Five things most injured workers in Illinois wish they knew

In no particular order, here are five things that most new clients didn't seem aware of until they talked to us:

1. If you don't have health insurance it doesn't matter.  On compensable cases the workers' compensation insurance carrier has to pay for 100% of your medical bills.  There is no network of doctors, you see whoever you want.

2. Pre-existing conditions don't matter if they were aggravated or accelerated by a job injury.  This is especially true when they try to deny your case because you broke your leg as a kid or were in a car accident years ago.

3. You have to notify your employer within 45 days of when you knew or reasonably should have known that your injury was work related.  Failure to do so could result in your case getting dismissed.

4. A workers' compensation claim in Illinois is not a lawsuit.  Although you have an attorney, we are not suing anyone.  Rather we are making a claim for benefits similar to health insurance.   In almost every case we deal with an insurance company and not the employer.

5. In most cases, the insurance company is supposed to approve or deny benefits within two weeks and if they deny benefits they need a valid reason (and "we are investigating the claim" is not a valid reason.  If they don't follow the law on this we can't ask for punitive damages (doesn't exist in Illinois work comp), but we can file a petition for penalties and fees which acts in a similar manner and can pressure the insurance company to do the right thing.

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

Hurt on the job with a vacation planned. What should you do?

An injured worker called us for help.  The insurance company doesn't dispute that he hurt his arm on the job.  In fact they have already paid for his surgery.  He has a 12 week physical therapy program and has completed two weeks of it.

Earlier this year, not anticipating that he would get hurt on the job, he booked his family's dream vacation to Disney World (side note, I was dreading that trip with my family, but took my kids this year and that place is awesome.  So well run and everyone is so friendly).  Not only is the money he paid for the trip non-refundable, but his wife and kids have been talking about it for months.  He certainly doesn't want to let them down.

The insurance company told him that if he took his vacation and missed out on physical therapy they would terminate his benefits.  Obviously this created a huge dilemma for him.

The good news is that there is a solution to his problem.  We suggested that he get a home physical therapy program to take with him to Disney.  It's important that he recover, but you don't have to drop every aspect of your life if you are hurt on the job.  While he can't do anything that would hurt his condition and it would be unreasonable to take months of time away, a pre-planned vacation would almost certainly not be deemed unreasonable. 

We will go to the insurance company with our very reasonable plan and will show case law that supports our position.  If they still cut him off we will file a trial motion and a petition for penalties and fees that will punish them for what would be unreasonable behavior.

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

 

Why is two weeks an important time frame for an Illinois work injury?

Under the Illinois Workers' Compensation Act, an employer or their insurance company has two weeks to either pay TTD benefits or approve medical care or have a good faith dispute as to why they are not paying.  If they don't, we as Illinois workers' compensation lawyers can hit them for penalties.  These penalties can be as much as $10,000 for failure to pay TTD and 50% of the cost of any unpaid medical bills or procedures that are not reasonably denied.  All of that money goes in to the pocket of the injured worker because under Section 16 of the Act they would have to pay our 20% fee as well.

It amazes us that so many law firms don't take advantage of this law.  If we have a client that needs a back fusion and they can't get it, if the surgery is being unreasonably denied, a penalties petition is great leverage for getting it approved.

Two weeks is also an important time frame because while your employer doesn't have to pay you for the first three days you miss from work due to a work injury, once you hit 14 days - and that includes days you aren't scheduled to work - they do.

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

Your employer has to pay all reasonable medical bills. Period.

Lately we've seen a lot of cases where people looking for an Illinois work comp lawyer are being told that even though their doctor recommends physical therapy or surgery, it's not going to be approved.  I spent 30 minutes with a physical therapist this morning whose clients are continually being denied treatment by medical management companies.

The Illinois Workers' Compensation Commission rules are clear. If the treatment is reasonable and related then it should be covered.  Treatment should not be denied unless the insurance company has a medical opinion from a doctor that says the treatment is not necessary or not related to a work injury.

The good news is that when this non-sense happens we can file what is called a Section 19b petition for immediate hearing.  We can also file a petition for penalties and fees that works kind of like punitive damages.

When you are dealing with nonsense you can either roll over and take it or send a message that it's not acceptable.

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

"I fell 35 feet and the insurance company says it's pre-existing!"

Not much stuns us anymore, but this one did.  A new client was working on a telephone pole when he fell 35 feet after a ladder collapsed.  Prior to the injury he was not receiving any medical care for any problems and worked out four days a week. 

As a result of the fall he has herniated discs in his back, a likely torn rotator cuff and a knee injury.  The insurance company sent him for an IME that said his back and shoulder problems were pre-existing and not due to the fall.

Now a lot of IME doctors are legit and then some like this guy are company whores.  I question how guys like that sleep at night.  I also can't wait to see his deposition and how he tries to justify his opinion.  Our client fell 35 feet!!!  He's lucky he's not dead or paralyzed.

They want him to put his bills through group insurance.  Not gonna happen.  We are going to file for an immediate trial and petition the Arbitrator to award penalties and fees.  Just absolutely stunning what some insurance companies will do.

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

If the insurance company or employer is unreasonable we can't get punitive damages, but . . .

We can get what is called penalties and fees.   Essentially, if you are not getting your benefits and there is no good reason - such as a reasonable dispute as to the extent of your injury or how it occurred - then they can be punished.

In fact they can be punished as much as 50% of your medical bills, money for each day that TTD benefits are inappropriately denied and 20% for attorney's fees which puts more money in your pockets.

There are often legitimate reasons that cases are disputed such as an IME report.  But often insurance companies just do the wrong thing.  We are amazed that more attorneys don't take advantage of this law and take their cases to trial.  In a recent case, an insurance company had to pay more than $110,000 in penalties because of their awful behavior.

If you are getting screwed over for no reason the law is on your side.  Use it to your advantage.

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