How To Respond When Work Comp Insurance Won’t Approve Surgery

By Mike Helfand on Posted in Benefits

An injured worker contacted us recently with the following scenario:

I tore my rotator cuff on the job and need surgery. My doctor faxed a note to the insurance company, but they say that they will not approve it because they do not have evidence that it is medically necessary. What do I do?

Does that scenario sound insane? It is, but it also is really common in Illinois. Insurance companies will fail to approve medical procedures even when your doctor says you need it and common sense says you do as well.

What the insurance company is doing here is blatantly against Illinois law. The only way they could legally do this is if they had a medical opinion, usually from an IME or a utilization review (that’s when a doctor doesn’t examine you but looks at your records) that says surgery is not needed.

If they had that, they would have to disclose it in order to make their behavior legal. That has not happened in this case.

What Should This Injured Worker Do?

This is happening for two reasons:

  1. This is just how insurance companies operate. They hope to frustrate you and make you give up.
  2. There is no case officially filed with the Illinois Workers’ Compensation Commission so the worker does not yet have any official way to respond that could compel the insurance company to do the right thing.

The good news is that it takes all of ten minutes to officially complete and file the application for adjustment of claim with the Illinois Workers’ Compensation Commission and get a case started.

If we were hired by this worker, we would at the same time file a 19(b) petition for immediate hearing to get the first possible trial date available. This would force the insurance company to actually provide evidence for their behavior or actually approve the surgery.

And more often than not, the simple act of filing a case with a lawyer is enough to get the surgery approved. The insurance company knows that they are acting in bad faith and often will just roll over when pressed. It is hard to argue that a laborer with a torn rotator cuff does not need a surgery. Even the hackiest of doctors would struggle to back that opinion.

It is kind of a joke that workers have to deal with this nonsense, but that is also why it is important to get an experienced and aggressive lawyer in your corner. The insurance company is not playing fair so you need someone who knows how to push back to get things done.

And if somehow the insurance company does have a doctor to back up their denial, you need to take the deposition of your doctor to help establish your position and then go to arbitration. When that happens, you will be able to get a court order to have your surgery paid for.

The bottom line is that workers’ compensation insurance companies are both ruthless and very easy to beat if the facts are on your side and you have an attorney in your corner who knows what they are doing and will actually do the work.

If you would like a free case review, please contact us any time at 312-346-5578. We cover all of Illinois and would love to help you.

How I Lost My First Illinois Workers’ Compensation Trial

By Mike Helfand on Posted in Tips if Injured

I became a licensed Illinois attorney 29 years ago. My first job was at an insurance defense firm that also occasionally represented injured workers. It was not a great place to work, but it was great training on how to handle cases, and it helped me realize that I never want to fight for insurance companies. I also learned a lot of inside information that has been valuable in advising injured workers.

I did not realize it at the time, as I was young and naive, but this firm did not take the cases of injured workers seriously, and really only cared about the insurance company cases. I should have figured that out when they gave me my first trial assignment.

I had shadowed other attorneys on their trials, but I was going to do this case alone. I was representing a worker who had done repetitive activities for years and had bilateral carpal tunnel syndrome. The case was denied because the insurance company had an IME that said his problems were not work related.

I could not have possibly been more prepared for the trial, except for my lack of experience. I knew his medical records and job description like the back of my hand and had written out all of my questions. I went over these questions with this worker before the trial and had a list of questions that he should be prepared to answer from the defense attorney.

I do not drink coffee or really any caffeine, but man was I hyped and excited. I really wanted to do well for this guy and felt clearly that we would win as the law and the facts were on our side. Yes they had an IME in their favor, but my boss told me that doctor was known as a hack and hired gun.

The Arbitrator on the case was old and mean. I had watched some of his other trials and he loved to yell at people. Just a miserable guy. The defense attorney was old and friendly. He could not have been kinder to me when we talked in the hallway about the case.

When I walked into the courtroom, I realized in about two minutes that I was going to lose this case. The very mean Arbitrator could not have been any nicer to the defense attorney. They were yucking it up and talking about their wives. As soon as the court reporter came in, he acted serious, but I could tell that I had no chance. They were friends and nothing I could do would win this case.

I still did my best and the defense attorney asked hardly any questions. A few weeks later the decision came in the mail and we had lost. I remember that we filed an appeal, but I do not know what happened with that as I was soon on to a new and better job.

Things are not as shady at the Illinois Workers’ Compensation Commission now as they were back then. Not saying this couldn’t happen today, but if it did I do not think the Arbitrator would be so obvious about it. There was just no way he going to give a victory to a first year lawyer over his friend.

Had my experienced boss taken this case to trial, our client would have gotten a fair shot. It is pretty shameful that he sold out our client like that and I was not surprised that years later he got in trouble with the disciplinary board for attorneys for inappropriate behavior.

The lesson for any injured worker now is to beware these law firms that hire very young attorneys and throw them into the fire so quickly. You do not want any attorney to be trained on how to handle a case by working on yours. You deserve an experienced lawyer in your corner who has gone to trial numerous times and handled thousands of cases. This gives you the best chance of success.

We do not guarantee anyone a result, but do promise that any attorney in our state wide network will be both experienced and a fighter. We will do whatever we can to get the best result possible and you will never lose because of lack of experience.

What You Should Get If You Hire An Illinois Workers’ Comp Lawyer

By Mike Helfand on Posted in Tips if Injured

When you hire an Illinois workers’ compensation attorney, no matter what your case facts are about, everyone signs the same contract with the lawyer. That is because every Illinois workers’ compensation case is required to use the same attorney representation agreement. It gets filed with the Illinois Workers’ Compensation Commission when your case is officially filed.

I do not know if there is any other area of law in Illinois where lawyers and clients are required to use a certain retainer agreement. It is used because it lays out the percentage that we as attorneys can charge which is 20 percent.

I have seen some attorneys write in clauses or create separate documents that have illegal language in them such as you can not fire the firm. That is simply not enforceable or true. You can fire your work comp attorney at any time and do not have to pay them out of pocket to do so.

Other firms will put in clauses designed to protect themselves from legal malpractice. They will clearly state that you are hiring them for the workers’ compensation case only and nothing else. That is included so if you have some other legal matter and miss a deadline to file that case, they can not be held responsible.

This clause is also used by some firms as a way to blow you off and I think that is a problem.

What You Should Get When You Hire An Illinois Work Injury Law Firm

When you hire an Illinois work comp law firm, you are hiring them to represent you on your workers’ compensation case. That is hopefully pretty obvious.

In my opinion though, they also should be addressing anything that is closely related to your work comp case. That does not mean they will represent you for that, but that they will point you in the right direction for it. Some examples include:

  • Getting injured on the job in a car accident that was someone else’s fault
  • Being fired for filing a workers’ compensation claim
  • Child support being taken out of your work comp checks
  • A treating doctor committing medical malpractice as part of your care
  • A work comp bill showing up on your credit report

By far the most common occurrence has to do with problems at work that injured workers feel are due to the work injury. Too often Illinois work comp attorneys blow their clients off and say that they can’t help them with that. In my opinion that is not right.

This does not mean that you should expect your work comp attorney to also be your labor law attorney. In fact, if they were that might be a red flag. It is no different than not wanting your orthopedic doctor to also help deliver your baby. You want your doctor and your lawyer to be narrowly focused in what type of work they do.

What it does mean though is that your workers’ compensation lawyer should have relationships with labor attorneys they can refer you to to consult with about any problems that have developed. We have multiple firms we work with on those cases and so should your lawyer. If they do not or will not, it is a HUGE red flag in my opinion.

A lot of injured workers will come to us hoping we know a labor lawyer for them. Some of these people already have attorneys. What we tell them is that because the cases are inter-related, it needs attorneys who are used to sharing information with each other. So we will not do one without the other. If your lawyer won’t help you or you do not like them, we can discuss taking the case over and then referring you to a labor lawyer after that.

What this all comes down to is customer service and caring for a client. We can’t always help you, but just like you should expect your attorney to promptly return a phone call, you should expect that if you have a separate legal issue beyond the work injury that they will at the very least try to give you some guidance as to who might be able to help you.

And if they will not do that then they probably should not be your attorney.

Cervical Myelopathy and Workers’ Compensation

By Mike Helfand on Posted in Injuries

I had major neck pain earlier this year. It sucked. I did not have an accident and fortunately for me, after two months it resolved with some physical therapy. It certainly made me even more sympathetic for injured workers I have helped who have had neck problems. And most of their injuries were much worse than mine.

It is common for a job to cause or contribute to neck pain. While I had a simple neck strain, other problems can be herniated discs or in the most serious cases something called cervical myelopathy. If you’ve been diagnosed with cervical myelopathy, and you work a physically demanding job, you may have a workers’ compensation claim even if you never had an accident.

What Is Cervical Myelopathy?

Your spinal cord runs through a narrow channel in the bones of your neck (the cervical spine). Cervical myelopathy occurs when that channel becomes compressed and squeezes the spinal cord itself. This is different than a pinched nerve that typically causes pain or tingling in one arm. Cervical myelopathy involves the cord, which means it can affect your entire body below the area of compression.

Common symptoms include:

• Weakness, clumsiness, or numbness in the hands and fingers
• Difficulty with fine motor tasks like buttoning a shirt or writing
• Weakness in the legs and balance problems
• A heavy, stiff feeling in the arms or legs
• Bladder or bowel difficulties (in the most serious cases)

How Does Cervical Myelopathy Happen and How Is It Treated?

Cervical myelopathy tends to develop gradually, which is one reason why workers often dismiss early symptoms as normal aches, aging, or fatigue. By the time the diagnosis is made, the spinal cord may have been under pressure for months or years.

Mild cases may initially be managed with activity restrictions, physical therapy, and close monitoring. However, because compression of the spinal cord carries a risk of permanent neurological damage, most cases of cervical myelopathy are treated surgically.

The two most common procedures are anterior cervical discectomy and fusion (ACDF) and posterior laminectomy. With ACDF surgery, the doctor reaches the spine from the front of the next, removes the disc or bone material that is compressing the cord, and fuses the vertebrae together. With posterior laminectomy surgery, the doctor approaches the spine from the back of the next and widens the spinal canal to relieve pressure.

Recovery from either surgery can take months, and some patients require ongoing physical therapy or they live with lasting neurological limitations even after a successful surgery.

Cervical myelopathy can have a natural degenerative component (due to aging), but workplace activities can accelerate it, aggravate a pre-existing condition, or directly cause the trauma that triggers symptoms. Under Illinois workers’ compensation law, aggravation of a pre-existing condition is fully covered. Even if you had some arthritis in your neck, for example, your medical bills and time off of work should be compensated. You should pay nothing out of pocket for your medical care.

Illinois Workers Compensation Laws For Neck Injuries

You can injure your neck on any job of course, but some are more common than others. Jobs that carry an elevated risk of developing cervical myelopathy include:

• Construction and heavy labor: repeated overhead work, carrying heavy loads on the shoulders, and vibration from tools all place chronic stress on the cervical spine
• Warehouse and manufacturing work: frequent lifting, bending, and awkward neck postures over a long career
• Truck and equipment operators: sustained whole-body vibration and prolonged fixed-neck driving positions
• Healthcare workers: patient handling, repositioning, and transferring puts significant force through the neck and upper back
• Overhead trades: electricians, painters, drywall installers, and HVAC technicians who work with their necks extended for long periods

Because of the big costs associated with the medical care and lost wages in a cervical myelopathy case (and because they care most about their bottom line), insurance companies often argue that cervical myelopathy is purely degenerative (a result of aging) and has nothing to do with work. They have doctors who will say exactly that. Winning a workers’ compensation claim for cervical myelopathy requires strong medical evidence linking the job activities to the development or worsening of the condition, as well as an attorney who knows how to handle the insurance company’s tactics.

You can not hire an inexperienced work comp attorney or one that has not handled at least dozens of similar cases. This is such a serious injury that it requires getting the best Illinois work comp attorney you can find. We have helped injured workers since 1997 and have a state wide network of top attorneys with similar backgrounds of success. In other words, we can help you anywhere in Illinois.

Every case is different, but having the right lawyer for a case like this can literally be the difference of hundreds of thousands of dollars as well as getting you the care that you are entitled to and need to make your injury better.

If you’ve been diagnosed with cervical myelopathy and believe your work contributed to it, contact us and we can connect you with an experienced Illinois workers’ compensation attorney who has successfully handled cervical myelopathy claims. They will put your interests first and only get paid if they get a settlement for you. Call us at 312-346-5578 or fill out our contact form any time for a FREE, confidential case review.

“I Need A Doctor Who Takes Workers Compensation Cases”

By Mike Helfand on Posted in Benefits

We have helped tens of thousands of injured workers since 1997. If you would like a FREE case review, please contact us any time at 888-705-1766.

An injured worker started a live chat with us and the first thing that they said is that they need to find a doctor who takes workers’ compensation cases. While that is not a common problem, it does come up from time to time.

Some things you should know:

  • Under Illinois law, you not having health insurance does not matter if it’s a work related injury.
  • There is no “in network” when it comes to work comp medical care. You can see any qualified doctor.
  • Most doctors will take work comp cases because they know they will get paid. Some do not because they think they will have to testify in litigation which is almost always not the case, especially if they are not orthopedic doctors.

The mistake this injured worker made is she did not seek out our help until six weeks after her accident. She said that she had been asking her boss who she can see and also the insurance company and everyone is making her wait.

Under Illinois work comp law, you do not need to wait for approval and should not wait. You should get to a doctor ASAP. Worst case scenario is you go to the emergency room and get a doctor recommendation from there.

We, as lawyers, of course know tons of doctors that handle work injury cases and do a great job taking care of their patients. We are happy to recommend a doctor to you if needed. What we will not do is insist that you see a certain doctor or recommend a doctor because they send us their patients. A lot of attorneys do this, and in my opinion, this is a huge and I mean HUGE red flag. If a lawyer is really pushing you to use a certain medical group, in my experience, there is something in it for them.

You also want to avoid a doctor that the insurance company sets you up with. If they are choosing them, it is often because they have a relationship with them and the doctor will look out for the interests of the insurance company. The same is true with company clinics. It is OK to go there right after you get hurt, but it should not be your primary source of treatment if your injury is something that needs more than a one time visit.

So while there is a lot to worry about, finding a good doctor should not be one of those things. We can help with that just like we can help with any other aspect of your case.

If you would like a FREE, confidential case review, please reach out any time. We will give you the same guidance that we would give to a friend or family member and will do whatever we can to protect you.

Death On The Job, When Do Benefits Start?

By Mike Helfand on Posted in Benefits

I can not even imagine the horror of a spouse or parent going off to work as healthy as can be and then having an unexpected death. Sadly, it happens a lot in Illinois. In the last year alone we have been consulted on cases where people have died on the job from gun shots, car accidents, being crushed by a machine, heart attacks while lifting heavy material, truck crashes and assaults.

While it is little consolation, Illinois workers’ compensation law provides very strong benefits. This includes:

  • Funeral payments up to $10,000
  • Payment of all medical bills related to the accident
  • Payment of 2/3 of the decedents average weekly wage for up to 25 years or $500,000, whichever is greater

Obviously the last benefit is the most important one and it is available to spouses, minor children or others who were financially dependent on the person who died.

A question we have received multiple times is when should these benefits start? The answer is immediately.

Unless there is some real dispute as to whether or not the death is work related, payments should start right away. If your spouse is killed as a passenger in a car crash on the way to visit a client, there should be no dispute. If they died of a heart attack, it might be reasonable to investigate what they were doing when that happened. You have to prove the job activities increased the risk of the heart attack happening.

The reality is that insurance companies are ruthless and make money by not giving it away or paying when they are supposed to. So even in situations that seem obvious, they will claim to be conducting an investigation when in reality they hope that you will just give up or some miracle evidence will occur. That is true even in obvious cases like dying in a car accident on the way to visit a client.

The only possible defense to a car accident death on the job would be if you were driving inebriated or recklessly. Those facts are usually readily available, but we have seen insurance companies take months to “investigate” what happened.

Or in another situation we consulted on, a worker was shot and killed while being robbed at gun point. When the victim’s spouse called us it had already been four months since the death and no benefits had been provided. That is shocking, disturbing and simply gross.

Insurance companies have the right to withhold payments when there are legitimate questions or disputes. In most death on the job cases in Illinois, there is no dispute. That does not stop some insurance companies from violating the law.

When this happens, the only option is to hire an attorney who can file a motion for benefits to be approved as well as penalties and fees for an unreasonable delay. Some people do not want to do that because they will then have to pay the lawyer 20% of what is recovered. The good news on that is that in cases like this, attorney fees would be capped.

Beyond that, if you hire a lawyer right away after the death just to make sure nothing goes wrong, attorney fees are limited to $100 if there is no actual dispute at all. We have helped multiple families over the year this way and it is our pleasure to take no fee when we simply act as a security blanket in case the insurance company does something wrong.

If you have any questions about this or would like help with a case, call us at 312-346-5578 for a FREE, no commitment call with a lawyer. We help all over Illinois.

Estimate Of What My Illinois Work Comp Case Is Worth

By Mike Helfand on Posted in Benefits

We are experienced Illinois workers compensation attorneys who will talk to you for FREE. Please contact us any time for a free case review with a friendly lawyer.

By far the number one question we get from people is “what is my case worth?” If you have been injured on the job in Illinois, that is a reasonable question. Depending on when you were hurt and where you are in your medical care, the answer will be one of two things:

  1. It’s too soon to accurately tell.
  2. We can tell you, but we need to see your medical records and discuss the case facts.

For active clients, an Illinois work comp attorney will of course have the medical records and know the case facts. When people call us out of the blue, we do not have that.

One recent called did not want an answer to what his case was worth. He just wanted an estimate. “I’m not going to hold you to it, I just want an idea as to what I will get some day.”

Fair enough. I then went through my usual spiel and told him I needed some information to determine what his case might be worth:

  1. When were you hurt?
  2. How?
  3. When did you first go to the doctor?
  4. When did you report it to your employer?
  5. How much money were you earning when you got hurt?
  6. Did you have any other jobs?
  7. Had you treated for similar injuries in the past?
  8. If so what was that treatment?
  9. What medical care did you have for this injury?
  10. What recovery did you make?
  11. Are you back to the old job?
  12. Any permanent restrictions?
  13. Has any part of your case been denied, if so, why?
  14. Are you owed back pay for TTD?
  15. Are all of your medical bills paid?
  16. Do you need any future medical care?
  17. How old are you?
  18. How have you felt since you went back to work?
  19. Was vocational rehabilitation needed?
  20. Do you have other health issues?

Those are the questions I would typically ask. If that seems like a lot, it’s because it is. This is what legal work involves and how we earn our 20% fee when we represent someone. If you skip these steps, you could lose out on a ton of money. And even with this, we might not know what defenses the insurance company has that could affect settlement negotiations. This could be things like surveillance, you not listening to your doctor, a gap in treatment or a whole list of other things.

This caller unfortunately could not give as detailed of a history as we would want with his medical care and I said I would need to see the medical records to give an accurate estimate. That was not an answer he liked and he made clear I would never see them.

As an aside, anything we discuss or learn about your case is confidential. We take that very seriously. This includes keeping medical information between us, you and any other lawyer who works on the case. That’s it.

The reality is that in most cases people ask us too soon what their case is worth. If you do not know your ultimate recovery, it’s all just a guess. This person had a shattered elbow. Based on the limited information I got from him, an estimate would have been between $35,000 and $250,000. That is such a wide range that it is meaningless.

The only way to get a real accurate estimate is to be back to be done with your medical care and able to work or know that you can work within certain restrictions. Without that, a lawyer is just making it up.

Delivery Drivers and Illinois Workers’ Compensation

By Mike Helfand on Posted in Injuries

Being a delivery driver involves fast-paced, physical work that takes a toll on the body. It also comes with risks out on the road. If you’re a delivery driver (whether you drive for a courier company, a retailer/e-tailer, a restaurant, or a third-party delivery service) who has been hurt on the job in Illinois, contact us for free advice and a referral to an attorney who is experienced in getting delivery drivers the workers compensation benefits they deserve.

The work of a delivery driver demands long hours behind the wheel, repetitive lifting and carrying, tight deadlines, and exposure to changing road and weather conditions. Some aspects of the job that may lead to injuries include:

Vehicle accidents. Driving is the core part of the job, which means delivery drivers face risk of collisions from other drivers, bad weather, and long hours on the road. Accidents while driving a route, heading to a pickup, or returning to a depot or warehouse during work hours are covered under Illinois workers’ compensation.

Lifting and carrying packages. Boxes, furniture, appliances, and stacked deliveries are often heavy, bulky, or awkwardly shaped, making it difficult to lift with proper form, especially when working quickly to stay on schedule.

Repetitive trauma. Repeatedly climbing in and out of a van, truck, or car, sometimes hundreds of times a shift, puts stress on the knees, hips, and lower back. Constantly reaching, lifting, bending, twisting, and carrying packages, day after day, can wear down the back, shoulders, and knees.

Slip and fall hazards. Icy steps, wet pavement, uneven driveways, and poorly maintained walkways at delivery stops put drivers at risk of falls, particularly when carrying packages that block their view of the ground.

Dog attacks and problems with other animals. Drivers making stops at homes and businesses are sometimes confronted by aggressive animals, leading to bites or other injuries.

Extreme weather exposure. Drivers working through summer heat or winter cold and snow (clearly this applies to drivers in Illinois) face risks ranging from heat exhaustion to frostbite, plus higher odds of weather-related accidents.

Considering these job hazards, certain injuries show up quite frequently in delivery drivers’ workers’ compensation claims:

• Lower back strains, sprains, and herniated discs
• Knee injuries
• Shoulder and rotator cuff injuries
• Neck injuries
• Fractures and broken bones
• Cuts and lacerations
• Dog bites and animal-related injuries
• Concussions and head injuries
• Sprained or fractured ankles and wrists
• Nerve entrapment conditions
• Heat exhaustion and cold-related injuries
• Whiplash and soft tissue damage

Some of these injuries happen suddenly, in a single accident like a truck accident or a fall. Others, like nerve damage or chronic back and shoulder problems, develop gradually after months or years of repetitive lifting and strain. Illinois workers’ compensation law covers both types of injuries.

Depending on the injury, your medical care may last for weeks or months and prevent you from working during that time. Unfortunately, your employer and their insurance company are not looking out for your best interest. They are looking at their bottom line. Sometimes they argue that a delivery driver wasn’t “on the clock” at the time of the injury. Or that a repetitive motion injury was caused by the person’s activities outside of work. They may send you to their company doctor who might downplay your injuries.

These are just some of the reasons why getting an attorney to look out for you is the smart thing to do. We have represented hundreds of delivery drivers and know the ins and outs of the industry and how to protect you. This includes many cases against UPS, FedEx, DHL, Amazon and other companies. Our state wide network of experienced lawyers gives you the best chance of success and allows you to focus on your recovery. We deal with the insurance company.

If you would like a free, no commitment case review with an attorney, please contact us any time at 312-346-5578. We help everywhere in Illinois and will do whatever we can to help you.

How Long Until The First Work Comp Check Arrives?

By Mike Helfand on Posted in Benefits

If you have never been hurt on the job before and suddenly can not work due to injury, you will likely have a lot questions. Among those can be:

  • How will I pay for my medical care? Under Illinois workers’ compensation law, all of your related medical care is paid for. You do not need health insurance.
  • What is my case worth? It’s too soon to tell and will depend on your recovery and treatment.
  • Is it OK to give the insurance company a recorded statement? We strongly recommend that you do not.

And a lot of people want to know when their first check is going to arrive.

This is a sensible question for a lot of reasons. You will not be getting your regular paycheck, so you need to know when you are going to receive money so you can plan your life. If you live paycheck to paycheck, it is especially important. There are bills to pay and if you go without the money you are entitled to, you could end up homeless, get sued for debts, etc.

Generally speaking, your first check should arrive within two weeks of when you went off of work. The key point is that it must be a doctor who takes you off work, your employer can’t accommodate restrictions if you have any and the insurance company needs to receive a copy of that doctor’s note.

Unfortunately this timeline is not always followed. Just the other day I was called by an injured worker who tore his ACL six weeks ago and still has not been paid.

Why Do Work Comp Insurance Companies Delay Payments?

There can be a variety of reasons why your first TTD check (lost time payment check or temporary total disability) does not arrive in a timely manner. This includes:

  1. There are legitimate questions if you were hurt at work. If your initial statement to your doctor was that you were hurt at home, your case will be denied. If a co-worker or your boss says that you got hurt outside of the job or were drunk, your case will be denied. That does not mean that you will not win your case, but that there is work to be done.
  2. There are legitimate questions as to if your case is covered under the Illinois Workers’ Compensation Act. This can include unexplained falls, injuries traveling to work, fights where you are the aggressor, some mental stress cases and many other reasons. Often an insurance company will say you do not have a case under Illinois law. Do not believe them. Always verify with an experienced Illinois workers’ compensation lawyer.
  3. The insurance company is disorganized and not worried about paying you in a timely manner or have their own policy of waiting just a little bit longer. That sounds nuts, but it happens. When you get hurt, your case gets assigned to a claims adjuster. It won’t get paid until he/she enters it into their system and requests a check. Some of these people are very lazy. Some are cruel. Some quit and you then are waiting on a new adjuster to pick up their caseload and review all of your files. Sometimes that process takes weeks or months. There is a solution to this which I will shortly discuss.
  4. The insurance company is trying to frustrate you. There are some insurance companies that act as third party administrators or TPA’s for big companies. Those big companies are self insured and hire TPA’s like Sedgwick, Gallagher Bassett and others to handle their Illinois work comp cases for them. There is pressure to keep those costs down, otherwise they could lose that big, lucrative business. So in some cases, insurance companies as a strategy will just not pay without reason. Their hope is to frustrate you enough that you will give up.

The solution to all of these delay issues is to formally file a case with the Illinois Workers’ Compensation Commission. This is the first thing an attorney does when you hire them. What this does is put pressure on the insurance company to respond. It also gives you and your lawyer the ability to force action.

We do this by filing what is called a 19(b) petition for immediate hearing and sometimes by filing for penalties and fees against them for an unreasonable delay. What this does is get your case before an Arbitrator and requires the insurance company to disclose the reason why benefits have not been paid. While every case is different, often just filing this motion will get you paid both retroactively and going forward.

It’s not a lawsuit, but it is you and your lawyer going on the offensive to make sure that the law is followed. When people say they want an attorney who is aggressive or who will look out for them, this is the text book example of that.

We have helped tens of thousands of injured Illinois workers and would love to help you. Please contact us any time to speak with a lawyer and get a free case review. We will do whatever we can to help you.

Nerve Entrapment Syndrome and Illinois Workers Compensation

By Mike Helfand on Posted in Injuries

Nerve entrapment syndrome (also called a “pinched nerve” or “compressed nerve”) happens when a nerve is squeezed, pinched or stretched. This pressure interferes with the nerve’s ability to send proper signals, causing symptoms like numbness or tingling (like the body part has “fallen asleep”); burning pain; sharp, shooting pain; and muscle weakness.

If you’ve developed some of these symptoms in your hands, arms, or legs after years of physical work, you may be dealing with nerve entrapment syndrome. You likely also have a legitimate workers compensation claim, and we can connect help you with your case via our state wide network of experienced lawyers. Contact us any time for a FREE case review.

There are various types of nerve entrapment syndrome, and they vary based on the nerve affected and where the nerve is located. Some common ones include:

  • Sciatica is the compression of the sciatic nerve or nerve roots in the lower back or glutes.
  • Tarsal Tunnel Syndrome is the compression of the tibial nerve in the ankle leading to feet and/or heel pain.
  • Cubital Tunnel Syndrome is the compression of the ulnar nerve at the elbow and causes funny bone pain and numbness in the fingers.
  • Carpal Tunnel Syndrome is the compression of the median nerve in the wrist and causes finger numbness and grip weakness.

These of course are not the only kind of nerve entrapment problems. And in helping injured workers since 1997, we have seen injuries with nerve entrapment to pretty much every body part.

Developing Nerve Entrapment on the Job

Nerve entrapment is frequently a part of a work-related injury. It typically develops slowly over months or years, and many workers don’t always make the connection between their work activities and nerve entrapment. Here are some of the causes:

Repetitive movements. Assembly line workers, meatpackers, cashiers, and machine operators perform the same motions thousands of times a day, placing constant stress on the same nerves.

Vibrating tools. Construction workers and mechanics who regularly use power tools, jackhammers, or heavy machinery are vulnerable to nerve compression.

Sustained gripping or pinching. Jobs requiring workers to grip tools tightly for long periods put ongoing pressure on nerves.

Awkward or prolonged postures. Bending body parts frequently or holding a position for extended periods can gradually compress a nerve.

Treating Nerve Entrapment

Treatment depends on how severe the compression is. Mild to moderate cases usually begin with splinting or bracing the affected joint, especially at night. Steroid injections or anti-inflammatory medication are common, as is physical therapy or occupational therapy. In severe cases, or if conservative treatment doesn’t work well enough, surgery may be needed.

With conservative care, activity modification and work restrictions may be necessary at work. With surgery, recovery can take weeks or months, requiring time off of work and ongoing rehab.

Workers Compensation Claims For Nerve Entrapment

Nerve entrapment cases are serious injuries. You are generally entitled to two things under the Illinois Workers’ Compensation Act:

  1. 100% of your medical bills paid for. You do not need health insurance and should pay nothing out of pocket.
  2. Payment for your time off work. This is called TTD which is 2/3 of your average weekly wage, tax free.

While those benefits are mandatory, a settlement is not, but you can get one by formally filing your case with the Illinois Workers’ Compensation Commission. This is where an attorney comes in. What your case is worth will depend on a variety of factors including your wages, the treatment you get and your recovery.

Even when it seems like the insurance company is doing everything right, they are looking for ways to end or minimize your benefits. They do this through things like:

  • Nurse case managers who interfere with your care
  • Independent medical exams (IME) with hired gun doctors
  • Recorded statements which you do not have to give
  • Trying to access medical records they have no right to possess
  • Surveillance

Hiring an Illinois workers compensation attorney who has deep experience in nerve entrapment cases is critical. You need to be prepared for these insurance company tactics and prevent them from happening when possible.

A skilled Illinois workers’ compensation attorney will use evidence to establish the link between your injury and your work. Insurance companies often argue that nerve entrapment is a pre-existing condition unrelated to the job. The attorney will also help ensure that you’re getting the right medical care and that you’re being seen by qualified specialists.

The very first step, though, is to reach out to us. Call us at 312-345-5578. We have helped tens of thousands of injured workers and would love to help you. We promise to give you the same guidance we would to a family member or friend.

LexBlog