The need to explain the unexplained falls

Sometimes you fall down, and you’re not sure what happened—you just fell, and that’s all you know.  But if you have a fall like that at work and you want to recover Illinois workers’ compensation benefits for your injury, then it’s a good idea to get the facts that are available to explain why you fell.

To be a work injury for workers’ compensation benefits, your injury needs to arise out of your employment.  In the case of a seemingly-random fall, this means that there has to be something about the circumstances of the fall that caused or contributed to your fall and your injury.  You want to be able to answer the question:  what condition or hazard existed when I fell that would not have existed outside of work, or would not have existed for the general public?

A recent Illinois case confirmed the need to have the facts if you want to prove your case.  A school social worker fell on the stairs at school during a passing period.  He was not able to be compensated under workers’ compensation, because he had not shown that the fall happened because of anything specific to his employment. 

There were several suggestions of possible causes, some that would have been work-related and compensable.  But because these were all just suggestions, it was determined that it was too speculative to reach any conclusion.  Work-related theories for the fall were just as plausible as non-work-related causes.  The worker had not met his obligation and lost his case.

We can learn from some of the mistakes of his case.  The weather the day of his fall was snowy, and there was the possibility that the staircase was wet.  But he wasn’t sure, and there was no physical evidence of that.  If he had taken a picture of the stairs that showed them being wet, or found someone there that day who remembered that they were wet, that could have helped.

Also, he apparently told the staff at the hospital that he had just missed a step, though he didn’t remember telling that to anyone.  Perhaps in that difficult time when he was in pain, he speculated about the cause of his fall, which didn’t help him in the end.  If you have information about your injury it’s important to tell the truth about it.  But an aimless speculation is not likely to help, and can often hurt you later.

The worker may have fallen because he slipped on a wet stair, or been distracted by students in the hall, or tripped on something loose.  Likely these reasons would have entitled him to benefits.  But he could have just as likely fallen because he simply missed a step and tripped, and for this reason, without any other proof, he couldn’t win his case.  Gathering evidence to help explain the reason for your fall can make all the difference.

 

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 was robbed at gunpoint and can't sleep. Do I have a case?

Not sure what it is about September, but we've received a call similar to this question three times in recent days.  There is not a crystal clear answer, but most likely there is a case.

In an odd ruling, a Court in Illinois years ago said that one factor in deciding if this is a compensable case or not is whether or not you work in a dangerous location.  In other words, if you work in a high crime neighborhood it would certainly be a case. If you work in a nice boutique in the Gold Coast it might not be a case.  To prove this we often cite crime statistics or get a police officer to testify.

The reason for this (in our opinion it's silly) law is that you have to show something about your job led to the robbery occurring.  Being in a high crime location could be one reason.  Another reason could be that it's your job to handle money and you were the one robbed.  On the other hand, if you work in a shoe store in a nice neighborhood and just see it happen then it's probably not a case.

Even if you are in a high crime area or have a gun pointed at your head, you still need to show an injury.  Sometimes robbers will beat you up.  Sometimes having a gun pointed at you or the bad experience itself will cause a psychological injury that requires counseling.  If you get counseling or need medical treatment that will show the injury you sustained.  Be warned though that all of your counseling records can be viewed by the insurance company and attorney for the employer.

Finally, two callers have asked if they could sue because no security was provided.  Illinois employers do not have an obligation to provide security, but often do.  They don't usually do this for the employees, they do it to protect their financial investment in the store, bank, etc.

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.

FCE, IME, MMI, ???

We are happy to answer any questions that people have about Illinois injury cases.  Three questions we get asked a lot are what are the abbreviations FCE, IME and MMI?

FCE- Stands for functional capacity evaluation.  Basically it's a test that has you perform a series of activities throughout the day to determine if you need any physical restrictions before returning to your job or what capacity you can work in.  It's an objective test that measures not just ability, but also effort.  If you are found to have used a bad effort it can hurt your case.

IME- Stands for independent medical examination.  This is the insurance company's right to send you to a doctor of their choosing to see if you are really hurt, what your diagnosis is, whether or not your problem is work related, what treatment is needed or anything else that they want to ask.  It's usually a one time visit.  Many of these doctors are hired guns or almost always favor the employer.  Some are truly independent.

MMI- This means maximum medical improvement or as good as you are going to get medically speaking.  We don't consider settling a case until a client is at MMI because once you settle you can not get any more medical treatment at your employer's expense.  Sometimes you are at MMI, but still need ongoing physical therapy or a yearly exam.  Your doctor determines when MMI has taken place.

If you have questions about any of these terms just let us know.

 

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.

Pre-existing conditions are for the most part irrelevant under Illinois work comp

It is not unusual for someone to have a bad back, sore arm, stiff knee, etc.  Especially as you get older the acts of daily living can wear your body down.  Many people also have problems due to past injuries.  We have represented a lot of clients who in the past have had non-work related back surgery, rotator cuff surgery, carpal tunnel and knee injuries.  These clients came to us when something about their job caused these pre-existing problems to flare up.

Under Illinois workers' compensation law, a pre-existing condition does not bar you from receiving benefits.  If your job aggravates or accelerates a pre-existing condition you should receive Illinois work injury benefits. 

In other words, your employer takes you as they find you.  If you had back surgery last year from a fall at home and then start a new job where you do some lifting and re-injure your back, the pre-existing condition should not reduce any rights that you have under the law.

Similarly, if you tore your ACL years ago and then twist the same knee when you slip on the floor at work, that is  a new case.

The best way to figure out if you have a case is to ask yourself, was I having problems with this body part to the extent I am now before the accident happened?  If the answer is no then you are likely entitled to benefits.

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.