account was a corporate business checking account, and was used by Respondent as the depository of property belonging to clients or third persons. The MB account was not a client trust account.

53. On or about January 16, 2012, Respondent received State Farm check number 101438131G, which had been made payable to Hardin and Respondent in the amount of $50,000, and which represented a portion of the Hardin settlement funds. On or about January 19, 2012, Respondent, or someone acting at his direction, affixed the purported signature of Hardin on the back of check number 101438131G and deposited the check into Respondent's MB account.

54. At no time did Hardin authorize Respondent, or anyone acting at his direction, to affix her endorsement to any check in connection with the Hardin settlement.

55. Between January 2012 and August 2012, Hardin contacted Respondent's firm on several occasions to find out the status of her settlement proceeds. In or about July 2012, Respondent, or someone acting at his direction, told Hardin that Respondent had not received all of the Hardin settlement funds, and was still waiting to receive a second check from State Farm Insurance Company.

56. The statement to Hardin that Respondent was still waiting for a second check from State Farm, made by Respondent or someone acting at his direction, was false and misleading, and Respondent knew it was false and misleading. By making that statement, Respondent, or someone acting at his direction, intended to mislead Hardin into believing that Respondent had not yet received all of the Hardin settlement funds.

57. As of December 24, 2012, Respondent had not disbursed any money to Hardin from the Hardin settlement. As of that date, Respondent should still have been holding $66,563.08 on behalf of Hardin from the Hardin settlement proceeds.

58. As of December 24, 2012, the balance in Respondent's MB account was $809.37, and Respondent had used $65,753.71 of the Hardin settlement proceeds by issuing checks and making withdrawals for his own business or personal purposes.

59. At no time did Hardinauthorize Respondent to use for Respondent's own business or personal purposes any portion of the amounts due Hardin from her settlement funds.

60. As of May 22, 2013, the date the Inquiry Board voted to file this complaint against Respondent, he had not disbursed any of the Hardin settlement funds to Hardin.

61. By reason of the conduct described above, Respondent has engaged in the following misconduct:

a. failing to hold property of clients or third persons that is in a lawyer's possession in connection with a representation separate from the lawyer's own property, by converting those funds to his own use and causing the balance in his account to fall below the amount then belonging to clients and/or third parties or otherwise failing to preserve those funds separate from his property, and placing client funds in his business checking account instead of a client trust account, in violation of Rule 1.15(a) of the Illinois Rules of Professional Conduct;

b. upon receiving funds in which a client or third person has an interest, failing to promptly notify the client or third person, and failing to promptly deliver to the client or third person any funds or other property that the client or third person is entitled to receive, and upon request by the client or third person, failing to promptly render a full accounting regarding such property, in violation of Rule 1.15(d) of the Illinois Rules of Professional Conduct;

c. failure to keep a client reasonably informed about the status of a matter and promptly comply with reasonable requests for information, in violation of Rule 1.4 of the Illinois Rules of Professional Conduct; and

d. conduct involving dishonesty, fraud, deceit or misrepresentation, by converting client and/or third party funds to his own use and causing the balance in his client trust account to fall below the amount then belonging to clients and/or third parties, and making dishonest statements relating to those funds, and signing his client's name without authority, in violation of Rule 8.4(c) of the Illinois Rules of Professional Conduct.

COUNT VI
(Conversion of Maria Mendoza's settlement proceeds)

62. On or about December 4, 2010, Maria Mendoza ("Mendoza") was injured while working for the Embassy Suites ("Embassy") in Rosemont, Illinois when she slipped on ice and injured her knee and back.

63. On or about December 28, 2010, Mendoza met with Respondent concerning a possible workers' compensation claim against Embassy. At that time, Respondent and Mendoza agreed that Respondent would pursue a workers' compensation claim on behalf of Mendoza. Respondent and Mendoza agreed that Respondent's receipt of a fee would be 20% of any recovery.

64. On or about March 5, 2012, Mendoza agreed to settle her claims against Embassy in return for the payment of $80,000 ("Mendoza settlement"). Under the terms of the settlement agreement, Respondent was to receive $16,000 in attorney's fees from the $80,000 settlement, and after other deductions, Mendoza was to receive $63,950.

65. On or about March 22, 2012, Respondent received LaSalle Bank check number 1101704224, which had been made payable to Mendoza and Respondent in the amount of $80,000, and which represented the Mendoza settlement funds. On or about March 23, 2012, Respondent, or someone acting at his direction, deposited the check into an account Respondent maintained at MB Financial Bank that ended in the last four digits 0704 ("MB account"). The MB account was a corporate business checking account, and was used by Respondent as the depository of property belonging to clients or third persons. The MB account was not a client trust account.

66. As of December 24, 2012, Respondent had disbursed only $5,000 of the Mendoza settlement to Mendoza from the MB account. As of that date, Respondent had still not distributed $58,950 to Mendoza of the $63,950 Mendoza was to receive from the Mendoza settlement funds, and Respondent should still have been holding $58,950 on behalf of Mendoza.

67. As of December 24, 2012, the balance in Respondent's MB account was $809.37, and Respondent had used $58,140.63 of the Mendoza settlement proceeds by issuing checks and making withdrawals for his own business or personal purposes.

68. At no time did Mendoza authorize Respondent to use for Respondent's own business or personal purposes any portion of the amounts due Mendoza from her settlement funds.

69. As of May 22, 2013, the date the Inquiry Board voted to file this complaint against Respondent, he still had not disbursed $58,950 of the Mendoza settlement funds to Mendoza.

70. By reason of the conduct described above, Respondent has engaged in the following misconduct:

a. failing to hold property of clients or third persons that is in a lawyer's possession in connection with a representation separate from the lawyer's own property, by converting those funds to his own use and causing the balance in his account to fall below the amount then belonging to clients and/or third parties or otherwise failing to preserve those funds separate from his property, and placing client funds in his business checking account instead of a client trust account, in violation of Rule 1.15(a) of the Illinois Rules of Professional Conduct;

b. upon receiving funds in which a client or third person has an interest, failing to promptly notify the client or third person, and failing to promptly deliver to the client or third person any funds or other property that the client or third person is entitled to receive, and upon request by the client or third person, failing to promptly render a full accounting regarding such property, in violation of Rule 1.15(d) of the Illinois Rules of Professional Conduct; and

c. conduct involving dishonesty, fraud, deceit or misrepresentation, by converting client and/or third party funds to his own use and causing the balance in his client trust account to fall below the amount then belonging to clients and/or third parties, in violation of Rule 8.4(c) of the Illinois Rules of Professional Conduct.

COUNT VII
(Conversion of Richard Beien's settlement proceeds)

71. On or about June 11, 2010, Richard Beien ("Beien") sustained injuries when a motorcycle he was operating collided with a taxi cab operated by Emmanuel Nundo ("Nundo") and owned by Bridged Cab Company ("Bridged").

72. On or about September 20, 2011, Beien met with Respondent concerning a possible personal injury action against Nundo and Bridged. At that time, Respondent and Beien agreed that Respondent would pursue a personal injury action on behalf of Beien. Respondent and Beien agreed that Respondent's receipt of a fee would be contingent upon obtaining a recovery for Beien, and would be 1/3 of any recovery.

73. In or about March 2012, Beien agreed to settle his claims against Nundo and Bridged in return for the payment of $55,000 ("Beien settlement"). Respondent and Beien agreed that after the payment of Respondent's attorney's fees in the amount of $18,333.33 and other deductions, Beien was to receive $31,239.46.

74. On or about March 7, 2012, Respondent received JP Morgan Chase check number 0076003654, which had been made payable to Beien and Charles Candiano, the associate at Respondent's firm who Respondent assigned to work on the Beien matter, in the amount of $55,000, and which represented the Beien settlement funds. On or about March 12, 2012, Respondent, or someone acting at his direction, deposited the check into an account Respondent maintained at MB Financial Bank that ended in the last four digits 0704 ("MB account"). The MB account was a corporate business checking account, and was used by Respondent as the depository of property belonging to clients or third persons. The MB account was not a client trust account.

75. As of December 24, 2012, Respondent had not disbursed any money to Beien from the Beien settlement. As of that date, Respondent should still have been holding $31,239.46 on behalf of Beien from the Beien settlement proceeds.

76. As of December 24, 2012, the balance in Respondent's MB account was $809.37, and Respondent had used $30,430.09 of the Beien settlement proceeds by issuing checks and making withdrawals for his own business or personal purposes.

77. At no time did Beien authorize Respondent to use for Respondent's own business or personal purposes any portion of the amounts due Beien from his settlement funds.

78. As of May 22, 2013, the date the Inquiry Board voted to file this complaint against Respondent, he had not disbursed any of the Beien settlement funds to Beien.

79. By reason of the conduct described above, Respondent has engaged in the following misconduct:

a. failing to hold property of clients or third persons that is in a lawyer's possession in connection with a representation separate from the lawyer's own property, by converting those funds to his own use and causing the balance in his account to fall below the amount then belonging to clients and/or third parties or otherwise failing to preserve those funds separate from his property, and placing client funds in his business checking account instead of a client trust account, in violation of Rule 1.15(a) of the Illinois Rules of Professional Conduct;

b. upon receiving funds in which a client or third person has an interest, failing to promptly notify the client or third person, and failing to promptly deliver to the client or third person any funds or other property that the client or third person is entitled to receive, and upon request by the client or third person, failing to promptly render a full accounting regarding such property, in violation of Rule 1.15(d) of the Illinois Rules of Professional Conduct; and

c. conduct involving dishonesty, fraud, deceit or misrepresentation, by converting client and/or third party funds to his own use and causing the balance in his client trust account to fall below the amount then belonging to clients and/or third parties, in violation of Rule 8.4(c) of the Illinois Rules of Professional Conduct.

COUNT VIII
(Conversion of Michelle Eaton's settlement proceeds)

80. On or about September 1, 2009, Michelle Eaton ("Eaton") injured her neck while working for the Porter County, Indiana, Sheriff's Office ("Porter County").

81. In or about September 2009, Eaton met with Respondent concerning a possible workers' compensation claim against Porter County. At that time, Respondent and Eaton agreed that Respondent would pursue a workers' compensation claim on behalf of Eaton. Respondent and Eaton agreed that Respondent's receipt of a fee would be 20% of any recovery.

82. In or about September 2012, Eaton agreed to settle her claims against Porter County in return for the payment of $27,500 ("Eaton settlement"). Under the terms of the settlement agreement, Respondent was to receive $5,500 in attorney's fees from the $27,500 settlement, and after other deductions, Eaton was to receive $21,791.46.

83. On or about October 4, 2012, Respondent received Northern Trust check number 481760, which had been made payable to Eaton and Charles Candiano, the associate at Respondent's firm who Respondent assigned to work on the Eaton matter, in the amount of $27,500, and which represented the Eaton settlement funds. On or about October 26, 2012, Respondent, or someone acting at his direction, deposited the check into an account Respondent maintained at MB Financial Bank that ended in the last four digits 0704 ("MB account"). The MB account was a corporate business checking account, and was used by Respondent as the depository of property belonging to clients or third persons. The MB account was not a client trust account.

84. As of December 24, 2012, Respondent had not disbursed any money to Eaton from the Eaton settlement. As of that date, Respondent should still have been holding $21,791.46 on behalf of Eaton from the Eaton settlement proceeds.

85. As of December 24, 2012, the balance in Respondent's MB account was $809.37, and Respondent had used $20,982.09 of the Eaton settlement proceeds by issuing checks and making withdrawals for his own business or personal purposes.

86. At no time did Eaton authorize Respondent to use for Respondent's own business or personal purposes any portion of the amounts due Eaton from her settlement funds.

87. By reason of the conduct described above, Respondent has engaged in the following misconduct:

a. failing to hold property of clients or third persons that is in a lawyer's possession in connection with a representation separate from the lawyer's own property, by converting those funds to his own use and causing the balance in his account to fall below the amount then belonging to clients and/or third parties or otherwise failing to preserve those funds separate from his property, and placing client funds in his business checking account instead of a client trust account, in violation of Rule 1.15(a) of the Illinois Rules of Professional Conduct;

b. upon receiving funds in which a client or third person has an interest, failing to promptly notify the client or third person, and failing to promptly deliver to the client or third person any funds or other property that the client or third person is entitled to receive, and upon request by the client or third person, failing to promptly render a full accounting regarding such property, in violation of Rule 1.15(d) of the Illinois Rules of Professional Conduct; and

c. conduct involving dishonesty, fraud, deceit or misrepresentation, by converting client and/or third party funds to his own use and causing the balance in his client trust account to fall below the amount then belonging to clients and/or third parties, in violation of Rule 8.4(c) of the Illinois Rules of Professional Conduct.

COUNT IX
(Conversion of Athens Springer's settlement proceeds)

88. On or about June 1, 2009, Athens Springer ("Springer") was injured when he was walking eastbound on Monroe Street near Wacker Drive in Chicago and slipped and fell on a metal grate and broke his ankle.

89. On or about July 16, 2009, Springer met with Respondent concerning a possible personal injury action against the City of Chicago and Commonwealth Edison. At that time, Respondent and Springer agreed that Respondent would pursue a personal injury action on behalf of Springer. Respondent and Springer agreed that Respondent's receipt of a fee would be contingent upon obtaining a recovery for Springer, and would be 1/3 of any recovery.

90. In or about March 2012, Commonwealth Edison agreed to settle Springer's claims for $40,000 ("Springer settlement"). Respondent and Springer agreed that after the payment of Respondent's attorney's fees in the amount of $16,000 and other deductions, Springer was to receive $14,784.11.

91. On or about March 21, 2012, Respondent received Bank of New York Mellon check number 0047140183, which had been made payable to Springer and Respondent in the amount of $40,000, and which represented the Springer settlement funds. On or about March 23, 2012, Respondent, or someone acting at his direction, deposited the check into an account Respondent maintained at MB Financial Bank that ended in the last four digits 0704 ("MB account"). The MB account was a corporate business checking account, and was used by Respondent as the depository of property belonging to clients or third persons. The MB account was not a client trust account.

92. Between March 2012 and January 2013, Springer contacted Respondent on several occasions to find out when he would receive his settlement proceeds. In response to Springer's inquiries, Respondent told Springer that he would receive his funds shortly. Respondent's statements to Springer that he would soon distribute the Springer settlement proceeds to Springer were false, and Respondent knew that they were false.

93. As of December 24, 2012, Respondent had not disbursed any money to Springer from the Springer settlement. As of that date, Respondent should still have been holding $14,784.11 on behalf of Springer from the Springer settlement proceeds.

94. As of December 24, 2012, the balance in Respondent's MB account was $809.37, and Respondent had used $13,974.74 of the Springer settlement proceeds by issuing checks and making withdrawals for his own business or personal purposes.

95. At no time did Springer authorize Respondent to use for Respondent's own business or personal purposes any portion of the amounts due Springer from his settlement funds.

96. As of May 22, 2013, the date the Inquiry Board voted to file this complaint against Respondent, he had not disbursed any of the Springer settlement funds to Springer.

97. By reason of the conduct described above, Respondent has engaged in the following misconduct:

a. failing to hold property of clients or third persons that is in a lawyer's possession in connection with a representation separate from the lawyer's own property, by converting those funds to his own use and causing the balance in his account to fall below the amount then belonging to clients and/or third parties or otherwise failing to preserve those funds separate from his property, and placing client funds in his business checking account instead of a client trust account, in violation of Rule 1.15(a) of the Illinois Rules of Professional Conduct;

b. upon receiving funds in which a client or third person has an interest, failing to promptly notify the client or third person, and failing to promptly deliver to the client or third person any funds or other property that the client or third person is entitled to receive, and upon request by the client or third person, failing to promptly render a full accounting regarding such property, in violation of Rule 1.15(d) of the Illinois Rules of Professional Conduct; and

c. conduct involving dishonesty, fraud, deceit or misrepresentation, by converting client and/or third party funds to his own use and causing the balance in his client trust account to fall below the amount then belonging to clients and/or third parties, and making dishonest statements relating to those funds, in violation of Rule 8.4(c) of the Illinois Rules of Professional Conduct.

COUNT X
(Conversion of Tommie Gills' settlement proceeds)

98. On or about April 17, 2011, Tommie Gills ("Gills") sustained injuries when a vehicle he was operating collided with a vehicle operated by Kyung Kim ("Kim").

99. On or about April 18, 2011, Gills met with Respondent concerning a possible personal injury action against Kim. At that time, Respondent and Gills agreed that Respondent would pursue a personal injury action on behalf of Gills. Respondent and Gills agreed that Respondent's receipt of a fee would be contingent upon obtaining a recovery for Gills, and would be 1/3 of any recovery.

100. In or about April 2012, State Farm Insurance Company, Gill's insurance carrier, agreed to issue payments to Gills totaling $14,122.04 as partial payment to Gill for injuries he sustained ("Gills settlement"). Respondent and Gills agreed that after the payment of Respondent's attorney's fees in the amount of $4,707.34 and other deductions, Gills was to receive $9,364.70.

101. On or about April 10, 2012, Respondent received JP Morgan Chase check number 101596590, which had been made payable to Gills and Respondent in the amount of $5,000, and which represented a portion of the Gills settlement funds. On or about April 18, 2012, Respondent, or someone acting at his direction, deposited the check into an account Respondent maintained at MB Financial Bank that ended in the last four digits 0704 ("MB account"). The MB account was not a client trust account.

102. On or about April 24, 2012, Respondent received JP Morgan Chase check number 101622961, which had been made payable to Gills and Respondent in the amount of $9,122.04, and which represented a portion of the Gills settlement funds. On or about April 27, 2012, Respondent, or someone acting at his direction, deposited the check into Respondent's MB account.

103. Between April 2012 and April 2013, Gills contacted Respondent on several occasions to find out when he would receive his settlement proceeds. In response to Gills' inquiries, Respondent told Gills that he would receive his funds shortly. Respondent's statements to Gills that he would soon distribute the Gills settlement proceeds to Gills were false, and Respondent knew that they were false.

104. As of December 24, 2012, Respondent had not disbursed any money to Gills from the Gills settlement. As of that date, Respondent should still have been holding $9,364.70 on behalf of Gills from the Gills settlement proceeds.

105. As of December 24, 2012, the balance in Respondent's MB account was $809.37, and Respondent had used $8,555.33 of the Gills settlement proceeds by issuing checks and making withdrawals for his own business or personal purposes.

106. At no time did Gills authorize Respondent to use for Respondent's own business or personal purposes any portion of the amounts due Gills from his settlement funds.

107. As of May 22, 2013, the date the Inquiry Board voted to file this complaint against Respondent, he had not disbursed any of the Gills settlement funds to Gills.

108. By reason of the conduct described above, Respondent has engaged in the following misconduct:

a. failing to hold property of clients or third persons that is in a lawyer's possession in connection with a representation separate from the lawyer's own property, by converting those funds to his own use and causing the balance in his account to fall below the amount then belonging to clients and/or third parties or otherwise failing to preserve those funds separate from his property, and placing client funds in his business checking account instead of a client trust account, in violation of Rule 1.15(a) of the Illinois Rules of Professional Conduct;

b. upon receiving funds in which a client or third person has an interest, failing to promptly notify the client or third person, and failing to promptly deliver to the client or third person any funds or other property that the client or third person is entitled to receive, and upon request by the client or third person, failing to promptly render a full accounting regarding such property, in violation of Rule 1.15(d) of the Illinois Rules of Professional Conduct; and

c. conduct involving dishonesty, fraud, deceit or misrepresentation, by converting client and/or third party funds to his own use and causing the balance in his client trust account to fall below the amount then belonging to clients and/or third parties, and making dishonest statements relating to those funds, in violation of Rule 8.4(c) of the Illinois Rules of Professional Conduct.

WHEREFORE, the Administrator respectfully requests that this matter be assigned to a panel of the Hearing Board, that a hearing be held pursuant to Supreme Court Rule 753(b), and the Panel make findings of fact, conclusions of fact and law, and a recommendation of such discipline as is warranted.

Counsel for the Administrator 
Attorney Registration and
Disciplinary Commission
130 E. Randloph Drive, #1500
Chicago, IL 60601
Telephone: (312) 565-2600

Respectfully submitted,

Jerome Larkin, Administrator
Attorney Registration and
Disciplinary Commission

By:  
Marita C. Sullivan

Where is my Illinois workers' compensation hearing site?

There are dozens of hearing sites throughout the state, where arbitrators act as judges over workers’ compensation cases. The arbitrators monitor progress, hold hearings and preside over trials in cases that don’t settle.

Your hearing site will be assigned after you file a claim. A claim is officially called an Application for Adjustment of Claim and is filed with the Illinois Workers’ Compensation Commission, usually at the main Chicago location.

Most cases are assigned based on accident location, so the hearing site closest to the accident site is where you’ll be. Not all workers with Illinois workers’ compensation cases were injured in Illinois, however. If you were hurt working on a job out of state, for example, your hearing site will be the location closest to your home in Illinois. Is some cases, a worker was merely hired here and doesn’t work or live here. They can still file a claim in Illinois, and their hearing site will be wherever is considered most convenient for the parties.

The Illinois Workers’ Compensation Commission has a chart that lists all the cities in Illinois and shows the hearing site for injuries within that city. There are hearing sites in Rockford, Wheaton, Peoria, Urbana, Chicago, Joliet (temporarily based in New Lenox), Springfield and Woodstock, to name a few.

So how much time will you spend at the hearing site? It depends. Your case will come up on the calendar every few months. This is how arbitrators monitor the progress of cases. Mostly, however, it’s up to you and your attorney and the insurance company to move things along. At these three-month status hearings, your attorney can request a trial, if the case is at that point, and the arbitrator will set a date. Otherwise, not much happens and the case is reset for another three months.

You may or may not want to show up for your status conferences. Ask your attorney. If you aren’t getting paid for medical bills or lost wages, then you can request an immediate hearing, which will be held at your hearing site. You will need to attend any hearings, as well as your trial if there is one. Many Illinois workers’ compensation cases end in settlement.
 

By Michael Helfand

Workers' compensation cases aren't handled in court

The process of an Illinois workers’ compensation case is a different from the process of an Illinois injury lawsuit, even though both deal with personal injuries. When you seek compensation for a work injury, it’s an insurance claim rather than a lawsuit, and the other side is usually your employer’s insurance company. It’s the insurer who typically pays benefits. They’re also the one who denies benefits.

When a dispute comes up, it’s usually about the payment of benefits. Maybe your TTD (temporary total disability) checks aren’t for the correct amount or aren’t coming at all, or maybe certain medical treatment that you need isn’t being covered. The workers’ compensation system has a process for disputes, where your case can be heard by an impartial arbitrator who is similar to a judge. So even though you can’t sue for your benefits, you have a similar option of getting your case decided by an impartial third party.

For these hearings, instead of going to a typical courtroom, you go to a hearing site. There are hearing sites throughout the state. Your claim will be assigned to the hearing site closest to where your injury occurred. If you were injured while working out of state, it will be the location closest to your home in Illinois. If you don’t live in Illinois, the hearing site will be the one that is most convenient for both sides. The location for your claim is assigned after you file an Application for Adjustment of Claim with the Illinois Workers’ Compensation Commission.

If a case can’t be settled, then it can go to trial. A workers’ compensation trial is in front of an arbitrator and is similar to a trial in other types of cases. The arbitrator will hear evidence and testimony from both sides and then make a decision. However, there are no juries in work injury cases.

Many times, injured workers wonder whether they can sue their employer instead, especially in cases where the employer was negligent and their negligence actually caused the accident that led to the injury. Unfortunately, the answer is no. The process described above essentially replaces the filing of a lawsuit. Fault doesn't matter, which is another major way in which these claims differ from lawsuits. Your employer's fault doesn't matter, and on the other hand, neither does yours. If it's your fault that you got hurt, you can still get benefits (if you're otherwise eligible).

By Michael Helfand

Everything we talk about is confidential, so . . .

If you want to talk with us about your case, we will talk to you.  Everything we talk about is between the two of us.  We aren’t going to call your employer.  We aren’t going to tell your attorney (if you have one already) that you are shopping around.
 
A lot of people that have already had a bad experience with an Illinois work comp attorney or don’t have a high opinion of lawyers in general are hesitant to share information.  I get this.  It’s perception versus reality.
 
But what I can tell you is that our talk is confidential.  If you want us to help you, even if it’s just giving you advice, you need to be open and honest with us.  Again, it’s all confidential, but if you want us to really help you, to really look out for your best interests then you need to be a straight shooter.
 
Recently someone called me looking for a Bloomington workers’ compensation attorney referral.  I work with some very good firms down there that get great results for their clients.  This caller insisted that he hadn’t ever had a lawyer before.  I found that unusual because it was a major injury and it happened more than two years ago.
 
So he asked me to have a lawyer call him and I did, relaying the information he shared including that he never had a lawyer before.  So this very experienced attorney called him and they had a great talk for one hour.  The worker wanted to hire him, but then revealed that he had already hired someone two years ago.
 
So he lied to me and this attorney he wants to hire.  That’s a deal breaker and now he can’t get the new representation he wants.  By the way, the first firm he hired is TERRIBLE.
 
He would have been way better off saying that he has someone, but doesn’t want to say who it is.  If he was open about the other aspects of his case then it would have been on the road to a good result.
 
Other people give fake names or phone numbers.  Again, I get it, but it’s only hurting you.
 
Hiring a firm is a two way street.  You have to want to hire us and we have to want to take you on as a client.  Crappy firms will sign up anyone.  Good firms will only take on good clients with good cases.  Those are the lawyers you want in your corner whether it’s someone in our network or someone you find elsewhere.  But you will be hurting yourself if you aren’t truthful.
 
I can’t promise we will take on your case, just as I can’t guarantee a result.  Only snake-oil salesmen do that.  But I do promise confidentiality, respect, blunt honesty and that if we do take you on we will go after your benefits as if you were a family member.  Hopefully that is enough to put your mind at ease and be direct with us.

By Michael Helfand

Why Illinois can never have anti-worker legislators

While I lean toward more “democratic” issues, I also agree with some “republican” positions. For the most part I don’t like any politicians and tend to ignore it.  I’d rather focus on my family and my clients.
 
But I do pay attention and talk to workers’ compensation lawyers in other states because some times a worker has an option to file their case in Illinois or somewhere else.  I always want to do what’s best for the client.
 
The other day I was talking to a lawyer friend in Oklahoma.  He advised that their legislature has basically done whatever they could to screw over workers if they get hurt on the job.  As part of that, a new law says that if you are hurt at work and return to your pre-injury job then you can’t get a settlement.  So even if you have a lumbar fusion and can’t do most of the things you used to do in your personal life, if you can work then you receive no compensation.
 
This affects probably 90% of the cases out there.  It also means that lawyers that used to handle these cases are now doing something else.  So if your TTD check is late or your medical bills aren’t getting paid, good luck finding a lawyer to represent you.
 
Now that’s not a problem for somebody with an Illinois case, but it used to also not be a problem in Oklahoma, Texas, Indiana, Kentucky and a host of other places.
 
So while I don’t believe this will happen in Illinois, that doesn’t mean that people haven’t tried or wouldn’t like to do something like this.  This would strip you of all of your rights and punish innocent people.
 
I’m kind of going off on a rant here because election season is far away and I don’t expect that my blog will influence people one way or the other.  But if you have been hurt on the job I assume that your view of how the system works has been changed.  Right now we have the most worker friendly system in the United States in my opinion.
 
And even though our system is great, there are tons of problems for workers.  I hear at least twice a week from people who have been hurt on the job that can’t believe how an insurance company is screwing them over.  Now imagine what would happen if all the laws were changed and your ability to bring a case.
 
There, I feel better. I’ll get off my rant and back to helping people find the right lawyer or answers for their case.

By Michael Helfand

"I don't need a doctor" ... Uhm, yeah you do

Usually the wacky comments I hear are from other lawyers or insurance adjusters who are making up laws in an effort to screw over an injured worker.  But the other day I heard something crazy from a potential client.
 
It was actually a doctor that called me.  He fell while on a business trip at a conference.  That was about two months ago.  He injured his leg when he fell and has been treating himself with ice, rest and pain meds.
 
He wasn’t going to do anything at first because he didn’t want to make waves, but now he realizes that his leg is getting worse, not better.
 
I asked him when he first went to the doctor and he told me that he didn’t need to do that because he was a doctor. I asked if he got x-rays and he said, “No, I know my body and nothing is broken.”
 
So basically he wants to be his own expert witness.  That will never fly as he’s clearly biased in his favor.
 
Whether you are a doctor, teacher, plumber, pilot, NFL QB or any other injured worker, you can only prove that you have an injury by getting actual medical treatment.  And that treatment needs to be from somebody independent who is going to give an honest opinion.
 
The longer that you wait after an accident to see a doctor, the harder it is to prove that your problems are related to the accident.  The first thing a defense attorney would do was grill you as to why you waited so long to get medical help.
 
Seeing a doctor helps prove your case.  If you act like a tough guy by not getting treatment or think you can take care of yourself, you will kill your case.
 
As an aside, I actually believe this doctor didn’t go to one of his colleagues for help because he was having an affair with a co-worker and it sounds like things have blown up on that end.  So it sounds like everything is getting worse for him.
 
Bottom line is that if you are hurt, get help.  And go from there.

By Michael Helfand

 

Can I video-tape an IME?

I got that very reasonable question from a doctor of all people.  They didn’t have a case, but instead were trying to help out a friend.  This doctor is in another state and apparently there it’s illegal to video-tape the “Independent” medical exam.  It’s not illegal in that state to bring another doctor with you to the exam.
 
Anyway, he wanted to know what his friend can and can’t do in Illinois. His friend believes that he is likely being sent to a hired gun who will try to screw him over in return for getting more referrals from the insurance company.
 
There are no clear cut laws on this issue other than that it’s usually at the discretion of the doctor.  I don’t know of any doctor that wants to be video-taped, mostly out of unfounded fear of being sued.  I can tell you that I don’t believe this is a good idea, even when the IME doctor is a hack.  The hackiest of doctors can still write an intelligent sounding report.  Your attempts at showing what really happened will usually do nothing more than make them defensive and turn against you.  In my experience, Arbitrators at the Illinois Workers’ Compensation Commission also frown upon this as well.
 
I think it’s less controversial to bring your spouse or child or friend in to the room.  Some doctors might not allow it, but if you are really uncomfortable being alone in there, it in my opinion is worth having a conversation about with the Arbitrator.  Some might say you should be allowed, others won’t agree.  It’s going to take that one case where it goes all the way to the Appellate Court to clarify what should and shouldn’t be allowed.
 
In the bigger picture, everyone is worried, and rightfully so, that the IME doctor won’t be honest in their evaluation.  Imagine that you have pain radiating down your legs from your back and can’t sleep yet some doctor that sees you for two minutes says you are 100% fine and ok to go back to your job on a construction crew.
 
So people want to record what really happened in the exam and/or bring a friend that can testify as to how short it was.
 
This evidence can be helpful.  But a lot of times these doctors base their reports on their review of your medical records and seeing you doesn’t have much to do with how they form an opinion.  It’s pathetic, but true.
 
IME’s are money making machines for these doctors.  Many of them earn an extra six figures from doing them.  I do believe that most docs are honest, but some want to keep that gravy train going.
 
If there is any silver lining for you, it should be two things: 1. A credible treating doctor will way more often than not sway an Arbitrator. 2.  Insurance companies, lawyers and Arbitrators all know who the real hired guns are and who will tell you what they really think even if it goes against the insurance company that is paying them.  So while your benefits might get delayed, ultimately you will almost always prevail at trial if you have a good doctor and lawyer in your corner.
 
As far as what to do at an IME, you should always talk with a lawyer first.  But I do recommend that you be as pleasant and honest as you can be.  Honesty is of course always the best policy.  But believe it or not, there are a bunch of IME doctors that will put you through tests to determine how honest you are being about your pain and abilities without you even knowing it.

 

By Michael Helfand

Employer safety violations and Illinois workers' compensation cases

We get a good amount of questions about safety rules and regulations and how violations of safety measures affect an Illinois work injury case. Specifically, people want to know if it helps their case if their employer created an unsafe work environment. Common sense seems to say that it should, but a workers’ compensation case is not like a typical lawsuit where the focus is on fault.

The simple answer is that in the realm of workers’ compensation, fault does not matter. If your employer was negligent and caused your injury, it does not work to your benefit, at least not in any official legal way. It may seem unfair, but consider what it means in the opposite situation. If you, the worker, cause your own injury by being careless, your fault doesn’t matter either. You are eligible for benefits regardless.

The next question we usually get from an injured worker in this situation is whether they can sue their employer separate from, or in addition to, their workers’ compensation claim. Unfortunately, it’s usually not an option. The Illinois workers’ compensation system is meant to be more efficient than conventional litigation, and filing a claim essentially replaces the right to file a lawsuit. The exception is if your injury is caused by a third party who is not your employer. In that situation, a third-party lawsuit might be an option.

The intended result of this system is that injured employees get compensated more quickly and employers avoid the threat of a lawsuit every time someone gets hurt on the job. It’s not perfect, but it’s what we have. And in most cases, someone who is hurt while working can get the compensation they’re eligible for, which includes payment of 100% of all reasonable and related medical expenses, payment of 2/3 of their wages if they are unable to work while they recover, and additional compensation if their injury is permanent.

In order to be successful, there are certain steps you should take after a work injury. Notify your employer about your injury, get medical treatment, follow the advice of your doctor, file a claim even if you start receiving benefits without doing so, and talk to an experienced Illinois work injury attorney if you have any questions or concerns.

But unless your employer does something intentional to hurt you – e.g. punches you in the face, purposely hits you with a car, etc. – then work comp is your only option for a recovery, no matter how bad their behavior is. 
 

By Michael Helfand

 

Why don't some crappy attorneys just find other work?

I was talking to a work comp defense lawyer in Chicago that I’m friends with (yes, we can be friends with the other lawyer, but still want to kick their butt on your behalf).  He was telling me about a case that he won where the Arbitrator denied all benefits to the injured worker.
 
He thought he had a shot at it, but knew he was in good shape when the lawyer for the injured worker didn’t write proposed findings to the Arbitrator.  Proposed findings are required in every trial.  Basically it means that we write a paper that tells the Arbitrator how we think he/she should rule on the case and why.  We write it as if we are them.  In many cases they just rubber stamp one of the proposed findings with no further explanation.
 
Well, they can’t possibly choose your findings if you don’t turn them in.  It would be like taking a class in high school and hoping that you get an A without turning in your final exam.  To be as blunt as I can, this is legal malpractice of the worst kind and this person does not deserve to keep their law license.
 
My friend told me that this same lawyer wouldn’t respond to e-mails or phone calls, even when he left a message asking to discuss settling the case. And this wasn’t a once in a lifetime thing, this is his pattern of behavior.
 
What’s crazy is that he does have a lot of clients because he’s in a smaller town and one of the few local choices.  People there seem to assume that is what working with a lawyer is like.  And he probably feeds them all a bunch of b.s. when they complain about anything.
 
Nobody makes him or anyone else do this job.  Sometimes the work can be exhausting and frustrating.  For me it can also be incredibly rewarding.  If he doesn’t like it, I don’t know how he can live with himself when his lack of action ruins the life of his clients that are depending on him.
 
Twelve years ago I created a state wide network to identify work comp lawyers that care and will really fight for their clients.  These are people I’d hire myself if I needed help.  We don’t win every case, but we would never sell you out or blow you off.
 
I do think the majority of firms around have good people there that try their best.  It’s just that you only hear about nightmare stories like this guy.
 
You’d think that if he really hates his job he’d find something that would make him happy.  Maybe it’s too hard to give up the paycheck.  Maybe he’s just a miserable person and wouldn’t be happy doing anything.  Who knows?  I’m just glad that hasn’t happened to me and promise that if it ever does I’ll walk away instead of letting my performance hurt somebody else.

By Michael Helfand

Random Illinois work comp info you should know

I came across this item which I had written a long time ago.  It’s not well organized, but here are a bunch of relevant facts for injured workers.

  • All injuries received while working are not necessarily compensable injuries under the Illinois Workers' Compensation Act - the injury must arise out of and occur in the course of employment.
  • Just because an injury occurs outside the work place does not necessarily mean it is not a compensable injury under the Illinois Workers' Compensation Act.
  • In addition to specific injuries, repetitive trauma injuries, where a worker's body breaks down because of the repetitive nature of their work, can also be compensable under the Illinois Workers' Compensation Act.
  • The benefit to employers of the Workers' Compensation Act is that injured workers cannot usually sue for things like negligence or pain and suffering.
  • If you are injured at work, under most circumstances the only legal remedy you have against your employer is under the Workers' Compensation Act - it should be noted, however, that the "exclusive remedy" provision of the Workers' Compensation Act only applies to employers - in other words, the Workers' Compensation Act does not prevent an injured employee from seeking damages against defendants other than his employer who may be responsible for his injuries.
  • A workers' compensation insurance carrier in Illinois is also subject to the same restrictions as the employer - for example, neither an employer nor an insurance carrier can interfere with an employee's exercise of his/her rights under the Act or discriminate against, threaten to discharge, or refuse to re-hire an employee because of their exercise of such rights.
  • A copy of the Attorney Client Representation Agreement must be filed with the Application for Adjustment of Claim.
  • A worker who comes into Illinois for an out of state employer can be subject to and eligible for benefits under the Illinois Workers' Compensation Act.
  • The statute of limitations under the Workers' Compensation Act is an Application for Adjustment of Claim must be filed within 3 years of the date of accident, or two years after the last payment of compensation (weekly benefit payments or medical payments), whichever is later.
  • If you are off work for a work related injury, you are entitled to benefits equal to 2/3 of your average weekly wage up to a statutory maximum.
  • Injured workers are entitled to three separate benefits under the Illinois Workers' Compensation Act: medical benefits, temporary off work benefits and permanent impairment benefits.
  • If you hire an attorney to pursue your claim at the Illinois Workers' Compensation Commission, that attorney is generally entitled to receive 20% of any award you receive. Generally, those attorneys are not entitled to hourly payments for the work they do on your behalf. This fee arrangement is a "contingency fee" fee arrangement.
  • Even after an arbitrator enters an award on behalf of the employee, there is a multi-stage appeal process that can take years to go through - specifically, the arbitrator's award can be appealed to a three commissioner panel, then to the Circuit Court, then to the Appellate Court, and even possibly to the Supreme Court (of Illinois).
  • On average, less than 5% of the cases filed at the Workers' Compensation Commission actually proceed to hearing before an arbitrator.
  • Just because a contract exists defining a worker as an independent contractor does not necessarily mean that worker will not be considered to be an employee under the Illinois Workers' Compensation Act.
  • The most important factor in determining whether an alleged independent contractor is actually an employee under the Act is whether the alleged employer controlled the manner in which the work was performed.
  • Minors have the same rights and obligations as adults under the Illinois Workers' Compensation Act, except that illegally employed minors may reject their rights under the Act within six months after an accident and may sue the employer under the common law.
  • Aliens have the same status as other employees under the Act, except that death benefits are reduced by half when the beneficiaries of those aliens do not reside in the United States, Mexico or Canada, except as otherwise provided by treaty.
  • Domestic servants employed by a family (e.g a nanny) are not automatically covered by the Act unless the employer elects to come under the Act or if the domestic servant is engaged in extra hazardous activity.
  • The aggravation of a pre-existing condition or disease may be an accidental injury and may be compensable under the Illinois Workers' Compensation Act.
  • In some states, it need only be shown by the injured worker that some risk of the employment contributed to the injury - this concept is sometimes referred to as the "positional risk doctrine" - Illinois has expressly rejected that concept. In other words, there must be a risk of the employment to the employee that provides a risk greater than the risk provided by the general public.
  • The burden of proof under the Illinois Act is that the party seeking an award must prove each element of their claim by a preponderance of the evidence.
  • If an employee indicates on a former application for group health insurance benefits that an injury is not work related, that by itself does not necessary mean that compensation will not be awarded by the Commission.
  • A mental or psychological condition that results from a work related physical injury is compensable under the Illinois Workers' Compensation Act.
  • Psychological or mental disabilities without physical injury are much harder to prove - in those circumstances, the employee must show that he suffered a "sudden, severe emotional shock" traceable to a definite time, place and cause which caused the psychological injury or harm.
  • Heart attacks, strokes, aneurisms, pulmonary embolisms and thrombophlebitis can be compensable conditions under the Illinois Workers' Compensation Act if they are causally related to the employee's work activities.
  • Suicide can be compensable in Illinois if the cause of the suicide is traceable to an original compensable accident.
  • Even if the cause of an employee's injury is internal to them, or "idiopathic" that injury can still be compensable if some aspect of their work significantly contributed to the injury.
  • Assaults by co-employees or others are not compensable under the Illinois Workers' Compensation Act unless the altercation arose out of something work related and the injured worker was not the aggressor.
  • As of September 1, 2011, Intoxication from alcohol or drug use will not necessarily prevent an injured employee from receiving workers' compensation benefits, unless the intoxication caused the injuries. Under the Illinois Act, if the worker fails a drug or alcohol test, they have the burden of proving that the intoxication was not the cause of their injuries.
  • If an injured employee's work activities require them to travel, their injury will be considered to be covered by the Illinois Workers' Compensation Act as long as the activity they were performing at the time they were injured was foreseeable to the employer.
  • Injuries occurring in employer controlled parking lots, even after an employee has clocked out, can be compensable under certain circumstances.
  • Injuries resulting from medical treatment rendered at the request of the employer's physician are compensable.
  • If an employee is engaged in recreational activity, his injuries will only be compensable if the employee was compelled by the employer to participate in the recreational activity.
  • If the injured employee is authorized off work by a physician because of a work related injury, he/she will be entitled to payments of 66-2/3 of their average weekly wage, commonly referred to as temporary total disability benefits.
  • All non-medical benefits under the Illinois Workers' Compensation Act are paid on the basis of an injured employee's Average Weekly Wage, which is an independent calculation under the Illinois Workers' Compensation Act from what an employee receives in compensation from their employer - the calculation of average weekly wage can be quite complicated.
  • Failure to cooperate with medical treatment or rehabilitation efforts may result in the suspension of temporary total disability benefits.
  • An injured employee is entitled to include the wages from a second job, or concurrent employment, with her average weekly wage if her employer was aware of the second job.
  • An employee has the right under the Illinois Workers' Compensation Act to choose two different physicians, and any physician those doctors refer them to for the treatment of their work related injury as long as that treatment is considered reasonable and necessary. As of September 1, 2011, If the employer has a preferred provider network, the employee must choose from that network. If the employee opts out of the network, they will then have just one physician choice.
  • If an employee's work-related injuries restrict him from returning to his prior employment when he recovers, he will be entitled to the payment of 2/3 of the difference between what he could have made in his previous employment and what he is able to make within his permanent medical restrictions on a weekly basis. As of September 1, 2011, a worker can receive these benefits until age 67, or for five years after the benefits were awarded, whichever is later.
  • If an injured employee's injuries prevent him from ever returning to any type of employment, he will be entitled to 2/3 (under some limitations) of his wage on a weekly basis for the rest of his life.
  • If an employee's medical benefits or temporary total disability benefits are suspended improperly by the employer, the Workers' Compensation Act does allow for an expedited hearing process.
  • The employer is entitled to have an injured employee examined by a consulting physician from time to time under the Act as long as the employer pays a mileage expense to the injured worker.
  • If an injured worker suffers some disfigurement to the hand, head, face, neck, arm, leg (below the knee), or chest (above the auxiliary line), they will be entitled to disfigurement benefits under the Act.
  • If an injured employee recovers from an injury fully and is able to return to work, he/she is still entitled to permanent partial disability as a result of that injury in most cases.
  • Even if no doctor says that an injured employee cannot return to work because of permanent medical restrictions related to their work-related injury, they could still be permanently totally disabled if they are unable to find employment because of their medical restrictions.
  • Dependents of a fatally injured employee may be entitled to benefits under the Illinois Workers' Compensation Act - the issue of eligibility can be quite complicated and often requires a sophisticated evaluation.
  • If an injured employee obtains proceeds from a common law action that arises out of his/her workers' compensation injury, the employer may have a lien for any workers' compensation payments made.
  • If an employer acts in a retaliatory manner towards an injured worker for seeking workers' compensation benefits, there are many tools available to the employee to protect his/her workers' compensation rights.
  • If an injured employee receives group short or long term disability benefits for an injury that is eventually considered to be a workers' compensation injury, the employee's employer may have a credit for those payments if it paid a portion of the premium for the disability policy.
  • If a worker injures the same part of the body a second time (with the exception of the neck, head and back) and she received workers' compensation benefits for the first injury, her employer will get a credit for those past payments, even if the past payments were made by a different employer.

By Michael Helfand

Why it's important to have your doctor on your side

Even though you know your body better than anyone else, in workers’ compensation cases it’s your doctor who has the power to determine the state of your health, at least for the purposes of getting benefits.

If you hurt your back and can’t go to work, you can’t just decide this on your own. Not if you want to get paid for your missed time. Illinois workers’ compensation law gives workers 2/3 of their average weekly wage if they are unable to work because of an injury on the job. Your employer’s insurance company pays benefits and they are going to see what your doctor has to say. They won’t be taking your word for it.

The same is true if you need restrictions, meaning you can work but you can’t do everything you used to do. A common restriction, especially for a back injury, is no heavy lifting. Again, your doctor will likely need to say that you need such restrictions. This is especially important if your employer doesn’t have a job for you to do within those restrictions. If that’s the case, then you essentially can’t work and are entitled to payment of 2/3 of your wages while you are out of work. Again, your doctor’s orders can make all the difference.

This is one reason why it’s important to choose your doctor carefully. For most people, the best doctor is your regular, trusted doctor and the specialists to whom they refer you. Your regular doctor is likely to know you better than a new doctor. This can help, especially if you have a good relationship. If you tell them you simply can’t go back to work yet, you want them to trust that you are being honest about that and be on your side if the insurance company disagrees.

Your employer or insurance company might try to tell you that you have to see the doctor they choose. This is not true. If you see a doctor they work with, you can imagine whose side they’re likely to be on. If you have any questions about any of this, talking to an experienced work injury attorney is your best bet. You need someone looking out for your best interests, not the bottom line of their business. There are some shady lawyers who have arrangements with doctors, referring clients back and forth. Not only does this put your medical care in jeopardy, but the arbitrators who are like judges in workers’ comp cases, don’t take these doctors seriously.

The bottom line is that no one should be forcing you to see a certain doctor. It can end up hurting your claim and your benefits.
 

By Michael Helfand

Be skeptical of a settlement offer, even if it sounds really good

Let’s say the insurance company offers you $100,000 to settle your work injury claim. This means that they pay you $100,000 and you agree to close your case and not ask for any more benefits in the future. To many people, that’s a lot of money, and saying yes seems like a no-brainer.

However, you should be skeptical. There are times when $100,000 isn’t a good offer. If your case is really worth $200,000, then it’s a terrible offer. It’s also bad if you have a lot of treatment ahead of you. If you need back surgery, then $100,000 isn’t enough. If you settle, that surgery will be on your own dime; workers’ compensation no longer pays for treatment after settlement. It’s also not enough if you can’t return to your old job and you were making good money. If you can get $250,000 at trial, that’s obviously better than $100,000.

It can be scary to turn down a settlement that seems like a lot of money. This is why it’s important to have an attorney with tons of experience in how insurance companies work. For example, they’ll know that the insurance company isn’t going to offer you more than your claim is worth. So if you’re getting an offer of $100,000, it’s not a windfall. Your claim could actually be worth much more. A good attorney will be able to give you solid advice on whether you should accept an offer or go to trial.

It’s really important to have an attorney who isn’t going to urge you to settle because they see dollar signs. Your attorney should look out for your best interests and take your case to trial if necessary. Their focus shouldn’t be on getting their fee but getting you the amount you really deserve. They should be thinking about your future, including any medical care you might need and your job prospects.

Once you settle a claim, your case is essentially closed. Never settle without getting legal advice from someone who knows what they’re doing. 

By Michael Helfand
 

No one should dictate your medical treatment

Well, no one except you and a trusted doctor. Don’t let the insurance company or your employer force you to see the doctor of their choice. The insurance company wants to spend as little money as possible on your claim. Your priorities are different. You need to look out for you, and it’s usually in your best interest to see a doctor you already know and trust.

In Illinois, injured workers get to pick their own doctor for treatment of their work injury. Prior to 2011, that freedom of choice was even broader, but it’s still better than many states. You essentially get two separate choices of doctors. Included in each choice is any specialist or other doctor to whom you are referred. Put another way, you get two chains of referrals. All treatment that is reasonable and related to your work injury should be covered 100%. You should not have any co-pays or out-of-pocket expenses.

Under recent changes in the law, employers in Illinois are allowed to set up preferred provider networks, which is a list of doctors you have to pick from. You are allowed to opt out, however. Also, while they can’t force you to be treated by their doctors, your employer and the insurance company can request that you undergo an Independent Medical Exam or IME with their doctor. This is usually a one-time exam and usually happens because the insurer is disputing your doctor’s opinion.

Not only should your employer and insurer not dictate your medical treatment, they should stay out of your appointments with your doctor. Some insurers try to send “nurse case managers” to injured workers’ appointments. They’re not allowed to come unless you consent, and we suggest that you don’t consent. They’re just looking for ways to save money on your claim.

It helps to have a lawyer you can trust, as well. Your attorney should not ask for any money up front. They should not force you to see a specific doctor (it’s a sign that they have an agreement with a certain doctor, which doesn’t make you look good), and they shouldn’t hesitate to get your case into court – including going to trial – if it’s in your best interest.
 

By Michael Helfand

The Illinois Workers' Compensation Commission is closed

Crazy weather we are having.  This is the first time I can recall the Commission being closed due to weather.
 
So if you were expecting to go to trial today it’s not going to happen.  If you are hoping to get a trial date at the status call, it’s been postponed.  We are still  waiting to hear when it will be rescheduled for.
 
This is part of living in Illinois.  I’m sure we’d all be happy to be in Hawaii right now, but you have to take the good with the bad.

By Michael Helfand

If you wait too long to file an Illinois workers' compensation case . . .

A couple of weeks ago I got a phone call from someone that was injured while working up in McHenry County back in 2010.  He originally thought the accident date was December 10th and unfortunately he called me on December 13, 2013.  He hadn’t had any benefits paid toward the case in the last two years so it looked like he missed the date for filing the case by three days.
 
That was really too bad because whether you miss it by three days or three years, the statute of limitations has the same effect.  It’s a rather hard and fast rule.  Not knowing how long you have to file a case is irrelevant and not an excuse even if it’s unfair.  Unless you can prove that the insurance company somehow lead you on and tricked you in to waiting too long, you are typically out of luck.
 
You must remember that until you have representation, nobody is looking out for you except for you.  If you don’t know what you are doing or you make a mistake, there is nothing that can be done.  Well at least not typically.
 
In this case I told the caller that he needed to call all of his medical providers and double check the accident date to make sure it was in fact too late.  And I told him to do it ASAP.
 
Good thing he listened because he found some paperwork from the insurance company that listed the accident date as actually December 13, 2010.  This was around 2:00 p.m., so we had approximately three hours to get the case filed.
 
Had he decided to wait until the next morning or even later that night to check then he would have been out of luck again.  As it is, he nearly cost himself a mid five figure settlement, but fortunately that shouldn’t happen.
 
The bottom line is that you should never wait to bring a case.  It doesn’t benefit you in any way and it’s not as if you are paying your lawyer any up front money.
 
This was certainly a crazy phone call.  I’ve talked to many people who have missed the filing deadline by a few weeks and many others that missed by a year or more, but never have I had a call from somebody that just happened to call on the date that their time limit was up on and not realize that they were on the verge of blowing their case completely.

By Michael Helfand

 

What to do if your doctor says you can work and you know you can't

A reader asks:

I had a lumbar fusion5 months ago the doctor released me back to work with no restrictions but I don't think I am ready . What do I do?

This is a great question.  Nobody knows your body better than you do.  At the same time though, under Illinois law, temporary total disability benefits are only owed if you have a doctor stating that you can not do your job or that you need work restrictions that your employer can’t accommodate.
 
To me, the best way to solve a problem like this is to establish a good relationship with your doctor at the get go.  Some doctors will release patients as soon as they can because the patient just bugs them.  So a nice thank you card or a box of candy can go a long way (my friend created www.crafthousecocktails.com if you are looking for a great gift that isn’t too expensive).  Point is that having a great relationship with your doc can go a long way.
 
Beyond that, I’d be sure to express your concerns to the physician.  If they are releasing you to full duty work then perhaps you can do a trial run of a few weeks on light duty.  Maybe you can do work hardening which is a rehabilative process designed to condition you to get back to work.  It’s almost like a “spring training” of sorts.
 
You can also ask him/her about what you should do if you feel pain while working and what the next steps would be.
 
What you don’t want to do is act like someone that thinks workers’ compensation is a free vacation and that you’ll never be able to get back to your old duties.  Let them know that you want to work, but are scared (assuming that’s the truth).  If you act like you’ll never get back on the job and then the insurance company catches you doing any meaningful activity, you are dead in the water and will hurt your case.
 
For my clients who have done all of this, I just tell them the truth: they have to try working.  Sometimes it goes way better than they expect.  Other times they get re-injured within five minutes.  But while you know your body better than anyone else, your surgeon knows these injuries better than you do.  So you have to trust their judgment or be willing to sit at home and not be paid.
 
This is the kind of news that often sucks to deliver, but we don’t ever tell people what they want to hear.  We tell the truth and the reality is that if your doctor isn’t in your corner then there isn’t much that can be done for you.

By Michael Helfand
 

Merry Christmas!

Happy and safe holidays to everyone.  No post today, but should have a new one soon.
 
Cheers,
Mike Helfand

Is the insurance company too big to fight?

I’m always amazed when a lawyer lies to a client instead of just telling them the truth.  In law school, we aren’t trained in customer service or business practices or anything else that involves actually running a firm.  So sometimes people with bad life skills are in charge which leads to what I’d consider unethical behavior.
 
The most recent example was from a caller who told me that he had an attorney on the case, but they withdrew.  When I asked what the problem was, they said that they didn’t know, but the lawyer had told them that the insurance company was so big and had so many resources that they were just too difficult to go up against.  Essentially he said that his one person law firm couldn’t take on a billion dollar company.
 
What a crock!  Every single case involves an insurance company that is humongous and a lawyer for the worker that is no where near that size.  If this lawyer was truthful then we’d lose every case.  But the reality is that almost every case is a lawyer and injured worker on one side and a lawyer and insurance adjuster on the other side.
 
Sure the insurance company has more money that we ever will, but they didn’t make that money by throwing it away.  It would make no sense to spend $100,000 to fight a work injury case that’s only worth $25,000 for example.  Beyond that, handling an Illinois work comp case isn’t so complex that a team of lawyers, investigators or whoever should change much.
 
If you are honest, get injured while working and properly report your accident, things will usually work out fine.  If some hack doctor hired by the insurance people says you are fine when any sane or reasonable physician would say that you are not, you simply need to get in to court.
 
I’ve heard similar stories from people who say something like “I want a lawyer that isn’t afraid to take on the State of Illinois” or “I need someone who’s not scared to go up against Walmart.”  It’s all perception versus reality, at least in the work comp business.  If you have a good case then who your employer is should be irrelevant.  I don’t know of anyone that’s “scared” to take on somebody.  If they are then what they are really saying is that they don’t want to do any work at all.
 
What really happened in this case is that the lawyer discovered that the worker had given different stories to his doctors and was caught on surveillance video doing activities that went beyond his work restrictions.  That behavior made it a bad case.  For whatever reason, this guy didn’t have the guts to call out his client on the case issues and thought that telling a fib was the better way out of the relationship.
 
Like I said, I don’t get it, but some great law firms are run by terrible business people.  But please don’t ever think that your case isn’t going anywhere because of who our opponents would be.  No matter who you hire that should never happen.

By Michael Helfand

What a little aggressiveness can do in a case

We just received two settlements, one for $150,000 and the other for $160,000.  They came via a lawyer in our statewide network of experienced work comp attorneys who was willing to take over a case from two different law firms.
 
The first case originally had a lawyer in Chicago on it who has a reputation for extreme laziness.  He was telling the client to take the $40,000 offer on the table.  The client wisely got rid of him and a year later ended up with an extra $111,000.  That was the value of the case when the first attorney had it, but insurance companies don’t just hand out six figure settlements.  They know which firms have fighters and which ones roll over.  It would not surprise me at all if they made the offer so low based on who was representing the worker.
 
In the second case, the original attorney is a downstate guy who is in his late 80’s.  He was a driving force in Illinois work comp law 30 years ago, but since I’ve been in the business all I have ever heard about is the number of lawyers that he fires (when a new attorney is handling your case every six months that isn’t good for you) and an allegation that he fired his own son.  My opinion is that this guy isn’t the right lawyer for anybody.  That certainly proved true in this case as the end result was a great six figure settlement that was much higher than what the client would have gotten if they didn’t make a switch.
 
In both cases, the new firm acted aggressive and got results.  When a lawyer has a reputation of not being afraid to go to trial it makes an insurance company take notice.  Neither of these cases did go to a formal hearing, but the knowledge that they could put the insurance company in a position of having to be fair because at trial they could lose so much more.
 
You don’t want to switch firms if you don’t have to, but at the same time, once you settle the case is over and done with.  So if you end up taking way less than what was reasonable that is all on you.
 
As a side note to this, I recently was called by a woman who had settled her case, but thought that her lawyer was going to steal her money because he hadn’t paid her yet even though the case was settled in August.  I doubt he is stealing, but what was really disturbing is that she said she still needed treatment for her back injury.  He had convinced her that the back troubles weren’t going to go away so it’s probably better to just end the case now.  Now she had nobody to pay for her treatment.  Never let your lawyer give you medical advice.  If you still need treatment then you don’t even think about settling your case.  If you take a different approach then the only person who would benefit is your attorney.

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

By Michael Helfand
 

Should I hire a Chicago lawyer for my work comp case?

There is a good concentration of workers’ compensation attorneys in Chicago, and if your case is going to be assigned to the Chicago hearing location, then we’d almost always recommend one of these local attorneys.

All claims are filed with the Illinois Workers’ Compensation Commission at their main location downtown Chicago. The claims are then distributed among the various hearing locations throughout the state. Your location will be the one closest to where you were injured, or if that isn’t applicable, then the location closest to your home. For Cook County, the hearing location is Chicago; for Lake County, it’s in Waukegan; and for DuPage County, the hearing location is in Wheaton. Other hearing locations include Peoria, Decatur and Rockford. There are others, as well.

Most Illinois work injury lawyers focus their practice on representing workers who are assigned to the hearing location near their offices. That said, many of them will travel elsewhere in the state to handle cases if necessary. Although location matters, it ultimately comes down to finding the attorney who is a good match for you and your case.

The most important criteria are, in our opinion, the attorney’s experience and their familiarity with the arbitrator hearing your case. So usually this means that a local attorney is best. If your attorney knows the arbitrator (the judge in a workers’ compensation case), it can give you an advantage. Obviously, it’s not going to help you out if the attorney isn’t well respected, so that’s an important part, too.

We have a network of workers’ compensation attorneys throughout the state of Illinois who have experience in the various hearing locations. We believe this is key, especially if your case goes to trial.
 

By Michael Helfand
 

Your behavior after a work injury can make or break your case

It all comes down to being honest – with yourself, your doctors, your attorney and your family. If you are injured, don’t pretend that you are not. Don’t “tough it out.” If you do so, and end up worsening your injury, that can jeopardize your benefits.

Don’t exaggerate either. Insurance companies often monitor employees who have an injury that is preventing them from working. They’ll actually use surveillance to watch you. Their goal is to catch you doing something that you said you couldn’t do, or something that your doctor told you not to do. They want to prove that you either aren’t as hurt as you’re claiming or that you are making things worse by not following your doctor’s orders and that they shouldn’t have to keep paying.

Be honest with your doctor. Obviously, don’t tell them you’re hurt when you’re not. What we’re mostly talking about, however, is being clear about what is hurting and why. If your doctor doesn’t have the opinion that your work caused your injury, then your case could be over. You need to explain your work duties, what you were doing when you got hurt, etc. And call back or make another appointment if your symptoms or pain worsen.

And always be upfront with your attorney. It’s the only way they can do everything they can to help you get the benefits you need. Much of the success of your claim lies in your own hands. If your job caused you an injury, the law says that you get your medical expenses covered and checks for lost wages while you’re unable to work. If you need help getting started or if you’ve hit a roadblock (denied claim, stopped benefits, etc.) and you have questions, let us know.
 

By Michael Helfand
 

Fill out accident report right away, and don't stop there

If you suffer a work injury, however minor it might seem, notifying your employer as soon as possible is key to protecting your rights. If you have an accident at work, tell your supervisor that day if possible. Fill out an accident report right away. Keep a copy if you can, but at least make notes of what you wrote and what date the report was made.

The deadline for reporting an injury is 45 days after the date of the accident, or 45 days from when your repetitive stress injury becomes apparent. The longer you wait, however, the more opportunity you create for the insurance company to deny your claim. The insurance company would love to point to the fact that you delayed as proof that your weren’t as hurt as you say you are, or that your injury occurred outside of work. This saves them a ton of money.

After reporting your injury, don’t sit around to see what happens. See your doctor if there is any indication that your injury is serious or getting worse. If you are in pain, see your doctor. Again, the longer you wait the more you allow the insurance company to question your injury, motives and truthfulness. In addition, you obviously put your health at risk if you allow an injury to worsen.

Waiting can put your ability to get benefits in jeopardy. In Illinois, employees who are injured on the job are entitled to coverage of medical bills and lost wages and can receive a settlement for the permanency of their injury. If the insurance company has denied your claim, talk to an experienced Illinois work injury attorney about what to do next. Their denial doesn’t have to be the final answer. You can get your case before an arbitrator (similar to a judge) who can make an unbiased decision based on the facts.
 

By Michael Helfand

Confidentiality agreements in workers' compensation settlements


A confidentiality agreement, as part of a settlement, is meant to prevent you from revealing the details of your settlement. Basically, the defendant (or respondent in Illinois work comp cases) doesn’t want others to know how much they paid you. The defendant might be afraid that the information would provide an incentive for others to file a claim of their own, or that it might make them look guilty. 

Most workers’ compensation cases, especially those that involve a permanent injury, end with a lump sum settlement for the worker. In some cases, the employer might want the injured employee to agree to keep the amount and terms of the settlement confidential. There are a few reasons why you should think twice before agreeing to something like this.

The main thing we want to point out is that the records of all claims at the Illinois Workers’ Compensation Commission are public anyway. The results of your settlement can be found pretty easily by anyone specifically looking for it. So in reality the confidentiality agreement isn’t going to keep the settlement amount confidential. It does prevent you from talking about it, though.

Also, signing a confidentiality agreement as part of your settlement agreement can be risky in that it might open you up to tax liability. In general, your workers’ compensation settlement should be tax-free. The law says that most payments that compensate someone for an injury are not to be taxed. However, if you are paid to sign a confidentiality agreement, that money can be taxed as income because you’re not being paid for an injury. You are being paid to keep quiet. If it’s all lumped together (confidentiality clause within a settlement agreement), then the IRS might try to claim that part of your settlement was payment for keeping quiet and that part should be taxed. You don’t want to open up this can of worms unless you are being given a significant amount of money for your potential trouble.

And back to our first point about the information being public anyway. The fact that others can still find out about the terms of your agreement put you in a difficult position. The other side might blame you for breaching the confidentiality agreement, even if you said nothing. You could be looking at a lawsuit where you’d have to pay a lawyer by the hour to defend you.  Who needs that headache?

For these reasons, we don’t usually recommend signing a confidentiality agreement. And in general, we believe that the more information that is available to the public, the better, so confidential settlements tend to rub us the wrong way.  And after all, these aren’t lawsuits, but claims for benefits

No matter your opinion on this stuff, don’t sign a settlement agreement, confidentiality agreement, or anything else for that matter, without running it by an attorney and talking about the potential pitfalls.. You don’t want to get caught off guard by one of these little-known exceptions in the law.
 

By Michael Helfand

What does Obamacare mean for my Illinois work injury case?

Whether you are a Republican, Democrat, independent or something else, whether you love Obamacare or think it will be the death of our country, if you have a work related injury and need medical care, the law treats you the same.
 
And by that, I mean that Obamacare will mean virtually nothing to your work comp case.  That’s because your medical treatment shouldn’t be put through your group insurance carrier.  And if you have no insurance at all it shouldn’t matter either.
 
100% of your reasonable and related medical bills should be covered by the work comp insurance company your employer paid for.  That means no co-pays, no out of pocket expenses, nothing at all.  In other words, if you fall off a ladder and break your leg, anything related to that accident should be taken care of at no cost to you and you get to focus on your health.
 
On the other hand, if your appendix ruptures, that would be covered by your normal insurance if you have it.
 
If you are made a part time worker because of Obamacare, the only effect on your case would be the chance in your average weekly wage which is used to calculate your benefits.
 
It’s important that if you do have health insurance that you don’t let them pay for bills related to a work injury.  If they do that in error, they could sue you to reimburse them or refuse to pay for future medical treatment that you or a family member needs until they have been reimbursed.  So you could blow out your back on the job, but if your group insurance pays for your care, if your child needs to see a doctor you’ll have to pay for that out of pocket.
 
Overall, getting medical treatment for job injuries and accidents isn’t difficult in Illinois and having your own insurance is pretty much meaningless.  The most important thing is that if you are hurt that you see a doctor and focus on your health.  Delaying medical care can not only ruin your ability to win a case, it can make a minor problem become much more serious.

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

By Michael Helfand

You should not be talking to the insurance company

A caller to my office the other day wanted to know my opinion on the lawyer she had been talking to.  I hadn’t heard of him, but did notice that he had only been licensed for around four years.  That doesn’t mean he doesn’t know what he’s doing, but at the same time, it doesn’t speak well to his experience.
 
But his youth wasn’t why I told her that she had the wrong firm.  She relayed to me that he instructed her to keep on talking to the insurance company, even if he filed a claim on her behalf.  What?!?!?!?
 
The whole point of hiring an attorney is to navigate the system for you, answer your questions, represent your interests and allow you to focus on your health.  Nothing we say can be used to hurt your case.  Anything you say can be used against you if your case goes to trial.
 
Point is that you shouldn’t be talking to the insurance company and no work comp lawyer in their right mind would be advising you to do so.
 
It’s really such a bizarre piece of advice that I’m not even really sure what he could be thinking.  The case had been accepted, but her TTD benefits were delayed.  He should have been the one on the phone figuring out what the problem is and/or filing a trial motion and a petition for penalties and fees.
 
It would be like going to a restaurant and being asked to do the cooking.  What’s the point of that?
 
The sad thing is that while Illinois workers’ compensation can be a challenging area of law, success as an attorney comes down to actually just doing your job.  For some they don’t do it because they are burned out.   Others try to make their paralegal or secretary handle most of the heavy lifting.  Some are just so overloaded with cases because they will take on any claim that walks through the door that they don’t have the organizational skills to handle that much work.  And still others have a problem because they have such high lawyer turnover (should tell you what type of firm it is if attorneys keep quitting) that nobody seems to have a handle on what is going on with any of the cases.
 
Whatever the reason, it’s not your problem and is certainly not something you should deal with.  We don’t promise a result, but in creating a state wide network of hard working lawyers, we don’t see these types of problems.  And usually that means great success for whoever we are representing.

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

By Michael Helfand

Hail Mary's aren't just for football

On Saturday, Northwestern University lost to Nebraska on a last second “Hail Mary” to Nebraska.  Nebraska was down three points with 5 seconds left and was about 55 yards from scoring so they didn’t have a choice.  It wasn’t a great choice, but of course they had nothing to lose.  Sometimes you just throw stuff against the wall to see if it sticks.  In this case it did.
 
That happens in other areas of life too including workers’ compensation claims.  In fact, I recently got a call from a guy who was the victim of an insurance company Hail Mary.
 
He injured his leg in 2009 and has been receiving TTD benefits ever since then.  Then out of the blue he gets a letter from the insurance company saying that his current condition isn’t work related and they are going to stop sending him benefit checks.
 
Of course there was no real basis for this denial.  It was throwing a dart against the wall to see what would happen.  What did happen is it forced this nice guy to get a lawyer and stop the craziness.
 
I have no problem when an insurance company defends a case because it’s defendable.  Reasonable people can disagree over what an outcome should be and that’s why we have our court system.  But when they act with complete disregard for your health and with no morals, then we have a really big problem.
 
From their standpoint, they already have lost, so what’s the worst that can happen.  Maybe you buy their nonsense and settle your case for less than it’s worth.  In a crazy world, you’d just give up.
 
If they are successful even just once out of ten times then they win in the long run.  Your case is about you and your life.  But to them it’s just another file number and they don’t care about your well being or what struggles their actions will cause you to go through.
 
The good news is that this is an easily problem to solve and we can file for penalties and attorneys fees that if done enough and collected enough can actually deter them from doing the wrong thing.
 
Whatever happens, don’t despair.  We do have a very strong work comp system in Illinois for workers that is also fair to employers.  As long as you educate yourself and protect yourself, things will be fine.

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

By Michael Helfand

Emotional trauma and Illinois workers' compensation benefits

In Illinois, workers’ compensation doesn’t cover all emotional injuries, but it does cover some. The general rule is that you have to suffer an emotional shock that is sudden and severe. Often this means that you must be able to point to a specific incident that caused the trauma. A bank teller held up at gunpoint would likely qualify, whereas an employee who has a mental breakdown because of a demanding boss likely would not.

There was a recent case involving a police officer who filed a workers’ compensation claim for post-traumatic stress after being involved in a standoff. The person the officer was dealing with appeared to have a handgun (later turned out to be a BB gun). During the next few days, the officer started to experience anxiety when responding to calls at work. He was diagnosed with PTSD and sought benefits.

Sometimes claims like these will be denied based on the fact that the emotional trauma developed over time and therefore wasn’t sudden and severe. In this case, the officer didn’t begin suffering anxiety until a few days after the incident, and the worker’s compensation commission said benefits were not allowed because there was no immediate shock or emotional harm.

Another reason the claim was denied was because the incident (the standoff) was something this man was fairly likely to be exposed to as a police officer. In other words, it shouldn’t cause him as much anxiety as the average person because he’s a trained officer.

The case went up to the Illinois appellate court, which reversed the decision. They said that there was sudden and severe emotional shock, which led to PTSD. And the court also said that the man shouldn’t be held to a higher standard because he is a police officer. If a standoff would traumatize the average person, then it could traumatize anyone, regardless of that person’s job.

So, the existence of emotional shock is an objective, not subjective question. When determining whether emotional trauma is worthy of benefits, the person’s occupation and training are not relevant.

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

By Michael Helfand

Employer can't fire you for filling an Illinois workers' compensation claim

Illinois law provides workers with benefits while they recover from a work injury, including coverage of medical bills and payment of a portion of any lost wages. Many injured workers also get a lump sum or settlement for the permanent nature of their injury.

In order to get benefits, you typically file a claim with the Illinois Workers’ Compensation Commission. If your boss doesn’t like it, that doesn’t matter. Illinois law also protects employees from retaliation by an employer. You can’t be fired, demoted or otherwise discriminated against for filing a claim.

This is an important way that Illinois law encourages injured workers to get the help they need. The courts found it necessary that employees be able to file a claim for benefits without fear of their employer holding it against them. The point of workers’ compensation is to support injured employees and help get them back into the workforce.

If your employer fires you for filing a claim, you can go after them for two types of damages. You can get compensatory damages for financial loss, usually lost pay. And you can also seek punitive damages, essentially making them pay extra for breaking the law.

Just to be clear, you can be fired while out on workers’ compensation. It just can’t be because you filed a claim. If you have a case against your employer for breaking this law, it’s important to be able to prove why you were fired. An experienced and proactive attorney can help you determine whether you have enough evidence and help you gather evidence to prove your case.
 

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

By Michael Helfand

Company clinics don't have the final word

A lot of companies, especially those in and around Chicago, have a policy that if one of their workers gets injured, they have to go to a company affiliated health clinic for a medical examination.
 
These places are regular doctor’s offices, but they cater to the employer because it means a big pay day.
 
As a result, it’s not uncommon for us to be contacted by someone who was sent to one of these clinics in terrible pain following a work related injury, only to be told that there is nothing wrong with them and they can return to work.
 
I’ve seen this happen to workers with broken arms and torn ACL’s.  But the most common injury is someone who has a back or neck injury because the extent of those problems isn’t going to show up on an X-ray or many table exams.  Usually you need a MRI.
 
The bottom line is that you don’t have to accept what these hired guns tell you.  What you do need to do is go and see a doctor of your own choosing who will look out for you and give you an honest evaluation as to what is wrong with you.
 
That doctor, assuming they are credible, will trump anything this clinic doctor thinks.  That doesn’t mean you win your case as you still have to prove everything else that is required under the law.  But you shouldn’t stress about this awful doctor.  You just need to get with somebody honest that the company doesn’t pay for. 

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

By Michael Helfand

Hot off the presses, 2014 Arbitration assignments announced

Every fall, the Illinois Workers’ Compensation Commission changes up the Arbitrator assignments for the next year.  So if you weren’t happy with the Arbitrator assigned to your case, it may just be a matter of waiting a few months until they are placed in a new location.
 
Not too many of them are changed, but here is the full list courtesy of the IWCC.
 
 
Effective January 1, 2014, arbitrators will have the following assignments:

Zone 1:   Collinsville, Herrin, Mt Vernon:  
Lee, Lindsay, Zanotti

Zone 2:   Springfield, Quincy, Urbana:  
Dearing, Gallagher, Pulia

Zone 3:   Bloomington, Peoria, Rock Island:  
Erbacci, Holland, McCarthy

Zone 4:   Geneva, New Lenox, Ottawa:   
Granada, Mathis, O'Malley

Zone 5:   Rockford, Waukegan, Woodstock:   
Andros, Falcioni, Fratianni

Zone 6:  Chicago, Wheaton:   
Cronin, Doherty, Luskin

Zone 7:  Chicago:   
Black, Carlson, Dollison, Flores, Huebsch, Kane, Kelmanson, Mason, Simpson, Steffen, Thompson-Smith, Williams

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

By Michael Helfand

Safety rules, employee fault and Illinois work injuries

An employee who breaks the safety rules and gets hurt as a result can still get workers’ compensation benefits in Illinois. Violation of a safety rule does not automatically disqualify you, nor does the fact that the injury was your fault.

What does disqualify you is if you were outside the “scope” of your employment when you got hurt. This means that you were doing something for your benefit and not the benefit of your employer. It can come down to whether you were doing your job or just goofing around.

A worker was recently injured while welding. He had refused to wear the safety mask provided by the employer and suffered flash burns to his eyes. Some states have rules that prevent benefits, or reduce benefits, when an injury is caused by failure or refusal to follow the safety policy set by the employer. In Illinois, however, there is no such rule.

In the case of the welder, he was performing his job duties when he was injured, and that is what matters. His injuries should be covered and he should get benefits, such as payment for lost wages while he’s unable to work and coverage of his medical bills. Had he been doing something that wasn’t for his employer’s benefit, such as playing around with the welding equipment, his claim would likely get denied.

There’s a well-known case where a worker jumped onto a forklift with another employee to catch a ride to lunch. He was injured. The claim was denied, not because the company had a policy against riding double on forklifts (which it did), but because he was not within the course or scope of his employment when he got hurt.

Each case comes down to the very specific facts of the employee’s situation, work environment, etc. Talk to an attorney (someone with a lot of experience helping injured workers) before deciding whether you should file a claim for Illinois workers’ compensation.
 

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

By Michael Helfand

Fired for lying about a work injury

If you’re fired for lying about your work injury, it doesn’t necessarily mean you lose your benefits. Often, they are two separate questions.

First, there are rules about getting fired after a work injury. You can’t be fired because you filed a claim or sought benefits. It’s illegal to fire someone in retaliation for trying to get benefits that they’re legally entitled to under Illinois workers’ compensation law. However, you are not protected from being fired for all of the regular reasons, such as breaking the rules or violating the conditions of your employment.

Second, there is the issue of lying about your injury. It’s never a good idea, but people often do things out of fear or embarrassment, even when they know they shouldn’t. Lying about your work injury can have serious consequences. If you were not injured at work, and you say you were, that is fraud. If you exaggerate your injury, the insurance company can find out and cut off your benefits. However, there was a situation recently where lying about the work injury might not result in loss of benefits.

The worker misrepresented his work accident in the description that he provided to his employer. When the employer found out, he was fired for falsifying records. The question is what will happen to his temporary total disability checks. It’s unclear how the arbitrator will rule, but the key might be whether he would have qualified for workers’ compensation had he not lied. In this case, it looks like he was eligible either way. In other words, even though he lied, it didn’t affect the fact that his work injury claim was legitimate.

The employee probably won’t be able to get his job back. It seems he was fired for a valid reason. However, his benefits should continue. Regardless of the lie, he is still recovering from a serious injury that happened on the job. It’s a unique situation. He should consider himself lucky if he’s able to keep his benefits. Lying about a work injury can cause you lose everything.
 

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

By Michael Helfand

Gas mileage for going to your doctor or physical therapy

Injured workers receive a lot of great benefits under the Illinois Workers’ Compensation Act.  And we always try to get the workers that we represent everything allowed under the Act.  But the one item not usually available is one that we are often asked for.
 
Generally speaking, there is no requirement for an insurance company to pay your travel expenses to go to and from a medical provider.  So if you have to drive 5 miles or 20 miles, unless it’s a provider that that the insurance company made you go to, you will have to pay for your travel related expenses.
 
It’s not what most callers and clients want to hear, but it is the truth.  There are some limited exceptions.  For example, if the type of treatment you need is so specialized that you don’t have any choices, you could get compensated for your travel.  The most common example of this would be if you had to go to somewhere like the Mayo Clinic for treatment that only they provide.  Another example is if you live in a really rural area in downstate Illinois and the only neurologist is more than 100 miles away.  An argument could be made in that case that your gas mileage should be reimbursed.
 
In general though this is not a benefit that is typically available.  For our clients in the Chicago area it’s not a huge concern given how many medical choices there are (although clients that have to pay to park at downtown medical offices certainly have something to gripe about).  It’s a much bigger deal for injured workers in rural areas.  We see this issue a lot because our statewide network of attorneys handle cases in every county in Illinois.
 
Even though it’s not an available benefit, if you do have travel concerns, I suggest you raise that issue with your attorney.  Often we can get the insurance adjuster to address these issues.  Our biggest success has been with clients who have physical limitations that impact their ability to travel.  Years ago we worked on a case where a worker was told to get out of the car every ten minutes to stretch.  So the insurance company actually hired a limo company in order to drive the guy to his doctor as it would allow him to move freely without having to pull over to the side of the road.  That’s incredibly atypical.
 
So in general this is not an available benefit for you, but like anything in life, it doesn’t hurt to ask.

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

By Michael Helfand

Illinois workers' compensation basics, part 1

We only represent injured workers.  That said, we think there is a great value in looking at cases from the perspective of an insurance company or defense firm.  It’s a great way to know how they think as well prepare to deal with them.  In addition, they often have great overviews on case law.  Here is something from a defense firm that is an overview of the Illinois workers’ compensation system.  It’s very wordy and overly legal and nothing like the plain English that I try to write in. But if you can look past all of that it’s really informative.

 

I.  Jurisdiction

 

Every person in the service of another under any contract of hire, express or implied, oral or written, including persons whose employment is outside the state of Illinois where the contract of hire is made within the State of Illinois, persons whose employment results in fatal or non-fatal injures within the State of Illinois where the contract is made outside the State of Illinois, and persons whose employment is principally localized within the State of Illinois, regardless of the place of the accident or the place where the contract of hire was made, and including aliens, and minors who, for the purpose of this Act are considered the same and have the same power to contract, receive payments and give quittances therefore, as adult employees.  820 ILCS 305/1.2.

 

II.  Statute of Limitations

 

In any case, other than one where the injury was caused by exposure to radiological materials or equipment or asbestos unless the application for compensation is filed with the Commission within 3 years after the date of the accident, where no compensation has been paid, or within 2 years after the date of the last payment of compensation, where any has been paid, whichever shall be later, the right to file such application will be barred.  820 ILCS 305/6(d).

 

 

III.  The Employer/Employee Relationship

 

An employer-employee relationship is a prerequisite for an award of compensation benefits under the Act.  Roberson v. Industrial Commission, 225 Ill. 2d 159 (2007).

 

A.        Factors to consider:  whether the employer controls the manner in which the persons performs the work; whether the employer dictates the person’s schedule, the manner of pay, withholding of income taxes and social security, whether the relationship can be terminated by either party, who provides tools, equipment, and materials, and whether a written contract exists outlining the relationship.  Also considered is whether the work that is asked to be performed falls within the scope and general business of the potential employer.  No single factor determines whether a person is an employee or independent contractor and the significance of these factors will change depending on the work involved.

 

We are going to post this in three parts since it’s rather large.  Check back for part two in a couple of days.

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

By Michael Helfand

When does your case have to go to trial?

I had a very nice call with a woman regarding her father’s case.  She asked us to take it over which we declined because there was already a very significant settlement offer on the table and the case was over five years old.
 
However, in the course of discussing the case, she told me that the lawyer told her that they had to settle or go to trial this fall because the insurance company wouldn’t agree to any more continuances.  Of great importance, her Dad is still under going active medical care for his back injury and is getting paid for his time off of work as he has been the entire time.
 
So while it wasn’t the original purpose of the call – I was told that they realized their lawyer has zero experience with Illinois work comp trials -,  this statement was a big red flag.
 
From the time a case is filed, it has three years until it is “above the line.”  That’s a random legal term.  Basically it means that after three years, your case has to be set for trial unless you can show the Arbitrator that you are still receiving treatment and benefits.  It’s a way to prevent cases from sitting around forever.  If there were no lazy lawyers it wouldn’t be needed because if you want to get a hearing date, you can pretty much do so at any time.  The rule exists to prevent attorneys with huge caseloads or no interest in their clients from taking forever.  It’s actually quite shocking how many cases get settled after three years even when they could have been resolved a long time ago with minimal effort.
 
But in the caller’s case, they don’t have to go to trial because they still have an active case.  There are a handful of cases from the 1990’s still floating around the Illinois Workers’ Compensation Commission.  I don’t expect that this case will take that long, but it’s not uncommon in a major injury to get cases continued after the three year point.
 
So what happened is one of two things:  1. The lawyer lied to his client because he wants to get the case over with (there is a settlement offer in excess of $200,000).  2. The insurance company is calling the shots because this attorney is very inexperienced.
 
Whatever happened, it’s awful.  I tend to think it’s a matter of him not knowing the law so the insurance company, who badly wants to close out the case so they can stop paying on it, pushing him around.
 
For you, rest assured that if you are healthy and ready to settle or your benefits are denied, your attorney can file a trial motion at any time for you.  And if you aren’t healthy and still receiving compensation from the insurance company, your case can continue on past the three year deadline.  Every claim is different and needs to be looked at on its own merits.

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

By Michael Helfand

I want to know what my case is worth - is there a calculator for that?

One of our readers sent the following question to us:

My husband hurt his back at work. He has a salary position at a local factory. His salary wage is $1750 bi weekly. He generally earns overtime above this amount as well. He was off for 1 year and 2 weeks. He had to have back surgery. He was just released from his surgeon and allowed to settle. We do not have a lawyer, as his companys insurance has paid everything without question. His doctor said his body loss was 25%. We have no idea how much to anticipate for a settlement. Nor are we sure we want to get a lawyer since the insurance company hasn't caused any problems. Is there a standard method to calculating how much of a settlement would be realistic? I've found conflicting calculators online; one coming up with $26,000 and another $130,500 (big difference!) as what he should get. I'd like to know a ballpark of what he might realistically get offered so we know whether or not to pursue getting a lawyer to try and get more.

 

One of the great myths out there, that is being pushed by a handful of attorneys, is that there is some calculator where you can plug in your injury and wages and determine what your case is worth.  I believe there hope is to get you to hire them by them convincing you that your case is worth a ton of money so you’ll hire them.  That’s why you see results like the one above that are so far off from each other.  It’s basically all made up.

Beyond that, the doctor rating is mostly irrelevant as it’s just one of six factors that should be considered in determining a case’s worth. 

 

This case could be worth hundreds of thousands of dollars.  It could be worth $30,000.  But with an injury this serious you would be foolish not to have a lawyer at least look at it.  When you have such a high range of what a case might be worth, you could cost yourself tens or hundreds of thousands if you don’t have real help.

 

But gimmicks like calculators are just a joke, no different than someone who tells you what a case is worth without seeing your medical records.  It’s a great marketing trick to get you in, but there is no authenticity to it.  I never promise a case result (other than that we’ll bust our butts for you), but we’ll never try to trick you in to hiring us or anyone in our network.

 

And to answer the question, there is no standard method to figuring out what a case is worth.  Every case is unique and you have goals and issues that others don’t have.  There’s no hidden secret to making a proper evaluation.  You can only truly do it by having years of experience and truly getting to know a case.

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

By Michael Helfand

One of the strangest calls I've ever received

So this guy calls me and here’s the gist of what he said when I asked him what his situation is:


“I currently have a claim and am being represented. I received a back injury which has resulted in surgery, physical therapy, and currently, an intensive job search per my restrictions. Dr. Says 20lbs weight limit, no repetitive bending, twisting, or squatting. It's only been a week, but something tells me that I could be on my way down to disability lane.  I'm 40 years old and healthy otherwise with plenty of life ahead. My question is, what do you think the value of my case might be?  I have an awesome work comp lawyer, I just find it hard to talk to him at times, he's like the freakin CIA or something.”

I didn’t tell him what I thought the case was worth.  But I did ask him what was so “awesome” about his lawyer if he can’t ask these questions to him or is hard to talk to?  I didn’t get a real response.
 
I’m happy to talk to anyone about their case.  A lot of times I can talk people off the ledge and help them realize that their attorney is actually doing a good job.  Other times we discuss my firm or someone in our network taking the case over an putting it on the right track.  And for some people we’ll just answer a question.
 
But if you have a lawyer who is going to get 20% of your settlement and has access to all of your medical records, they are the best people to tell you what your case is worth.  I find it completely bizarre that someone can love their lawyer when they don’t feel that they can go to them and answer your questions.
 
The job of an Illinois work comp attorney is to represent and look out for their clients.  That doesn’t mean that they are there for you and you alone 24/7, but it does mean that they have an obligation to answer your questions, treat you with respect and fight for your best interests.
 
The reality is that this lawyer isn’t great.  Maybe he did something good for the client at some point, but if he isn’t approachable then he needs to find a new line of work.
 
It’s especially true when you have a major injury like this guy appears to have.  Demand good service from your lawyer.  If you were in a restaurant and they made you wait for 30 minutes before they gave you a menu and then took two hours to bring out your food, you wouldn’t go on Yelp and give a great review.  You’d probably leave after 15 minutes.  If your attorney isn’t approachable and talking to them doesn’t make it better then it’s probably time to move on.  You’ll probably never realize how much better things can be otherwise.

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

By Michael Helfand

You have 45 days to notify your employer of a work injury in Illinois

Illinois law says that an injured employee must tell their employer about their injury within 45 days of the date of injury. In some cases, especially serious injuries, your boss will clearly know. It’s still a good idea to put your notice in writing. The reason is that the insurance company can try to deny your claim based on failure to give notice.

You have 45 days, but sooner is better so that there’s not question about whether you met the deadline. If the date of your injury is clear, then you shouldn’t have a problem figuring out your deadline. However, if your injury did not happen in a single incident but rather occurred over time, your case is a bit trickier.

When it comes to a repetitive stress injury, Illinois law says that you have 45 days from the day you reasonably should have known you were injured (and that the injury was caused by your job) to notify your employer. There is some room for argument here, so again, the sooner you tell your employer the better.

If you are unsure of whether you have a work-related injury, go see a doctor. Make sure to tell your doctor all of your symptoms, what you’re doing when you experience symptoms, what your job duties are, etc. Give your doctor all of the information so they can give an informed opinion on the cause of your pain.

If you miss the deadline and the insurance company tells you that you’re out of luck, talk to an experienced workers’ compensation attorney about what you can do next. You may still be able to get the benefits you need to recover and get back to work.

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

By Michael Helfand

Injured at work? Don't talk to the insurance company

Your employer carries workers’ compensation insurance (in most cases), and if an employee gets hurt, it’s the insurance company that pays benefits. The insurance company, therefore, hopes that you don’t get a lawyer and that instead you do what they say. You can expect them to ask for a recorded statement. They might try to tag along to your doctor’s appointments. And if you say no, they might imply that your benefits are at risk if you don’t go along with these requests.

The truth is that you are entitled to benefits regardless of whether you give a recorded statement, and your insurance adjuster is not allowed to attend your doctor appointments unless you consent. In fact, you should say no to both of these things.

The purpose of the recorded statement is to get you to inadvertently say something that hurts your case. If you express any doubt about how you got injured, it might give them something to go on and deny that your injury is work related. As for the doctor appointments, don’t let anyone from the insurance company try to direct your treatment. 

The insurance company’s goal is to save money by paying you less. Or by paying nothing at all. We don’t mean to sound paranoid, but we’ve seen it happen time and time again. If you hire an attorney who knows what they’re doing, they’ll handle all communication with the insurance company, including informing them that you will not be giving a recorded statement.

Talking to the insurance company is not going to help you, even if you are completely honest (and we would never suggest being anything other than honest). It’s just that they know how to manipulate a situation to their benefit.

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

By Michael Helfand

Don't talk yourself out of filing a claim

We know people who have hesitated to file a claim because their pride got in the way, or because they were embarrassed that they slipped up and got hurt, or because they simply thought it would make them look bad. None of these reasons outweigh the importance of filing a claim for benefits after a work injury, especially if your injury is serious.

First of all, Illinois workers’ compensation law was set up as a compromise between employers and employees. Employers get something out of it too. You have the right to file a claim against their insurance if you get hurt, and they are protected from lawsuits. Injured employees can’t sue their employers for personal injury. In most cases, workers’ compensation is the only option. You can get benefits regardless of whether an injury is your fault.

Second, you won’t be dealing directly with your boss. Many employers are required to carry workers’ compensation insurance, and you’ll be dealing with the insurer. That said, insurance companies can be tricky, so ideally your attorney will be dealing with them.

Third, you are entitled to full coverage of all reasonable medical treatment related to your injury, as well as payment of a portion of your wages if you’re out of work while you recover. You may also get a settlement at the end of your case. These benefits can be essential for your physical and financial recovery.

Finally, if you wait too long, it will hurt your case, or prevent you from filing a claim altogether. The more time that goes by, the harder it can be to prove how you were injured and what you are owed in benefits. Also, Illinois law sets a deadline of three years from the date of your injury. If you don’t file a claim by then, you can forever lose your chance.

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

By Michael Helfand

 

Is this lawyer any good?

Callers to our office often want to know our opinion on certain law firms.  We’ll tell it to you straight.  Often that means that we think you have made a good choice.  Other times that means we’ll give you the feedback we’ve gotten on them or what we’ve personally seen about them.

I had a different spin on this question when I was asked about a lawyer from a defense attorney I know.  He told me that he had three cases with the guy and the attorney had been fired by clients on all three cases. There were others copied on the e-mail and the responses went flying.  Here’s a sample:

“As a defense attorney I love him.  He always settles for nothing.”

“He never returns my calls.”


“Never showed for the trial.”


“Client was totally unprepared.”


Clearly this attorney (who I had never heard of by the way) doesn’t cut it.  When a defense attorney is excited that they are on a case, you know that’s a bad sign.

 

In fact, that would be a great question to ask any prospective work comp lawyer you are thinking about hiring:  “What would defense attorneys say about you?”


Hopefully they’d say that they are prepared, advocate for their clients, are ethical, will take a case to trial if it needs to, doesn’t take on b.s. cases, etc.  Of course you don’t know if that’s true or not, but I’m always interested to see if someone looks like they are lying or not.

 

In the case of the lawyer everyone was asking about, if he was truthful he’d say that most of his time doesn’t involve handling work injuries.  He probably wouldn’t say that he’s lazy and doesn’t care.  But I’d be really interested to see if he could answer the question at all.

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

By Michael Helfand

New Arbitrators at the Illinois Workers' Compensation Commission

Fresh of the IWCC website, here is info on some new Arbitrators and a new Commissioner (they hear appeals).  The turnover from five years ago is quite remarkable.   We are very happy with the re-appointments and are trying to find out what we can about the new Judges.
 
Governor Quinn appoints three new arbitrators, one new commissioner
Twelve arbitrators reappointed as Commission sees continued success following system overhaul
 
Governor Pat Quinn today announced the appointment of three new arbitrators to the Illinois Workers' Compensation Commission (IWCC) who perform the duty of enforcing the provision of the Workers' Compensation Act. These three arbitrators will join the 27 who are currently serving. In 2011, Governor Quinn championed and signed into law historic workers' compensation reform legislation to overhaul the system in Illinois. Today's announcement continues the Governor's commitment to making Illinois government more efficient, accountable and effective.
 
"These individuals have years of professional experience that will benefit the Illinois' workers' compensation program," Governor Quinn said. "I am pleased to appoint these arbitrators and a commissioner who will work for the people of Illinois to resolve workers' compensation cases in a manner which treats injured workers with respect and ensures that employers in Illinois receive a fair and efficient resolution to claims."
 
The reforms signed into law by Governor Quinn in 2011 called on the Governor to appoint new arbitrators to the Commission, considering the recommendations made by the Workers' Compensation Advisory Board, which is a body composed of six members representing the employer community and six members representing employees and working people in Illinois. Arbitrators at the Commission are responsible for ruling on claims filed by employees who suffer an injury at work.
 
The law requires that all newly-appointed arbitrators must be attorneys and that both arbitrators and Commissioners are subject to the ethical rules and requirements followed by Illinois judges. Arbitrators and Commissioners must also take at least 20 hours of training every two years while in office regarding professional and ethical standards, detection of fraud, evidence-based medical treatment, and Coal Workers' Pneumoconiosis.
 
Governor Quinn appointed the following new Arbitrators:
 
* Molly Dearing, J.D., Southern Illinois University School of Law; B.A., University of Illinois, Urbana/Champaign; Associate of Arts, Southeastern Illinois College
 
* Jeffrey Huebsch, J.D., Illinois Institute of Technology/Chicago Kent Law School; B.A., North Central College
 
* Ketki Steffen, J.D., John Marshall Law School; B.A., University of Illinois, Urbana/Champaign 
 
The Governor has appointed the following Commissioner:
 
* Michael Brennan, J.D., DePaul University College of Law; B.A., DePaul University 
 
The Governor reappointed the following Arbitrators:
 
* William Gallagher, J.D., Southern Illinois University - Carbondale; B.A., Southern Illinois University, Edwardsville
 
* Carolyn Doherty, J.D., John Marshall Law School; B.A., Marquette University
 
* Joshua Luskin, J.D., University of Michigan; B.A., Macalester College
 
* Robert Williams J.D., Loyola Law School of Chicago; M.B.A. University of Illinois at Chicago; B.S., Le Moyne-Owen College
 
* Barbara Flores, J.D., Chicago-Kent College of Law; B.S., University of Illinois
 
* Deborah Simpson, J.D., John Marshall Law School; B.A., DePaul University
 
* Brian Cronin, M.B.A., University of Chicago; B.B.A., University of Notre Dame
 
* Kurt Carlson, J.D., John Marshall Law School; B.A., University of Wisconsin-Madison
 
* Gregory Dollison, Paralegal Certificate, Roosevelt University; B.S., Illinois Institute of Technology
 
* Edward Lee, J.D., John Marshall Law School; B.A., Tulane University
 
* Molly Mason, J.D., Loyola University Law School; B.A., Harvard University
 
* Douglas McCarthy, J.D., Southern Illinois University Law School; M.A., Sangamon State; B.S., Illinois State University

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

By Michael Helfand

Do I have to take a drug test if I got hurt at work?

The Illinois Workers’ Compensation Act was changed in September of 2011.  One of the more subtle changes that has had a big impact on cases relates to taking a drug test if you are hurt on the job.
 
Under the new law, if you are injured, you have to take a drug test and if you test positive, it creates a rebuttable presumption that you were high at the time of your injury.  In plain English that means that the insurance company can deny your case until you can prove that you weren’t high when you got hurt.
 
It’s really a ridiculous law that was created for bogus reasons.  Someone made up a story that a worker got benefits even though they were wasted when they got hurt.  That wasn’t true and the law has always been that if you were under the influence and it contributed to your injury, you lost your case.  But perception became reality and this is how workers get punished in Illinois.
 
So now what happens is that you smoke marijuana at your house on Saturday.  On Wednesday you sever a tendon in your wrist with a saw and have to go to the emergency room.  You test positive when clearly your smoking played no role in you getting hurt.  Now you need an expensive surgery and can’t get it performed because the case has been denied.
 
We’d gladly take this case on and win it, but you would unfortunately suffer in the months it took to get to a trial hearing.  That’s how ridiculous the law is.
 
The question we get a lot is should a worker even take the drug test at all, especially when it can open up a can of worms like this?  The answer is that you have to and if you don’t you can lose your case right then and there.  Some people feel it’s an invasion of their privacy, but whatever your reasons, don’t risk your case because you don’t want to pee in a cup.  You just have to do it.  I’m sure that’s not what some people want to hear, but we never do anything other than tell the truth.  We’ll fight like hell for our clients, but this is a fight that can’t be won.  You just have to take the test.

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

By Michael Helfand

"I don't want to ever come to Illinois"

 

I got a call from a trucker in Georgia who works for an outfit out of Texas and was injured while making a delivery inIllinois.  See if you can keep all of that straight.

 

He had originally tried to pursue a Georgia work comp case, but was told by a lawyer down there that he couldn’t since he wasn’t hurt there or hired there.

 

He then tried to go through Texas because he’s originally from there and still has family there.  He quickly learned that work comp laws in TX are awful for the worker.  They are so bad that he couldn’t find any attorney that would take his case down there.  So somebody suggested he call Illinois since he was hurt in Chicago.

 

The first thing that he told me was that he didn’t like Chicago, didn’t feel safe here and never, ever wants to come toIllinois.

 

The good news for him is that he doesn’t have to come back to IL to start a case. He just needs to sign paperwork that will get filed and we can begin working on his case.  In fact, we’ve worked with a ton of out of state employees that were hurt here who we never met.  Many of them are truckers, but a lot of the others were here on business or for a convention. 

 

With e-mail and the phone, it’s easy to work this way.  We actually have represented folks in other countries via our state wide network, the farthest away being Australia, I believe.

 

The bad news is that if there ever is a trial on his case, he will have to come back to testify in person.  There is no way to go to a hearing without that happening.  Fortunately, most Arbitrators are very accommodating when it comes to out of town witnesses and will let us specially set a trial date so you only have to come in once.  Usually clients will arrive the day before to go over their testimony and then be on the witness stand the next day.  In most cases they can leave that night.

 

So while we do whatever we can to make it so you don’t have to come back, our bigger goal is making sure that you get the best case result possible.  If the insurance company knows/believes that you’ll never travel here then they won’t be fair with you.

 

The silver lining is that Illinois does have much better work comp laws than most states.  So while a day or two of travel might be a bother, it’s nowhere near as bad as not being able to get the medical care that you need or fair value for the permanent extent of your injury.

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

By Michael Helfand

You can't settle and then get more treatment

I had the pleasure of talking to a police officer in the Rockford area recently.  He had two injuries on the job.  In one, he was shot in the leg.  In another he was hit by a car.
 
For the physical aspect of his injuries, he received all of the medical treatment that he needed.  But now he was suffering from post traumatic stress disorder (PTSD).  He came to us because he knew that the attorneys in our state wide network had represented a lot of officers and that we also have great experience with PTSD.
 
The problem for him is that he had already hired an attorney for these two cases and received a lump sum settlement.  Once you settle a case, that closes out your medical rights as relates to that injury.  If you have a new accident that aggravates your old problem, that’s a new case.  But unfortunately for this guy, his PTSD relates back to cases that are now closed.
 
It’s no different than if he had torn his ACL, had surgery, settled his case and then later on developed an infection in his knee or hurt his back because he suddenly walked funny.  If it traces back to the closed case, you are finished.
 
It wasn’t a fun conversation to tell him that there was nothing we could do for him, but it was the truth.  It’s a pretty unique problem he has because these types of problems don’t usually show up later on without some sort of triggering event.  For example, we once represented a sheriff that had war flashbacks after having to dig up a grave on the job.  The digging itself was a new injury.
 
For you, even if you don’t think you are going to have psychological problems at a later date, make sure you are 100% confident that you won’t need medical care in the future for your injuries before you settle.  If you think that you might or just want to keep your medical rights open, you can always go to trial and know that if some unforeseen problem arises in the future, your bills will be paid.

 

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

By Michael Helfand

Does size matter? (In Illinois workers' compensation cases)

Recently we’ve had calls from two people who had bad cases that no lawyer wanted to take on.  They both believed in their hearts that they had a great case no matter what all of the attorneys they had spoken to had told them.
 
Sometimes an attorney doesn’t want to take on a hard case.   We’ve had lots of success over the years by getting involved in cases that other firms declined.  Earlier this year, a downstate lawyer in our network settled a case for $400,000 that had been rejected by two firms.  But if we tell you that you don’t have a good case, we’ll tell you why. Sometimes there is no real injury.  Other times the case is not covered under the law such as getting in to a car accident on the way to work.  Whatever the situation, we’ll tell you the truth.
 
These two recent callers had their own theory as to why nobody would take their case.  The first one worked at a small daycare and told me that “Chicago workers comp attorneys only want to take on cases against big companies so they can get a big pay day.”  The second one told me, “Every firm I’ve talked to is chicken to take on a big store like Walmart.”
 
So either we only want to go after the big guys or we are afraid of the big guys.  Or the truth which is that in Illinois work comp, none of that matters.  All of these cases are handled by insurance adjusters.  While some corporations have a say in how the cases are defended, the reality is that if you hurt your back lifting a box at a mom and pop hardware store or if you hurt your back lifting at Home Depot, it’s essentially the exact same case.
 
Beyond that, we deal with the same defense attorneys and same Arbitrators on all of these claims.  Nothing about the size of an employer changes anything.  Size does not matter in any way.
 
The reality is that these two callers are just frustrated and that is understandable.  They went from healthy to injured and nobody can help them out.  I’d be frustrated too if I were them.  All I can tell you though is that no attorney makes money by turning away cases.  If we think you have a good case, we will gladly take it on no matter who you worked for.  It’s not tough talk to say this, it’s just the reality of how these cases are handled.

 

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

By Michael Helfand

How did an injured worker end up with a new bed?

Under the Illinois Workers’ Compensation Act, one thing you get are reasonable medical expenses to be paid to help you with your recovery.  Typically people think of this as doctors visits, physical therapy, x-rays, etc.  For most injured workers, this is all that you will get.
 
However, if you have a more major injury, there may be other items that are not traditionally considered as medical treatment that you can have paid for.
 
For example, I have represented a man who became paralyzed from the waist down.  In my years working for him, we’ve gotten him a special van that he can drive.  We’ve also had his home modified to work with his paralysis.  This was all achieved by having his physician state that it was medically necessary for his recovery.  Of course none of this is medical treatment, but it is enhancing his life.
 
Other clients we’ve worked with have had gym memberships paid for.  Whether it’s to get in shape or have a place to do exercises on a machine, this can strengthen your recovery.  Insurance companies don’t typically fight this because it’s actually cheaper than paying for a worker to go to physical therapy.  We don’t push for one over the other, but instead let your doctor dictate what you should do.
 
And recently, a reader of our blog called us to tell us how wonderful her work comp attorney is and suggest that we add him to our state wide network.  She had a major back fusion surgery.  For 20+ years she had slept on a water bed which wasn’t practical for the back problems she had.  Sleeping in it could worsen her recovery.  So her lawyer got the insurance company to buy her a new bed and take away the old one.  She looked at him as a miracle worker, but the reality is that while he is doing a very good job, it’s her doctor that suggested it which made it a no brainer.  The insurance company was motivated to go along with it because it makes the chances of her eventually returning to work much greater.
 
In the big picture, just think about what is reasonable for your situation.  If your doctor agrees with you, then your attorney should be able to make it happen.

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

By Michael Helfand

Tripping over shoe laces at work - is it compensable?

Recently we were called by an office worker in Downers Grove.  She hurt her knee when she tripped while working and assumed that because it happened at work, she should get Illinois workers’ compensation benefits.  Unfortunately for her, she fell because her shoes were untied and she tripped on the laces.  She wasn’t carrying anything, wasn’t rushing and wouldn’t have fallen if it weren’t for the laces.
 
I don’t think she has a case because nothing about her job contributed to the accident other than that she was there.  It would have been different if she fell in to a machine that cut her arm or if she had to wear special shoes for her job that constantly became untied.  But in this case, she wasn’t at an increased risk for an accident so I don’t think we can help.
 
Compare that with a nurse in Carol Stream that called me who also fell at work and also hurt her knee.  She too tripped on her untied shoelaces.  But I think that nurse has a case because she was carrying multiple patient charts and was running to a call from another hospital worker for help.  The charts and the fact that she had to rush contributed to her accident.  Because that was part of her job duties, I think she would win the case if it was disputed.
 
We actually did a lot of research on this issue.  There haven’t been any major appellate court decisions on tripping from shoe laces, but the Illinois Workers’ Compensation Commission has made many rulings.  They essentially state that when you are carrying something, it prevents you from being able to put your hands down and catch yourself.  Because of that, you should win if that happens to you.  Something about the fall has to be related to your job, it can’t just be a personal risk such as you weren’t paying attention or you just fell.
 
So in any fall at work, especially if you trip over shoelaces that weren’t tied, think about what part of the job contributed to the accident.  If it’s anything other than simply it happened at work, you should get benefits.

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

By Michael Helfand

What doctor should you see if you get injured at work?

A nice man called us recently after hurting his shoulder on the job while working up in Highland Park.  He called his family physician who told him that he doesn’t accept workers’ compensation cases.  Apparently he had some hassles dealing with an insurance company once and prefers to focus on patients with regular insurance.  Kind of a shame, but it’s his prerogative.
 
So the caller wanted to know where he should go for medical treatment.  As a general rule we don’t tell clients who their doctor should be because if it ever comes out on a witness stand, it could look bad.  We will, however, tell them the names of doctors that we think do a good job and leave it up to them as to who they want to see.
 
In the bigger picture though, it’s important to see a physician that has relevant credentials for your injury.  Under Section 16 of the Illinois Workers’ Compensation Act, the employer (or really their insurance company) has to pay for all medical treatment that is reasonable and related to your accident.  The key thing to focus on is reasonable.  In general, lots of chiropractic care isn’t seen as reasonable by Illinois Arbitrators.  Neither is experimental medicine.
 
The best way to handle this is to seek a referral to a specialist.  Your family doctor is fine for a first point of contact, but usually an orthopedic or neurological type doc will need to be seen, especially if you have a lingering injury.  It’s almost impossible to dispute the care being recommended by a reputable surgeon.
 
If there is out of the box type care you want such as naturopathic care, you are best served by getting the insurance company to agree to that treatment before it takes place.  Often they will agree because a lot of that care is cheaper than having a surgery, but you don’t want your claim being held up over $5,000 in medical bills that are deemed unreasonable.  You may win that argument in the end, but you’d have to go to trial to do so.
 
Above all else, make sure to look out for your health.  Tell the doctor truly how you are feeling.  Don’t exaggerate your symptoms, but don’t under-report it either.  Many an injured worker has created problems for themselves because they were too proud to tell their treater what was really going on.

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

By Michael Helfand

If I'm hurt on the job in Illinois, can I quit and still get work comp?

This isn’t the most common question we get, but I do hear it about once a month.  The answer is that yes you can still get workers’ compensation benefits, but that doesn’t mean you should quit.

 

If you hurt your back for example, you might realize quickly that your days of heavy lifting on the job are over.  So if an opportunity comes up to get a job with similar pay and no physical risks, you can take it.  The insurance company for the old employer will still have to pay your medical bills.  However, unless you are completely taken off of work (from perhaps a surgery), they won’t have to pay you TTD benefits.

 

The danger comes in when you quit and go to a job with similar risks of injury.  If you hurt your back and then go to a job with heavy lifting, if you aggravate your condition, the first case might come to a halt and you’d be forced to bring a case against the new employer.  They’d probably fight the case too and you’d find yourself without any benefits. 

 

This can also be a risk when it comes to getting a settlement.  A new injury lowers the value of the first case and certainly delays your ability to get paid.  And even without a new injury, leaving the employer can cause your case to lose some value and it certainly can take away leverage you’d have in settlement negotiations.  The facts of your case determine whether or not this is truly a big deal.

 

I typically advise clients of the risks, but remind them that they have to live their lives.  Sometimes taking a risk is part of that.  Hopefully it works out, sometimes it doesn’t.  And the truth is that while you are more likely to get injured in a labor job, we’ve worked with tons of office workers who got hurt moving a box, slipping on a wet floor or doing any number of other things.  We’ve also talked to iron workers who’ve been on the job for 40 years without a claim.  You never know what’s going to happen.

 

So my advice is that you should live your life, but educate yourself and never make this decision without talking to an attorney first.  You don’t want to quit and cause yourself harm that could have been easily avoided.

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

By Michael Helfand

If the insurance company plays games, you can hammer them

There is nothing more maddening to a lawyer or client than an insurance company that plays games or denies benefits without any valid reasons.  On some cases we can disagree with them, but at least acknowledge that they have a valid reason for fighting the case.  But when they have no basis whatsoever, you wonder if it’s personal against the injured worker.
 
The good news is that when your TTD benefits are unreasonably denied or your medical bills aren’t paid, you can file a petition for penalties under Section 16 and 19 of the Illinois Workers’ Compensation Act.  Essentially this can require the insurance company not only to pay up when they acted in bad faith, but also pay you personally 50% of what the medical bills were, pay your lawyer 20% of that amount for lawyer fees and also subject them to a daily penalty over the TTD.
 
We recently were involved with a trial in Chicago on behalf of a suburban city employee.  He needed a spine stimulator and other medical treatment that totaled over $90,000.  The insurance company refused to pay those bills and had no reason for their bad behavior.  The attorney we referred our caller to is great at taking cases to trial and not only won the case, but also got an order for an additional $45,000.00 to go to our client for the nonsense that they had to deal with.  Attorney fees were more than $18,000 because of this, none of which came out of the pocket of our client.  So this suburb that is struggling financially had to pay more than $63,000 because they acted inappropriately.
 
They also failed to pay TTD benefits without reason for four months.  In fact, they cut our client off without sending him to an IME doctor.  As a result they paid our client about $5,800 for that issue, plus more than $1,000 to us.  Again, none of that money came out of our client’s pocket.
 
Instead of trying to help this poor guy get better, they jerked him around and cost tax payers a ton of money.  It’s really pathetic.
 
From your standpoint, the thing to know is that if there is no reasonable dispute, the law in Illinois does provide for penalties.  You just need a good case and a lawyer that is willing to fight for you.

 

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

By Michael Helfand

Don't be the reason you can't get medical treatment

For the most part, the Illinois workers’ compensation system is really worker friendly.  There are rules to follow as not everything is in your favor, but if you do things the right way, you shouldn’t have too much trouble.
 
One area where we see injured workers causing themselves problems (before they see us or any other attorney) is in jumping from doctor to doctor without a referral.  Under Illinois law, you can see two chains of physicians. In other words, if the ER sends you to your primary doctor who refers you on to an orthopedic doctor who then sends you out for physical therapy, that is one chain of referrals.  You can seek a second opinion without a referral – although we think you should still get one – and anything beyond that would be considered beyond the two chains of referrals.
 
A potential client recently came to us with this problem.  She was so rushed to get treatment, which is understandable, that she never got a referral to see the 3rd opinion doctor.  This doctor wants to perform a surgery and she wants him to do it.  On top of that, the IME doctor the insurance company sent her to agrees that the surgery is needed and said that this particular doctor would be a great choice to perform the procedure.
 
The problem is that the insurance company doesn’t have to pay for this treatment since it’s outside the two chains of medical referrals allowed.  They could care less about this worker, her pain and who she thinks is the best doctor for her issue.  But unfortunately there isn’t anything that can be done other than try to reason with them that the worker will get better if she has the surgery.  That strategy is a long shot.
 
So while I encourage you to be anxious about getting better, don’t be so hurried that you cause yourself problems.  Take some time to learn what the law is and what you can and can’t do.
 
The flipside to this are the people that allow the insurance company to call all of the shots and end up with a hack doctor or a nurse case manager that interferes with your treatment.  Education is so key, even if you wish this would all go away.  Feel free to trust an insurance company, but always verify.  They make money by minimizing what they pay and the truth is that most don’t look at you as a human being, but instead as a file number.  Look out for yourself.

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

By Michael Helfand

The most interesting call I've gotten in a while

I learned a long time ago not to be in awe of celebrities or athletes.  They are just people and if they didn’t have that one special skill they’d be just like anyone else.  So while we’ve worked with pro athletes and some actors, for us it’s just another person.
 
All that said, I got a call from someone that has what I believe is an interesting case.  It turns out that he’s in California, found our blog and wanted to ask a general question.  I know an outstanding Los Angeles work comp attorney so I connected them as we only handle Illinois cases.
 
His job involves providing security to A list stars.  He didn’t tell me who and I didn’t ask, but he did say it was a world famous pop star.  But what I find fascinating is the work he does in general.  His job is to be around his client, but not necessarily seen as security.
 
On the day he got injured, his client wanted to work out at the gym.  So he went along and used machines near the client.  He appears to the general public to just be working out, but if anything happens he springs in to action.  Long story short, he was using an upper body machine and fell tightness in his shoulder.  The next day he woke up and was really sore.  He attributed that to normal working out.
 
The pain didn’t go away and finally he couldn’t lift his arm above his head.  He went to the doctor who ordered a MRI and learned that he has a torn rotator cuff.  Apparently the insurance company denied his case because he waited a week to go to the doctor.
 
I don’t know what the law is in California, but in Illinois he’d have a great case.  While he admittedly loves to work out and does so all the time, he got injured while working out as part of his job.  It would be no different than a member of the Chicago Bears injuring themselves in off season training.  It’s part of the job and a unique risk to the job.
 
Hopefully he wins his case.  Either way, it is a great example that even things that seem like atypical job activities can actually lead to compensable Illinois workers comp cases.  Don’t ever assume that you don’t have a case because your situation isn’t like everyone else.

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

By Michael Helfand

Do I have to give a recorded statement?

A truck driver from Georgia got hurt in Illinois while unloading part of his haul in Peoria.  Because the accident happened in Illinois he can get Illinois work comp benefits.
 
He called me because apparently the insurance adjuster told him that it’s the law that he has to give a recorded statement about the accident to her and if he doesn’t then the insurance company can withhold his benefits.  He wanted to know if that was true.
 
I have no idea what the law is in Georgia, but can tell you that without a doubt it’s not true for Illinois.  You don’t have to give a recorded statement and you shouldn’t give one either.
 
The insurance company wants to record you because they are looking for some evidence that can be used to deny you benefits.  They make up the questions and they try to make you say something that will hurt you and help them.  It’s not just about getting the facts of how you recently hurt yourself.  If you injured your back last week on the job, they’ll want to quiz you about back treatment from ten years ago.  They’ll ask you how often you drink.  Sometimes they’ll make stuff up to see how you respond such as “A co-worker of yours told us that you were complaining of back pain two weeks ago.  That’s true, isn’t it?”
 
It’s all designed to trip you up and scare you.  And you don’t have to play that game.
 
When we start representing an injured worker, we tell them that we will deal with all communication from the insurance company.  If the insurance company wants to send us written questions, we’ll take a look at them and consider which ones to respond to.  But we don’t let the adjuster go on a fishing expedition or try to find a loop hole to hurt you.
 
An attorney’s job is to protect their clients.  You can look out for yourself too by knowing as much basic information as possible.  That is one reason we created this blog, to educate injured workers.  And much like life, sometimes saying nothing is your best bet.

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

By Michael Helfand

Knowing the Arbitrators is really important

A downstate lawyer in our network brought up a great point about whether or not to go to trial in a work comp case.  In downstate Illinois they typically rotate the Arbitrators.   This is so there is no perception as to whether or not any of them are too buddy, buddy with any of the attorneys.  The theory is that if we aren’t before them very often, a relationship can’t be established.  This is kind of like whack a mole because it assumes that every Arbitrator and lawyer is unethical and ignores the good parts about everyone knowing each other (mainly that it keeps a nice checks and balance) as well as the fact that we see these Arbitrators at the other court venues too.
 
The Arbitrators were supposed to be rotated on July 1st, but the Chairman of the Work Comp Commission announced that wouldn’t happen until January 1, 2014 at the earliest.
 
So that means that if you have a fair and reasonable Arbitrator on a tough case, it would be really smart to take that case to trial before the end of the year if you can.  On the flipside, if the Arbitrator is not so favorable, it makes sense to wait until 2014.  No point in taking a case to trial if you think that the biggest reason you are going to lose is the Judge.
 
This really makes clear the point of having a lawyer who handles nothing but work comp cases all day, every day.  An attorney that takes every case that comes through the door (e.g. they’ll handle a DUI, divorce, accident, etc.) doesn’t give you the best chance of a good result in your claim nor does it offer the best chance for strategy.
 
One reason we created our state-wide network of work comp law firms is to increase the resources available to clients.  Knowing an Arbitrator can make a difference.  Sharing strategies can make a difference.
 
If your case is in a position to be settled this year, but the insurance company is dragging their feet, ask your lawyer about the Arbitrator and their tendencies.  If they are in your favor, you should really push for a trial.  If you don’t and your lawyer doesn’t, your case may lose value at the stroke of midnight at the end of the year.

 

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

By Michael Helfand

When you can lose your trial and still win the case

Any good Illinois work comp lawyer reads updates on case laws and interesting trial decisions.  If they don’t, they aren’t doing their jobs and they aren’t learning which certainly doesn’t help their clients.
 
I recently read through a summary of about 50 cases.  I didn’t learn much knew this time, but it was definitely relevant for providing consultations and advice to callers and readers.  But there was one case that to me was so interesting that I have to share it.  Note, my office did not handle this case.  And even though it’s interesting, it’s one of those rulings that would be obvious to any experienced work comp attorney in IL, but not to very many employees.
 
Long story short is that a trucker out of Canada was lifting some heavy tarps and had a heart attack.  This all happened in Illinois.  He got medical care, went back home to Canada and filed a work comp case.  And the case was filed in Canada.  He had some sort of hearing and lost for whatever reason under Canada law.
 
Most people would think that would be the end of the case, but it was not.  Because he was injured in Illinois, he can file a case here.  So as a result, he applied for benefits and ended up having to go to trial here.  The insurance company denied the case because in their opinion the trucker had already had his day in court.
 
But the reality is that only the Illinois Workers’ Compensation Commission can end and IL work comp case.  Our standards are different than every other State, some which is better, some which is worse.  But you can’t lose your rights in Illinois based on what happened in another State or country.
 
In fact, while this case is kind of unique, I can think of at least 20 times where we’ve been involved in claims where a worker was injured here, but from another State and settled their case in their home State.  They then came to us to get an increase of benefits.  In other words, if their case was worth $60,000 in Illinois, but they settled for $20,000 in Ohio, we could get them an extra $40,000 here which is the full value of the case, less a credit for what was already paid.
 
It may be counterintuitive, but it’s true.  So to paraphrase John Belushi in Animal House, “Nothing is over until the work comp commission says it is.”

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

By Michael Helfand

A pre-existing injury does not end an Illinois work comp claim

I’ve noticed a big uptick in insurance companies denying what are clearly work related injuries.  Their defense is that the problem is pre-existing and that the work injury was nothing more than a temporary aggravation.  As you can probably guess, nine times out of ten the insurance company is full of it.  But don’t sweat that fact.  Insurance companies make money by limiting what they pay out.
 
It used to be that they’d try to deny a claim if you had any previous treatment.  I once got a call from a pipefitter in Chicago with a back injury.  20 years prior he’d been in a car accident where he underwent physical therapy for six weeks.  He hadn’t seen a doctor for a back problem until he had an injury from lifting at work.  The insurance company tried to cut him off and of course their denial of benefits went nowhere once we hooked him up with an attorney that had handled similar cases hundreds of times before.
 
Now the insurance companies are more selective, but they are still denying cases when there is any evidence of treatment within a year of the accident.
 
The reality of the law is not really on their side though.  It’s on the side of injured workers.  If you injured your knee on the job in June of 2013 and had seen an orthopedic doctor as recently as March of 2013 (hypothetically), you can bet they will fight your case.  But the reality is that you weren’t under active treatment at the time of your work injury.  So if you have extensive problems with your knee all of the sudden, you should win.
 
Even if you were getting care, if the job accident made things noticeably worse, you should win.
 
The bottom line is that you do need to be ready for a fight.  Before you hire an attorney, verify how many cases they’ve taken to trial in the last year.  Fair or not, you are probably headed that way.  Some lawyers don’t like to try cases and will blow things off.  If that happens, you will suffer.  So make sure they are really in your corner and will fight for you before you hire them.

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

By Michael Helfand

Illinois work comp, child support and lawyer lies

An injured worker that contacted my office six months ago didn’t hire us because I told him something different than the lawyer he ended up choosing.

 

This worker has a serious back injury and is going to receive TTD benefits for about two years or so.  He’s paying his ex wife child support and didn’t want to have to give her any of his TTD check.  We told him the truth which was not what he wanted to hear.  The truth is that child support can be deducted from TTD if the ex gets a court order.  This other lawyer told him that we didn’t know what we were talking about and that if he hired him, he’d make sure that no work comp benefits went anywhere other than his own pocket.  That sounded great to the caller so he went with this otherChicago workers’ compensation law firm.

 

Flash forward six months later and this worker calls me, asking if I’ll take over the case.  He said that it turned out that his lawyer was lying and now even denies stating that he could get around a child support order.

 

The Illinois Income Withholding Support Act states that income is:

 

“[A]ny form of periodic payment to an individual, regardless of source, including, but not limited to: wages, salary, commission, compensation as an independent contractor, workers' compensation, disability, annuity, pension, and retirement benefits, lottery prize awards, insurance proceeds, vacation pay, bonuses, profit-sharing payments, interest, and any other payments, made by any person, private entity, federal or state government, any unit of local government, school district or any entity created by Public Act; however, "income" excludes:…”

 

In other words, it’s just about everything.  There isn’t a loophole to get out of paying child support just because you got hurt on the job.

 

We have lost a lot of potential clients over the years because we never give a sales job or tell callers what they want to hear.  We will tell you that we’ll fight for you, which is true.  We will tell you that we have a state wide network of some of the most experienced, successful and caring work comp lawyers, which is true.  But we’ll never promise a result or as in this case, make something up just to get you to sign up with us.  We always tell our clients to think long term as to what’s best for them.  A lie is a short tem benefit that doesn’t help anyone in the long term.

 

My advice to anyone that hears different things from different lawyers is to do one of two things:  1. Ask for evidence.  If the caller had asked me way back when to show proof on my child support claim, I would have.  Had he asked the other attorney to do the same he would have been met with silence.  2. If you can’t get proof, get a third opinion.  If multiple lawyers are telling you the same thing and only one say something else, you can usually bet that the majority is correct.

 

And if none of that works, remember, if it seems too good to be true then it probably is.

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

By Michael Helfand

Help your work comp case - avoid social media

We don’t want to make you paranoid, but people are watching you. If you have been injured at work and filed a claim for workers’ compensation, the insurance company has you on their radar. This is especially true if your injury is serious and costly for them to cover.

 Insurance companies hire private investigators to make sure people aren’t filing false claims. They also watch you to see if you do anything that you say you can’t, like lifting heavy objects. If they can discredit you, or show you were lying, they may be able to successfully deny your claim.

 One way for an investigator to follow you is online through social media. It can be a good idea to take a break from Facebook, Twitter and other similar media while dealing with a work injury and your employer’s insurance company.

 This type of surveillance doesn’t happen in every case, but it’s a good idea to assume that it does, because you never know. Don’t give them an opportunity to deny your claim using evidence against you that they acquired from a private investigator. Follow your doctor’s orders, listen to your attorney’s advice, and take care of yourself. You don’t have to lie or make your injury seem worse than it is – just be honest, and be careful.

 

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

By Michael Helfand

 

Chicago carpal tunnel lawyer advice

We get a ton of calls and e-mails from people who are diagnosed with carpal tunnel syndrome.  There is a lot to know if you have injury.  Here are 10 things I think are important.

 

  1. Carpal tunnel is usually a result of repetitive trauma, often from typing or working on an assembly line, but a single incident can cause it to.  We’ve helped a lot of people who were diagnosed after falling on to their palms for example.
  2. To test for carpal tunnel, a doctor will typically order a test called an EMG.  It’s an exam that sends minor shock waves through you.  I’ve had it and while it’s not the most comfortable thing I’ve ever done, it’s over fairly quickly.
  3. If you have to have a surgery, CTS surgery is probably the safest you can have.  I’d estimate that 90% of the people I’ve seen have this operation are as good as new within 4-6 weeks and you don’t usually need much physical therapy.
  4. There is no set amount of time you need to be on the job and working before you can bring a workers’ compensation claim in Illinois for carpal tunnel.  Sometimes people get it after a couple of weeks, other times the body breaks down after many years of service.
  5. However, the longer you wait to bring a claim after you’ve stopped working, the harder it is to prove that your injuries are work related.  In other words, if you quit your job on June 1st and don’t see a doctor for problems with your wrists until September 1st, it would be really hard to prove that your job duties caused your injuries because theoretically your pain should have improved once you stopped working.  Moral of the story is that if you are in pain you need to got to the doctor.
  6. Pregnancy, diabetes and obesity are three common contributors to carpal tunnel, but having any of these doesn’t mean you don’t have a case.  The law is that if your job causes, aggravates or accelerates your problems then you should get work comp benefits.
  7. There are a lot of hired gun doctors for the insurance company that will always state that typing doesn’t cause carpal tunnel problems.  These opinions are based on one study from the Mayo Clinic.  Fortunately, most of these doctors have no credibility because they treat every case the same.  So usually we are able to beat them at trial.
  8. The big symptoms are pain in the wrists and/or numbness and tingling in your fingers.  If this is happening to you, get to a doctor ASAP.  Orthopedic hand surgeons are usually the best choice.
  9. We see a lot of injuries when you increase your workload.  It can happen even with just a few extra hours of work.  But make sure your increased workload isn’t really you surfing the internet or playing video games at home.  That’s a great way to kill a case.
  10. Believe it or not, some of these cases are actually neck injuries and other times, a neck injury is really carpal tunnel.  The EMG test can help sort that out as can a MRI.

 

And of course there’s a lot more to know.  If you have any questions feel free to contact us at any time.

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

By Michael Helfand

The biggest (and lamest) threat to injured workers in Illinois

If you get hurt while working in Illinois, you are entitled to see a doctor of your own choosing.  The insurance company has to pay for all reasonable and related medical care that physician provides.  When I say related, I mean having to do with your job injury.  If he takes out your appendix even though your work accident was to your knee, then work comp doesn’t pay for the appendix surgery.
 
The insurance company can also send you to an “independent” medical examination (IME).  This is a doctor of their choosing who does not provide you with medical treatment, but instead reviews your medical records, examines you (although some of them don’t do it for more than two minutes) and then writes a report about your condition, the treatment you need, whether your problems are related to your job duties, etc.  A lot of these guys are hired guns, but at least they have to physically look at you before they try to mess with your life.
 
But they aren’t the biggest threat to you if you are injured on the job and have long term medical care.  The insurance company can pull what I think is a dirty, albeit legal, trick and send you for what is called Utilization Review (UR).
 
Unlike an IME, with UR, some doctor who has never seen you and never will, looks at your medical records and sight unseen determines if the medical care being suggested by your doctor is appropriate.  It may be an excuse to deny you a MRI exam.  It could be the reason that they don’t authorize the surgery that you so desperately need.  Whatever the reason, it’s a total crock of you know what.
 
UR’s doctors, in my opinion, are the ultimate hired guns. It’s a joke that it’s allowed.  The only saving grace is that everything they say is hearsay, so to get those reports in to evidence we can force the insurance company to pay for their deposition.  In most cases these opinions can be proven to not be as reliable as the physician that has in person examined you multiple times.  But regrettably this case delay your care and case.
 
It’s gotten slightly better.  It used to be that all of the UR reports came from retired doctors that were out of state because they were so cheap.  The first one I ever saw was from some guy in his 70’s that lives in West Virginia.  It’s a pretty easy way for them to make a living, even though it comes at the expense of innocent injured workers.
 
The only real way to counter these reports is with an immediate trial motion.  But I’d be lying if I didn’t state that UR’s are a threat to you and your case.  And the worst part is that they don’t have to tell you that they are doing it, so you don’t know about the results until the insurance company has an opinion in their favor.

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

By Michael Helfand

Do I have to go to the IME appointment?

A reader asks:

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

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

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

By Michael Helfand

Illinois work comp - Independent medical examiners and what they do

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

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

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

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

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

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

By Michael Helfand

 

 

Nursing home employees injured on the job

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

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

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

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

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

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

By Michael Helfand

The most important thing in any Illinois workers' compensation case

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

 

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

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

 

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

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

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

By Michael Helfand

 

Illinois work comp - what to do when you are getting screwed

A common call to my office goes something like this:
 

I injured my back at work six months ago.  I had an MRI and it shows that I have a herniated disc.  My doctor agrees that my problem is work related, but the insurance company sent me to some IME doctor who says that I’m fine and that any problems I have must be from a car accident from when I was 17 years old.  I’m 52 now.  How can they deny me?  I’ve been very patient with them, but they won’t approve my surgery and I am running out of money.
 

I don’t want to over-simplify how the Illinois workers’ compensation system works, but this scenario is fairly easy to work out.
 
Step 1 – Hire a reputable work comp lawyer who has a history of going to trial on cases.
 
Step 2 – They gather all of your medical records and schedule a deposition of your doctor and the IME doctor.
 
Step 3 – You meet them at the Illinois Workers’ Compensation Commission for a trial and put your fate in the hands of an Arbitrator.
 
It does take a few months for all of this, longer if you don’t already have a case filed, but this isn’t rocket science.  A case like the one in my example is really straight forward and quite honestly, there is no way a good lawyer should lose that case.  You just need to get the wheels in motion to get a decision from an Arbitrator.
 
Unfortunately, many injured workers either delay getting a lawyer (that’s your fault) or hire one that’s very lazy and doesn’t do what it takes to get to a trial (which is of course their fault).  Getting a case filed before you “need” an attorney is a security blanket in case the insurance company denies your case or cuts you off.  And while it’s not ideal to switch attorneys, if you have a lazy one that won’t go to bat for you –which is really all they have to do – then you fire them and get a good one in your corner.
 
In general though, if you are getting screwed over you can either accept it or do something about it.  I’m sure some lawyers try to talk all lawyerly and impress their clients, but it’s really not more complicated than what I said.  All I know is that if someone was kicking me in the gut, I’d do something.

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

By Michael Helfand

Illinois workers' compensation - should I see a chiropractor?

The short answer is no, you should not.
 
The longer answer is, I know many people swear by their chiro’s and have made good recoveries thanks to them.  But the honest truth is that at the Illinois Workers’ Compensation Commission and with insurance companies and lawyers too, chiropractors have no credibility.  This is especially true when you compare them to orthopedic doctors or neurosurgeons.
 
The reason I say this is because there are many chiropractors who over-treat and over-bill their patients and insurance companies.  Others get tied in with scummy lawyers and refer each other clients back and forth, treating them as much as possible to try and add value to the case.  I get solicited by these outfits all of the time (I always decline) So while there are plenty of honest chiro’s out there, they all suffer from the actions of the bad ones.
 
Beyond that, much of chiropractic care is designed to solve soft tissue problems and/or provide temporary relief as compared to medical doctors that treat the problems with advanced medicine and sometimes surgery in order to end the problem for good.
 
So if a case ever requires an opinion from a medical professional that an injury is work related or that a worker can’t do their job, a neurosurgeon or orthopedic doctor will always have the most credibility.  If you try to rely on your chiro and the insurance company has a MD in their corner, they will win and you will lose, even if you are in the right.  In fact, I’ve been handling cases since 1997 and can’t recall one time when an Arbitrator on a work comp case found in favor of the opinion of a chiro over a regular doctor.
 
I know some of you love your chiropractors and I’ve had clients tell me that their chiro is the best and is the only one that makes them feel better.  I respect that, but I’m not here to tell you what you want to hear, I’m here to tell you the truth.  And the truth is that anything beyond limited treatment will be disputed whether it’s valid or not and whoever the chiro is will not have a medical opinion that carries any way in proving the nature of your disability.
 
I never tell my clients which doctor they have to treat with because to me that’s scummy and could set up the injured worker to look bad on a witness stand.  But I will tell them if their doctor is going to hurt their case.  My general rule is that after two weeks with a chiropractor you are not all better, you need to ask for a referral to a specialist and let them take it from there.

 

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

By Michael Helfand

Crazy Joliet workers' compensation lawyer screw up

A Joliet attorney who alleges that they handle workers’ compensation cases really dodged a bullet according to their client that called me in a panic.
 
The caller had been injured in Will County and hired a local attorney that said he handled job injuries along with DUI’s, divorces and a bunch of other stuff.  The lawyer told my caller that he wanted to meet him at court to discuss a settlement proposal.  So the client went to the Will County courthouse and met his lawyer there and waited for the defense attorney to show. And they waited and they waited and the defense lawyer never appeared.
 
Finally the lawyer got a call on his cell phone from this other attorney, asking where he was.  The lawyer for the caller was pissed and said, “What do you mean where am I?  Where are you?  I’m at the Joliet courthouse waiting for you with my client.”
 
And that is when the defense attorney informed this general practice lawyer who was trying to dabble in workers’ compensation claims that the Will County location for workers’ compensation hearings had been moved to New Lenox.
 
The hearings used to be at the Joliet courthouse, but were transferred to New Lenox a couple of years ago.  Of course this is something every regularly practicing Illinois work comp lawyer knows, just as we all know that the hearing location in Bloomington just moved as well.  This stuff happens, not every day, but every year for sure.
 
So I say the lawyer dodged a bullet because it was only an attorney waiting for him, not an Arbitrator that could have dismissed the case.  So the lawyer ended up with egg on his face and a pissed off client.  It could have been a lot worse for both the lawyer and the client.
 
The moral of the story is that if your attorney isn’t handling workers’ compensation cases every single day then you are playing with fire, especially if you have a serious injury.  The laws change a lot and even the hearing locations change.  If your attorney isn’t on top of things, you could be the one that gets screwed.

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

By Michael Helfand

Lots of good Illinois workers' compensation questions

I keep track of good questions that come from clients or readers who post comments to our blog.  Here are a few that are worth sharing:

 
I slipped on ice taking out the garbage on my job.  I’m a fireman in the northwest burbs.  Can I sue the city for my injuries since they didn’t get rid of the snow and ice?
 
The answer is no you can’t because in exchange for getting “no fault” workers’ compensation benefits, workers lose their right to sue their employer for general negligence like this.
 
A lawyer told me that I don’t have a case because I didn’t report my accident to my boss within 45 days of it happening.  But he knew I hurt my back because he saw me walking with a cane after this happened and knew that I left work early to go to my doctor.  Isn’t that enough?

 
The answer is that it depends, but there is a case that was decided that is pretty similar and went in the worker’s favor.  So we’d probably take this case on, but it’s always best to report an injury because you don’t want to create and possible defense for the insurance company or you can lose your rights.
 
When my case settles does my lawyer get one check and me the other or do they just send one check?
 
There is no rule on how this has to happen, but typically the insurance company sends one check payable to the lawyer and injured worker.  Usually the worker will sign a limited power of attorney form that allows the attorney to endorse their name to the check and deposit it in their client trust account.  After that the attorney writes a new check to their client which is the settlement less the 20% fee and the expenses on the case that the attorney advanced.
 
My mom was killed on the job.  The insurance company says they only have to pay for her medical bills and the funeral.  That sounds crazy.  Is it true?
 
I talked to this person and learned that he’s 26 and the only child of his mother who is divorced.  He was not financially dependent on his mom in any way.  So unfortunately the insurance company was telling the truth on this one.  The law only requires them to pay medical bills and funeral expenses up to $8,000.  That’s it.  It’s sad, but true.
 
I see that you have a state wide network of lawyers.  That sounds cool, but tell me who is the best workers comp lawyer in Illinois because I only want the best working on my case.
 
It’s true.  We have a network of lawyers throughout Illinois who only handle work injury claims.  But I’d be full of it if I claimed that one of them (myself included) is the best.  You shouldn’t be looking for the best lawyer (which of course is just an opinion), but instead should figure out who is best for your case.  That depends on a lot of things such as the background of your case, the type of injury you have, is a trial likely, what are your goals, who is the Arbitrator, what city were you hurt in, do you have prior accidents, who is your doctor, etc.  Anyone who calls themselves the best is just marketing themselves.  There is no rating system beyond our network that is invitation only and kicks lawyers out who don’t deliver.
 
If you have questions fill out our contact form or call us at (312) 346-5578.  We’ll talk to anyone for free at any time about their case and do so in confidence.

 

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

By Michael Helfand

Happy anniversary to me

So it was 12 years ago that I opened up my own firm.  Shortly thereafter I decided to improve the way finding a workers’ compensation lawyer works.  I created a statewide network of like minded attorneys that care about their clients and do a good job.  When people contact us, we always recommend the lawyer within our network that is the best fit for their case.
 
I did a little math work and estimate that in the last 12 years, I’ve talked, met with or e-mailed more than 10,000 injured workers.  We haven’t helped all of them, but we’ve been direct and honest with every person that has called me.  It’s a pleasure and honor that people trust us to consult on what is often the most important issue in their lives.
 
We recently were involved in a case that settled for $400,000 after a man came to us for help having been rejected by two law firms.  I take pride in that result, but also am thrilled with the people who get smaller results that are reflective of the best possible outcome for their case.
 
So I don’t have any advice or anecdotes today.  I just want to say thank you for trusting in us and let you know that whether you come to us for representation or are one of the many people that just read our blog for some peace of mind, we look forward to twelve more years of helping people out.  And we always remain at your disposal if you want to talk. 

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

By Michael Helfand

Is your lawyer not interested in being an attorney?

There is a workers’ compensation attorney in Chicago that has been around for about 40 years. He’s kind of an ass and not really my kind of guy, but you can’t deny that he helped build one of the biggest and most successful work comp firms in town. 15 years ago if you were hurt on the job and hired him or one of his partners, I don’t think anyone would say that you made a bad choice.

Problem is that it’s not 15 years ago anymore. Of the four “name” partners at this firm, one is deceased, one has been retired for a while now and this third one that I mentioned earlier has also retired. The 4th is still around, but in his mid 60’s and probably headed to retirement soon. They do have some younger associates.

The guy that I was talking about in the first part of this post has settled most of his cases and for the ones he didn’t settle, I’m told that a lot of them are now being handled by an attorney that is not part of their firm. I have no idea why they would do that.

Twenty years ago, you might have said that Huey Lewis is the best musician in the world (you’d be insane, but at least he had some hits), but today he’s nowhere to be found. The truth is that many law firms for work comp in Chicago and elsewhere have made a reputation for themselves and live off of that rep instead of the work they are currently doing.

I have nothing against this guy for retiring. In fact, when I see an attorney in their 60’s that is still handling cases, I wonder what’s wrong with them. But he surely knew that he was heading toward a retirement and he still took on new clients. To me that is wrong, especially when his firm isn’t taking over those cases or adding quality lawyers to take over the firm.

Your case is about you and what’s best for you. When you hire a lawyer, you don’t want someone who is too young, but you also don’t want someone who is too old. The lawyer has a right to retire, but don’t they have a moral obligation to tell you that before you hire them and to continue to work hard for the people they already represent? I think they do.

Since your case is about what is best for you, don’t be afraid to ask a lawyer how long they plan on practicing for before you hire them. Don’t be afraid to ask who will take over the case if they aren’t available or something happens to them. Those are completely reasonable questions.

We have created a state wide network of experienced, hard working, caring workers comp lawyers. No one pays us to be a part of that network and if someone isn’t delivering, we’ll kick them out. Just because someone is the right lawyer for you five years ago doesn’t mean that they are the right lawyer for you today. And you know what, I think I’m great at this now, but in 20 years (or maybe less) there will certainly be someone who is better. And that’s just the way it goes.

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

By Michael Helfand

What to expect at an Illinois workers' compensation trial

Not every injured worker will experience a trial. However, if your claim is denied or there is a dispute about benefits, you may find yourself at a trial or hearing.

Workers’ compensation trials are different from typical civil trials. A work injury trial is called arbitration. The cases are heard by arbitrators rather than judges, but their role is much the same. They hear the case and make a final decision. Many of the arbitrators are lawyers, although it is not a requirement.

You won’t be going to the courthouse. Your dispute will be heard at the Illinois Workers’ Compensation Commission in downtown Chicago or at one of the other locations throughout the state. You will go with your attorney. The insurance company will have an attorney there, as well. Both sides will present their arguments and call witnesses if necessary. The injured worker usually testifies. Your doctor will testify as well, but usually not in person. His or her testimony will likely be taken ahead of time in a deposition and then submitted at the arbitration.

The arbitrator does not make a decision right away. They review all of the testimony that was heard, as well as all of the medical records in the case. You can expect an answer in a couple of months. You do have the right to appeal the decision, but most cases are not overturned.

Many work injury cases settle without going to arbitration. However, settling isn’t the best decision in every case. Your attorney will discuss the pros and cons with you. For example, if you settle, you know that you’ll get at least some benefits. If you lose at trial, you could end up with none. However, if you settle, you will likely give up any future medical benefits. If your injury worsens later on, you can’t go back for more coverage. If you win at trial, future medical benefits usually remain available.

Your attorney should be very familiar with arbitrations at the Illinois Workers’ Compensation Commission. It’s not the same as handling other types of trials. An attorney who knows the procedures, the arbitrators and the other attorneys has a distinct advantage. When hiring a work injury attorney, make sure they are willing to go to trial on your claim if necessary.

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

By Michael Helfand