Do You Need To Go To A Second IME?

A reader of the blog had a very interesting situation.  He had been hurt at work and right after he was injured, the insurance company sent him for an IME.  That hired gun doctor said he was fine and could go back to work.

Fortunately this injured worker was smart enough to seek out his own doctor.  That physician had a MRI ordered which showed a major injury.  As a result, the work comp case was accepted and they paid for his medical care.

Fast forward 10 months later and the worker is still getting medical care.  Now the insurance company wants to send him for another IME.  The question he had is does he have to go?

While insurance companies can’t just doctor shop until they get the opinion they want, they are allowed to ask for IME updates.  In a case like this, we would advise him to go to the exam, but before that happens we’d reach out to the insurance company or their lawyer to set up parameters.

The new exam should be limited to treatment from when this guy was last seen for the IME up until now.  He can address the MRI, the current treatment plan and the workers’ physical condition.

On the flip side, we’ve seen in the past where insurance companies don’t like what their report says or they are trying to manipulate your medical care, so they send you to another IME within a couple of months of the first one.  This usually shouldn’t happen. The exception would be if it’s a follow up after something like an EMG. But usually they can just review the records and shouldn’t need to see you.

I do think the insurance company in this case is wasting their money.  Their IME doctor has lost his credibility by saying that the worker was fine.  The MRI proved that he was very wrong. Any determination now that the worker is fine will be met by an Arbitrator with skepticism.

So most likely this is nothing to worry about.  I do though like that this reader is looking out for himself. You should never just roll over and do what the insurance company wants without asking questions first.  They will push you around if you let them, so don’t let them.

What To Know Before You Settle Your Work Comp Case In Illinois

This is the third in a three part series of advice for injured workers.  The first post discussed what you need to know immediately after you are hurt on the job in Illinois.  The second post offered a bunch of warnings and tips for how to handle the middle of a case. This last post is advice on what to think about just before settling a case or going to trial. If you have any questions about Illinois workers’ compensation law and want to talk to an attorney for free, contact us at any time. We cover all of Illinois with our state wide network.

As you get toward the end of an Illinois workers’ compensation case, hopefully you are doing better physically and can start thinking about settlement.  If that’s the case, we highly recommend that you return to work without issue for at least two months.  You don’t want to settle and then find yourself needing more medical care.  You should also, once discharged from care, call EVERY medical provider you’ve had on the case to make sure that there are no unpaid bills.  It’s all about preparing for the best settlement possible.

If you aren’t 100% better, meaning that you have permanent restrictions or a need for future medical treatment there is other advice you need.

First, if at all possible, don’t quit your job.  If you do it could greatly reduce the value of your case. If you are thinking about quitting or have a job offer somewhere else, do not do anything without sitting down with a lawyer and making sure it won’t cost you tens or hundreds of thousands.

In some cases you will have permanent restrictions that your employer can not accommodate. Once your doctor says you are as good as you are going to get, it’s up to you to begin a job search to show what types of jobs you can get.  That doesn’t mean you have to take those jobs, but you must do a job search.  As part of that, you should keep a detailed job log of the jobs you applied for, how you contacted them, the pay and the response you got. On average you should be looking to apply to 15-20 jobs a week.

If you need or want help in your job search, you can get the insurance company to pay for a vocational rehabilitation counselor.  They can help you prepare a resume, conduct a job search, give you testing to determine what jobs you are capable of and in some cases make recommendations as to what re-training you can get to help your job prospects.  Just like with your doctor, you can and should choose this person.  Your lawyer should tell you who to go with.  You want someone who is working for your best interests, not that of the insurance company.  It’s possible that they will determine based on your age, injury and job experience that there is no stable job market for you. But if you don’t go through the process you will never get to that point.

It’s also very important to talk to your doctor about any future medical care that you may need.  For example, if you had a surgery where hardware was put in your body, it’s likely it will need to be replaced at some point.  You can get compensated for those anticipated costs at the time of a settlement through a Medicare Set Aside.  It’s very important that you do this.  This is money that should go in to your bank account and that the lawyer shouldn’t touch.

In some cases you need to think about not settling.  If you’re going to have a lot of future medical care or the offer isn’t fair or if they owe you a bunch of money, going to trial is possibly the better route.  If you win it keeps your medical rights open for life, you might keep weekly benefits and/or you will still get money that is equivalent or more to what you could have settled for.

If your injury is serious enough that you had a surgery or more than six months of treatment, you’d be foolish to not have a lawyer. While this may sound like a lawyer angling for clients, I promise it’s not. The honest truth is that even with a 20% lawyer fee, you’ll end up with more in your pocket with an attorney than without one.  And in really serious cases, the end result can be a difference of tens, if not hundreds, of thousands of dollars.

As always, if there’s anything you are unsure about, get in touch. We will always talk to you for free and give straight forward, honest advice.

Illinois Workers Comp Law, What To Know During A Case

The other day we offered tips on what you need to know right away if you are injured on the job in Illinois.  Today I’m writing about the most important things to know in the middle of a case.  In a few days, I’ll write about what you need to know as settlement gets closer.  As always, if you want to talk to an attorney for free, call us at 312-346-5578 or fill out the contact form and we’ll call you.  We help with work injuries everywhere in Illinois.

This post assumes you have had an injury that requires six months or more of medical care.  These are tips that I think everyone should know. They will give you the best chance of success on your case.

If your injury is serious, you can expect that the insurance company will send a private investigator to tail you at some point. Surveillance is legal under Illinois work comp law. They are looking for signs that you are faking or exaggerating your injury.  You can’t stop them from following you.  The good news is that it’s expensive and if they don’t catch anything in a few days, they will likely stop. If you are being honest with your doctors and in your daily acts of living, you have nothing to worry about.

You can also expect in a serious injury case that a nurse case manager will be assigned to you.  This is a insurance company representative and they are often the most sneaky people around. The worst ones will try to schedule your doctor appointments around their schedule or talk to your doctor directly to try and manipulate your medical care.  They don’t have a right to do any of this, but will unless you stop them.  Typically one of the first things an attorney will do is put them in their place. They can ask for copies of medical records and bills and that’s it.  If they go to far they will often badger physicians in to having you do things that risk your health just so the insurance company can save a few bucks.

It’s really important that you listen to your doctor. If he/she says no lifting over 25 pounds, you can’t go and use the bench press at the gym just because you are feeling good that day. The goal is for you to be better. If you are going to try increased activity, ask for permission first. Also make sure you are communicating with your doctor.  If you have problems, tell them.  If they say you can’t work, make sure you get an off work slip from them.

You can expect that you will be sent to an independent medical exam or IME at some point.  This is a hired gun doctor chosen by the insurance company.  They aren’t there to treat you.  Their job is to determine if you were hurt at work, what your condition, what future medical care you need and if your medical care is from the job injury.  They tend to make money by favoring the insurance company. You don’t want to go in to one of these exams without talking to a lawyer first.  In general though, be friendly, honest and don’t exaggerate. There is a good chance the exam will last less than five minutes and they will find against you.  That’s part of the work comp process in Illinois and if you have a lawyer you can go to Arbitration to make sure your benefits aren’t denied.

If at any point you are unhappy with your doctor, you do have a right to a second opinion.  That said, there are laws that limit you from just hopping from doctor to doctor. Our best advice is that even if you are going to see a new orthopedic doctor, get a referral. Assuming that your family physician referred you to the first orthopedic, you can ask them for a referral to a different facility.  Doing so increases the chances that the bills will be paid.

If you have a lawyer, it’s really important that you keep them in the loop.  It can be as simple as emailing them after an exam to tell them what the doctor said and to provide them a copy of your off work slip.  If we don’t hear from clients we assume they are fine. If your TTD check is late or you are getting bills in the mail, if you don’t tell us, we won’t know about it.

I will talk about settlement in the next post, but in the middle of a case know that the #1 thing is your health and getting treatment for your injury.  No attorney can tell you the real value of your case until they know what your ultimate recovery will be.

The Most Important Things To Know Right After You Are Injured

I was going to write a post on the ten most important things to know when you are hurt on the job in Illinois.  I realized though that you really need to think differently at each stage of a case.  So I’m doing three posts about what to know at the beginning, middle and end of a case.  All of these tips are what I think a lawyer would tell a loved one to do.  They also will help you get the best result possible in your case.

Once you are hurt on the job and it’s something more than superficial, the first thing you should do is get medical treatment.  It sounds like simple advice, but I can’t tell you how many cases have blown up because an injured worker tried to “tough it out” and not see a doctor for many weeks or months.  The longer you wait, the harder it is to prove your condition is related to a job accident.  In the very least you give the insurance company a reason to fight your case.

If getting treatment is the first thing you should do, 1A is to report the accident to your employer.  Under Illinois workers’ compensation law, you have 45 days to notify your employer that you were injured on the job. Just like with medical care, the sooner you report, the better.  So if you are lifting a box and feel a pop in your back, mention it to your supervisor.  It can be verbal or written.  I prefer a short and sweet email because it prevents words from getting twisted and proves notice.  An example would be something like, “Joe, I was lifting crates all morning with Steve. After about an hour into it I lost my balance on one of them. As I went to catch myself, I felt a pop in my back. It’s really stiff and hurting so I’m heading to the ER.  Thanks, Mike.”

We see a lot of employers who tell injured workers to lie to the doctor and say that they got hurt at home. DO NOT DO THIS. It’s important to tell the truth and even if your employer promises to pay your out of pocket expenses it’s almost always b.s. and could torch your work comp case and entitlement to payment for time off work and for a settlement.

Assuming you go to the doctor and they order physical therapy or follow up visits, you can expect a call from an insurance adjuster. Our #1 tip in dealing with them is to not agree to a recorded statement.  They will ask questions that are designed to trip you up. For example, if you slipped at work and fell, they will try to make you say that you don’t know why you fell.  If you do that you could create a defense for them even if the truth isn’t what they got you to imply.

Getting a lawyer prevents them from talking to you and trying to mess with you.  It’s of course up to you to decide if you need/want an attorney.  The good news is that it costs nothing and a lawyer acts as a security blanket for you.  That said, if you think you are going to be fine physically, you might not need one.  Just be honest with your doctor, don’t volunteer to much to the insurance adjuster and focus on your health.

Part 2 will discuss what happens in the middle of a case and should be posted in three days. If you have any questions about anything related to Illinois workers’ compensation law, contact us at any time for a free consultation.

You Take A Risk By Working And If Injured Deserve Benefits

Ok, this is more of a rant than advice about Illinois work injuries. I recently overheard a lawyer boasting about how hard they work. In fact they were saying that they work harder than any of their clients. Stuff like that makes me fume. Who do these people think they are?

Yes lawyers work hard. Yes going to college involves work as does law school.

But is that work harder than the summer I had washing dishes in a busy restaurant. Harder than when I waited tables at Bennigans on the lunch shift and then worked as a bus boy at Ravinia for the dinner shift six days a week? Hell no.

And nothing I’ve personally done is harder work than laborers who are lifting 50-100 pounds all day for 20+ years. No work I’ve done is more difficult than being a teacher in charge of 30 kids in a classroom (I substitute taught for one day back in law school and never slept as well as that night). It’s not “harder work” to prepare for a trial than it is to be at the same job every day by 5:30 a.m. and on your feet until 5 p.m. There isn’t free time to search the internet, call a friend, have a long lunch, etc.

Most attorneys I know are normal people and not pompous. But man there are a lot of attorneys and other white collar professionals who don’t know how good they have it. These same people equate wealth with intelligence. They feel superior for having a graduate degree. Some were born on third base and think they hit a triple.

I respect everyone who grinds. What I don’t respect are people who aren’t self aware and don’t respect others. It’s like hearing an actor talk about how difficult their job is. I’m sure they put in long hours and are talented, but to whine about it is a joke. No attorney I know would give up their desk job for one that caused their back to kill by the end of the day. When they talk about how hard their job is, many of them mean it’s boring and they are stuck because they can’t do anything else.

I think this is what attracted me to work comp in the first place. Most of the people I get to talk to are salt of the earth, hard workers who just want to get better and back to their job. I rarely come across an arrogant jerk.  My clients aren’t entitled.

That’s my rant for the day. I’ll be back to normal blog posting in a couple of days.

Railroad Workers Hurt On The Job Are Covered Under Different Laws

Recently a train conductor was awarded $1.6 million for back and shoulder injuries after he hurt while on the way to work in a company van.  He was a passenger in the vehicle which was struck by a car.

While he did get the $100,000.00 insurance policy from the other driver, the $1.6 million was awarded to him after a jury trial against his employer.

If almost any other Illinois worker had this happen to them, there wouldn’t have been a jury trial because under IL law you can’t sue your employer for negligence.

But railroad workers, like this conductor, fall under Federal law via the Federal Employers Liability Act or FELA.  It’s not necessarily great for them though, as most injuries are not covered, and they need to show some fault was involved.

In cases like this, however, FELA law is fantastic.  It allows these rail workers to sue for the full extent of their injuries.  While this case was big, I have seen others go for a lot more money.

Unlike regular work comp cases, there are very few law firms with a real track record of success in filing and winning these claims.  Getting the right firm can be the difference of millions of dollars potentially.

Our firm doesn’t handle these cases.  So why I am I writing about it. Two reasons:

  1. We want all workers injured on the job to be educated of their rights. If you are a railroad worker and pursue a regular work comp claim, you will waste your time and potentially lose rights under FELA.
  2. We work with the firm that handled this case on a regular basis.  So why this is not the type of case we can personally take, we’d be happy to refer you to what we think is the best FELA injury law firm in Illinois.  They cover the entire state and in some cases go out of state.

Bottom line is that while FELA is unique, it’s like regular work comp in that to succeed you need an attorney in your corner with a real track record of success in winning these cases.  If you would like our help in getting connected with a great firm who will review your case, for free, please contact us at any time.

Can I File For Workers Comp If I Quit Or Got Fired?

We are Illinois work injury attorneys who will talk to you for free about your case.  Start a chat, fill out the contact form or call us for a no cost, no commitment consultation.

Do I have an Illinois workers’ compensation case? We get a form of that question many times a day.  Most of these questions come from people who are still employed.  But what happens when you are injured on the job and then quit or get fired?  Can you still bring a work comp case?

The short answer is yes.  The longer answer is it depends on the facts.

If you get hurt at work today when you crashed your truck, if you got fired over that you can still bring a case.

If you hurt your back six months ago, reported it, but never filed work comp and get fired or quit, you can still bring a case.

Same scenario, but you never reported it, you’d likely lose because you have to notify your employer within 45 days of an accident happening.

If it’s carpal tunnel or some other repetitive trauma case, you can file, but success will depend on how long after you left work you notified them and when you got medical treatment.

When you’ve never gone to the doctor or reported a problem and then quit or get terminated, it looks suspicious when you then raise the issue.  It doesn’t mean that it’s impossible to win, but it’s surely an up hill battle.

There are some benefits you will lose out on if you quit.  Mainly, if you are authorized off work with restrictions and have quit the job, you won’t get TTD benefits.  On the other hand, if you are fired and have any restrictions, they have to pay you TTD until you are better.

We’ve seen some cases where workers have tried to bring up an issue many years after they’ve quit.  In most of those cases it’s been too late.

Beyond all of this, when you quit you can lower the value of your case, so don’t quit if you don’t have to. If you get fired it could increase the value of your case.

Is this at all confusing? It probably is because every case is different. So to determine if you have a case we need to know what specifically happened to you.

The Danger Of Trying To Get A Settlement Without A Lawyer

If you have read my blog for a while or talked to me, you know I’m a straight shooter. I’ll tell people when they don’t need a lawyer.  I’ll tell people if their current attorney is doing a good or terrible job. I’ve made it my policy to be direct, blunt and honest.

So when I write a post that there is a danger in trying to get a settlement without an attorney, I don’t do that for my bottom line, but instead for yours. I was recently contacted by a woman who made the point clear.

The biggest reason to get a lawyer early is to essentially have a security blanket in case something does go wrong and to make sure nothing is going wrong. But I get that not everyone gets a lawyer.  The woman who contacted me tore her ACL on the job and never got an attorney. The insurance company made what seems like close to a fair offer to settle her case.

The problem is that she needs another surgery and they don’t want to pay for it.  Because a settlement offer has been made she can’t get a lawyer. How is that so?

If you get a lawyer involved after a settlement offer has been made, they can only get compensated if they get your offer increased.  So if you are offered $40,000.00 without a lawyer and they get the offer increased to $60,000.00, they only get paid based on the $20,000.00 increase.  As a result, many attorneys won’t touch a case once any real offer has been made.  This of course has caused insurance companies to make quick, low ball offers to try and prevent you from being able to get legal help while still not giving you close to what you are owed.

The problem in a case like this is that she needs more medical treatment. To get that approved she’ll need to go to court.  But no attorney I know will do that because they would have to do a ton of work without getting compensated for the full value of the case.  It’s not fair, but it’s reality.

In other cases you want to make sure your future medical needs are taken care of. This worker, for example, may need a knee replacement surgery.  If it’s anticipated now then she should get paid for it now.  The insurance company of course doesn’t want to do that.  So again, the only way to make that happen is with a lawyer.

And even when medical care isn’t an issue, you’ll almost never end up with more money without an attorney.

So I get why people try to go at things without a lawyer. It seems like the insurance company is doing everything they should.  You don’t want to have to get a lawyer (who would?). You are focused on returning to work.

I promise you though, whether you hire us or someone else, it’s almost always way better for you to have an attorney in your corner.

They Paid All My Bills And Then I Never Heard Anything

There are many things that are true across all Illinois workers’ compensation claims.  The truest is probably that the insurance company will do whatever they can to limit the amount of money they pay on a case.

Sometimes their strategy is just to deny a case for no reason and see how you respond.  Other times they’ll accept your case, but do whatever it takes to find a reason to deny you.  This may include talking to your doctor (which is illegal), doing surveillance on you, combing your medical record history for a pre-existing condition, taking a recorded statement or sending you for an IME.

But there’s another somewhat tricky way that insurance companies save money on cases where they have no defense.  They will be as nice as can be and pay your bills and lost time and then ghost you. Just the other day I got called from an injured worker who told me, “They paid all my bills, and then I never heard anything.”

So how does paying your bills save them money?  A lot of injured workers don’t realize that they are entitled to a settlement when the case is over.  So the insurance company is hoping that if they are nice to you, and don’t give you a reason to hire an attorney, you will simply go away and not realize that they owe you a bunch of money before it’s too late.  In cases where this strategy works, they will usually save the insurance company somewhere in the five figures.

You have three years from the accident date or two years from the last payment of benefits on your case (e.g. the date they last paid a medical bill or TTD payment) to file a claim.  So the good news is that even if they’ve blown you off, if you act fast enough, you can still get a settlement.

Sometimes you’ll call and inquire about one.  In our experience, two things happen when you do that.  One they make an offer, but it’s for way less than what the case is worth. Two they ignore you with the hopes that if they delay you long enough that you will lose your rights.  They may even tell you that your case is closed.  The good news is that if you file the case with an attorney it will be re-opened if it’s not too late.

Bottom line is that in almost every case you are owed a settlement.  If you want help getting it, we’d be happy to guide you.

IL Work Comp – What Is A Back Injury Case Worth?

The number one question any Illinois workers’ compensation lawyer gets is, “What is my case worth?” Recently I had a caller who wanted to know what his back injury was worth.  He had a lot of opinions on what it should be worth based on what a friend had gotten on a case a couple of years ago.  So I thought it would make a good blog post.

The short answer to this question is always “it depends.”  The longer answer has to do with a lot of things. The biggest ones are as follows:

What is your actual injury? It’s one thing to state that your back is in a lot of pain.  It’s another to prove it.  MRI’s are the gold standard in proving a back injury.  They can show the difference between a strain, a bulging disc and a disc herniation.

What physical problems do you have? With the worst back injuries there is a shooting pain down your leg, difficulty standing, constant aching, numbness, trouble walking, trouble lifting, etc.

What medical treatment have you had? Most back strains will recover with a few weeks of physical therapy, rest and some pain relievers.  More serious injuries require an epidural steroid injection.  The worst cases require surgery, but even with that, a laminectomy or discectomy is not as serious as a fusion.

Are you able to return to your old job? If so, do you have any physical restrictions.  If you can’t, what type of work are you able to do and are you making as much or close to the old job?  A laborer who has a high school degree, is 55 years old, has a five pound lifting restriction and used to make $40.00 an hour will have a difficult time earning that much.

How much money were you paid per week prior to your injury? The higher your average weekly wage, the more a case will be worth.

Work comp settlements in Illinois are based on what your wages were, the extent of your injury and your current condition.  So there’s no way to say without a review of your medical records and talking to you exactly what your case should be worth. In general though, the more you make, the worse your injury and recovery and the more severe your treatment, the more the case will be worth in the end.

Beware shady Illinois work injury lawyers who try to tell you up soon after you got hurt what the case will be worth.  They couldn’t possibly know because they don’t know what your ultimate recovery will be.  If you make $1,000.00 a week and have a back strain, your injury could be worth approximately $3,000-$7,500.  If you end up with a MRI that shows a herniation and eventually lose your job because you can’t do the work anymore, your case could hypothetically be worth $400,000-$600,000.  It could also be worth much less than that if the facts aren’t in  your corner or you don’t have an attorney who knows what they are doing.

Bottom line is that these are some of the factors that we think about when evaluating what a case is worth.  If you want to discuss your case, you can contact us for free any time.

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