Jewel Food Stores Get Hit With Over $400,000 In Penalties and Fees!

By Mike Helfand on Posted in Benefits

We are experienced Chicago attorneys for workers’ compensation claims. If you would like our help, fill out our contact form or call us at 312-346-5578.

It’s very common that insurance companies deny all or part of your Illinois workers’ compensation benefits in bad faith .  It’s also somewhat common that attorneys file a motion for penalties and fees over that bad behavior.

What’s sadly less common is the lawyer for the injured worker following through on their motion by going to trial.  And when they do go to trial, Arbitrators don’t always order penalties and fees when they are appropriate and when they are do it doesn’t usually seem to be for a large amount.

Arbitrators can award penalties for disputes that are “unreasonable, vexatious and without merit.”  In doing so they can essentially fine the insurance company up to 50% of any unpaid medical bills, $30 a day for unpaid TTD benefits (up to $10,000) and order them to pay the attorney fees too.

In this Jewel case, a man died after a work related accident and according to the Arbitrator’s decision, there was not a shred of evidence to dispute that he was hurt at work.  Beyond that, the insurance company had a bunch of theories as to how he was hurt or what caused his death, but none of them were supported by actual medical evidence or testimony.  They had depositions taken of many medical providers and the Arbitrator noted that not only didn’t call the accident or death in to dispute, but bolstered the case of the injured worker and his family.

In this case, the injured worker hit his head and had major head trauma.  His medical bills were over $712,000 and there were unpaid permanent disability payments.  So the penalties were almost $350,000.00 in total and attorney’s fees were over $60,000, bringing the total punishment to over $400,000!!!

This is the only way insurance companies will stop acting in an unjust manner.  Yes the amount they would have to pay had they done the right thing was a large number, but that doesn’t give them the right to act in bad faith.  While I’m sure this case will be appealed and my guess is that the attorneys for Jewel will try to negotiate a lump sum settlement, there is a great lesson here on the value of getting an aggressive attorney who will fight for their client when it is called for.

Most cases don’t have that much in medical bills, but it’s not uncommon to have $100,000 in bills, especially if you have a serious surgery.  If there’s no reason for your benefits to be denied, penalties and fees are the correct strategy.

Can An Out Of State Lawyer Handle An IL Work Comp Case?

By Mike Helfand on Posted in Out of state

With Illinois being a boarder state to Missouri, Indiana, Iowa, Wisconsin and Kentucky and with lawyers loving to make money, there are a bunch of attorneys who are licensed in both Illinois and out of state who handle Illinois workers’ compensation cases.

So if they have a law license for IL they can handle a case, but the question is should they and what is in your best interests as an injured worker?

I bring this up because I was contacted by an Iowa man who was hurt in the eastern part of Illinois and hired an Iowa attorney who is licensed here.  There is no way that lawyer handles a lot of work comp cases in the part of IL where the claim is going to be heard, so his taking the case on is not in the best interests of the client.

On the flip side, there’s nothing wrong with a Quad Cities Iowa lawyer taking a case in Rock Island as long as they have the relevant work comp experience.  The same holds true for me with work comp attorneys in St. Louis who practice just over the boarder.  It’s so close to Illinois and there are enough cases that a MO attorney could have the right amount of experience with IL work comp that he/she wouldn’t be hurting the client.

On the flip side, while I almost never see an Indiana attorney trying to take a case in Illinois, the amount of travel they’d have to do to get to court, along with the fact that Indiana work comp is so bad that they probably don’t do enough of it to make work comp their sole focus, leads me to believe that if you hire an IN attorney for an IL case you are likely making a huge mistake.

It kind of works the same way for Wisconsin because there aren’t major cities on the boarder towns.  That means that it’s more likely that an out of state attorney would only dabble in work comp which is not what you want.

The bottom line is that an out of state attorney can take a case here, but unless they are close to where the case is going to be heard and more importantly have a ton of experience with Illinois cases and are up to date on IL laws, they aren’t the right choice for you.  As soon as an insurance adjuster or defense attorney sees an out of state lawyer it raises a red flag for them and if they think they can use this to their advantage, they will even when they aren’t in the right.

Burn Injuries On The Job In Illinois

By Mike Helfand on Posted in Injuries

Many Illinois work comp cases are denied without reason. They will say you have a pre-existing condition or that you were hurt away from the job.  One of the hardest cases for an insurance company to deny is a burn injury.

The reason it’s hard for them to deny these cases is that a burn injury at work doesn’t happen anonymously.  Unlike a back strain that you can try to work through, if you get scalded with hot grease or burned with oil you are going to notice right away as will everyone around you. How severe a burn is depends on the heat as well as the time your skin is exposed to it.

The reason for a lawyer in a case like this is that while the insurance company won’t deny you were hurt at work, they will try to fight you on two things.

The first thing they will fight you on is medical treatment. Not the initial care, but if you have a more severe, partial thickness burn, they will often argue against follow up medical procedures.  Those burns are a big deal because they exist below the skin and can cause damage to nerve endings and blood vessels.  It’s a big deal if you can’t get the treatment that you need because it will increase your risk of infection.  More severe, full thickness burns, also known as third degree burns, can only be repaired with skin grafts harvested from other parts of your body.  A delay in this care can have severe, long term consequences, but because the treatment is expensive insurance companies often fight them.

The second area insurance companies try to screw you over on with a burn injury is the settlement value.  If it’s a surface level scar, they will low ball you.  If the scar is keloid or on your face, they will try to minimize what it’s actually worth.  For second and third degree burns, they will offer to pay you for the scar, but not for the damage to nerves or from having to have a skin graft.  And if you are really deformed from a burn and need psychological therapy as a result, you can bet they won’t want to compensate you for that.

The good news, if there is any, is that these cases are winnable with the right attorney.  You need someone in your corner who understands the medicine behind severe burns, knows how to properly value scar cases for the most money, and cares about their clients.

We, via our state-wide network, have helped hundreds of people with burns from work accidents and would be thrilled to help you. If you would like a free consultation, click on our contact form, start a chat or call us at 312-346-5578 any time.

When Your Illinois Work Comp Case Is Denied

By Mike Helfand on Posted in Tips if Injured

Here is a fairly common scenario:

You are at work and lift something.  You feel a pain in your back like you’ve never felt before.  You report it immediately to your supervisor and try to treat the problem with rest and pain pills.  Five days later it’s not better, it’s getting worse and you go to a doctor.  Your employer files the claim with their insurance company and an adjuster calls you and asks a bunch of questions. A couple weeks go by, you haven’t heard anything and then you get a letter in the mail from the adjuster. It’s a form letter that says they’ve investigated your case and have determined that your injuries are not work related.  They do wish you the best though.

Illinois work injuries get denied all of the time. Sometimes it’s for legit reasons, but quite often it’s without reason or for bogus ones like the one described above.  Cases can get legally denied because evidence indicates you weren’t hurt at work.  They can get denied because a medical doctor says your problems aren’t work related or that you are better.  What can’t happen but does all  the time is an adjuster to say your case is denied without any real reason.

They do this in hope that you will just go away or use your group insurance.  So the question is, what do you do when your case is denied?

Whether the denial is valid (e.g. they sent you to an IME doctor who said you are fine) or not, the first step is that you have to formally file a case with a lawyer.  This gets your claim assigned to an Arbitrator which allows you to have a hearing over the dispute if one is needed.

When they deny you without a real reason, often filing the case and threatening to file for penalties for a bad faith denial is enough to get them to do the right thing. If not then your attorney needs to subpoena your medical records, potentially take a deposition of your treating doctor who can testify that your problems are work related and then you would go to trial.

So it’s really a two step approach, either your lawyer is aggressive and gets your benefits reinstated with a phone call or your lawyer is aggressive and gets the case ready for trial ASAP.

The problem comes in when your attorney isn’t aggressive or is lazy and doesn’t like taking cases to trial or when they will handle the case, but half-ass it and aren’t prepared.  That’s how winning cases end up as losers.

The bottom line is that if your case is denied, don’t panic.  The law protects Illinois workers with legitimate cases.  You just need someone who will advocate for you.  Often a denial gets turned around the moment someone good is on the case and in your corner.

Starting An IL Work Comp Case After You Are Fired

By Mike Helfand on Posted in Do I Have a Case?

The cleanest type of Illinois workers compensation case is when you are hurt in a clearly defined job activity, it’s witnessed, you don’t have drugs in your system, you get medical treatment right away, and you follow what your doctor recommends.  Not to say that type of scenario can’t result in a contested case (most likely via a hired gun IME doctor), but it would be hard to dispute at least that you were hurt on the job.

Not all cases are clean of course, and people don’t formally file them, or even seek medical treatment, for all sorts of reasons.

A recent caller to my office worked in a warehouse and had to do a lot of overhead lifting.  His shoulder began to hurt him and he let his supervisor know about it.  The supervisor said, “now is not a good time for a work accident” because they were in a busy season where they needed the warehouse workers to be available for overtime.  So the worker popped a lot of pills, worked the OT, felt more pain, took more pills, had more pain, noticed the pills weren’t working anymore and then saw his production slip.

As you can guess, because he wasn’t working efficiently they fired him.

He called me a week after he got terminated in a lot of pain and freaking out because he doesn’t have health insurance.   He had yet to go to the doctor.  I told him it’s a good news, bad news situation.

The good news is that he notified his supervisor that he was hurting while he was still on the job so they have proper notice of the problem. The other good news is that if it is a work related injury, he doesn’t need health insurance because it will be covered under their work comp insurance.

The bad news is that it looks suspicious any time someone files a claim after they get fired, especially if they haven’t gone to the doctor first.  It’s not a case you can’t win, but you can bet that it will be met with resistance and you would absolutely need a lawyer.

I advised him to get to the doctor ASAP. The longer you wait and still have problems the more likely their insurance company will argue that you must be hurt from someone else.  I get that he’s looking for a new job and has worries, but if he has a major injury (he suspects a torn rotator cuff) then he’d be in real trouble if it’s not a case.  Go to the doctor and be honest. In this case that means telling the doctor what your job details involved, how much you lifted and how often and what you noticed while working.  Then ask if the job contributed to the shoulder problems in any way.

He’d been off the job for a week. Winning a case based on treatment started today is harder than if he started a week ago.  If he waits one more week it will be way worse.  Nothing is more important than your health so even if you no longer work for the company, get to the doctor.  As far as the work comp case goes, it will be more difficult, but certainly not impossible and in a case like this where he reported it before he was terminated, was working long hours and had a job that would lead to that type of injury, I would be surprised if he didn’t win the case.

WWE Wrestlers Hurt In Illinois Should Get Workers’ Compensation Benefits

By Mike Helfand on Posted in Do I Have a Case?

Sunday night the John Oliver show had a feature on WWE wrestlers and how the company screws them over by calling them independent contractors and making them sign contracts that say they are not employees.

I chuckled watching this, not just because the show was funny, but because we’ve seen many other companies try to get away with this nonsense.

I can’t speak for other states, but in Illinois you can’t waive your rights to workers’ compensation benefits and just because you signed something that says you are an independent contractor doesn’t make it true.

Under Illinois workers’ compensation law, the test as to whether or not you are an employee comes down to how much control the employer has over you. Per John Oliver, WWE wrestlers sign contracts that say they work for the company exclusively.  The WWE controls the scripts, when they wrestle, how much they get paid, where to go and if you are hurt and can’t wrestle for six weeks or more they can terminate the agreement at any point.

Does that sound like The Rock or Steve Austin or Chicago’s own The Miz are independent contractors?  It doesn’t to me.  They certainly aren’t like the accountant you hire for your taxes or a plumber you call when you have a leak.

I looked up the WWE at the Illinois Workers’ Compensation Commission website and can’t find any evidence that they’ve had a work comp case filed against them. That’s probably because the wrestlers are scared to lose their jobs or simply don’t know their rights.  We’d love to bring a case for any pro wrestler who wants to challenge this law.  If they were signed by the WWE in Illinois or hurt while working in Illinois, they can bring a case here and I don’t see how they’d lose.

Pro wrestlers are no different, legally speaking, than actors in a play or pro athletes other than to this point they haven’t received work comp benefits, have a much higher death rate and get treated like garbage by their employer.  I was a huge wrestling fan as a kid and it disgusts me to see how wrestlers are treated today.  I would love the chance to challenge the system that has been holding them down illegally.

The Most Important Thing To Know About Illinois Vocational Rehabilitation

By Mike Helfand on Posted in Benefits

A reader of my blog was getting toward the end of his treatment.  The insurance company tried to low ball settle with him and he refused.  Then the insurance company told him, because he has permanent restrictions that can’t be accommodated by his old employer, that they wanted him to do vocational rehabilitation.

Briefly, under Illinois work comp law, vocational rehabilitation involves hiring a voc counselor who helps figure out what jobs you are qualified for based on your age, experience and injury, helps you conduct a job search and/or recommends training to get you in a position to start a new career.  The path taken varies on a case to case basis.

In this case, the insurance company had recommended a vocational counselor to the injured worker, which brings us to the most important thing about vocational rehabilitation if you are hurt on the job in Illinois:

Just like you get to pick your own doctor, you get to pick your own voc counselor too.  That doesn’t mean the insurance company can’t suggest someone, or ask you to meet with someone they’ve chosen, but it does mean that you need to look out for you, and make sure that the counselor you decide to work with isn’t some insurance company hired gun.

The only reason an insurance company would suggest or insist on a voc counselor for you is to try and save themselves some money. Because if you used to make $40 an hour, and now, due to your injury, your rehab person says you can only make minimum wage, that makes your case worth somewhere in the six figures.  On the other hand, if they get someone to testify that you can get a job making close to what your old wage is (when that’s not true), it will cut the value of your case in half or more.

For many workers it’s not obvious that they have this right and it’s even harder to know who to choose as there are not hundreds of choices like there are for doctors and the truth is that most of these people favor the insurance company so finding someone independent can be a challenge.  This is, of course, where a good attorney comes in.  If your lawyer doesn’t have experience in this type of situation it could really cost you.

And like in any case, if you have questions or need help, please do not hesitate to get in touch with us at any time.

 

How Gastrointestinal Issues and Anemia Were An IL Work Comp Case

By Mike Helfand on Posted in Injuries

Most Illinois work injuries happen to your back, arm, hands, legs, feet, head or neck.  But not every work accident fits nicely into a traditional box and just because it’s not typical, does not mean it’s not a case.

Under Illinois law, any injury that develops from a work related injury, is also a part of the case.  So if you hurt your knee and then get an elbow injury when using crutches, they have to cover the elbow too.  Or if you are prescribed a lot of medication, and it eats up your insides and causes a gastric injury, they have to pay for that treatment too.

That’s exactly what happened in a recent case.  A firefighter badly hurt his back when he fell 16 feet at work.  He was eventually placed on a lot of pain medications and ended up in the hospital with gastrointestinal bleeding and possible iron deficient anemia.

The insurance company, of course, disputed that his problems were related to the meds, but the Illinois Workers’ Compensation Commission found that based on the chain of events (e.g. no problems before this), the credible testimony of the injured worker and the medical records that these problems were a part of the work comp case.

A situation like this really does sum up what happens in a lot of Illinois work comp cases.  The insurance company is going to try and get out of paying for anything it thinks it can get away with not paying for.  To win a case, you need a good (not perfect) fact pattern, an honest worker and most importantly, medical records that support your position.

When you have these things it’s not a guaranteed win, but in my 21+ years of experience, I find that more often than not you will win.  In this case the insurance company was ordered to pay for all of the medical expenses related to the GI problems.  We’ve seen in other cases where injured workers become addicted to pain meds and their lawyers have been able to successfully argue that the work comp insurance should have to pay for rehab.

Bottom line is that if your problem stems from the work injury, it should probably be covered and in the very least needs to be talked about.

Slip And Falls In Parking Lots At Work In Illinois

By Mike Helfand on Posted in Uncategorized

It’s been a crazy, brutal winter in Chicago and for most of Illinois.  I would guess that it’s been a record for the number of calls and emails I’ve received about people who have slipped on ice at work and been injured.

If your job requires you to travel and you fall on ice, it’s a case.  If you work outside and fall on ice, or there is snow/ice on the company premises, it’s usually a case.  But a tougher case is when you fall when you are in a parking lot.

What makes these cases not black and white is the fact that often when you are in a parking lot you haven’t started your day of work or the day of work is finished.   In some cases, if the lot is open to the public, an injured worker would be out of luck.  This law has been clarified.

In a recent court case (Smith v. Manhattan Park District), the Illinois Appellate Court made clear what the law is.  In that case, a park district employee hurt her leg when she fell in the parking lot on ice at the end of her shift. It had snowed that day and there was a lot of ice on the ground.    The lot was owned and maintained by the employer and open to the general public.

The Court said that the fact the general public used the parking lot didn’t matter.  That was because the injury was caused by a hazardous condition on the employer’s property.  Since the employer maintains and provides its lot for employees to use, the hazardous condition makes it a compensable claim.

This is a game changer for injured workers in Illinois as previously the law was interpreted to mean that if the general public was equally exposed to the same risk, you couldn’t win.  I’ve gotten around 50 calls about these cases this winter and I’d bet there have been at least 500 or more injuries from parking lot falls at work in Illinois this winter.

It’s all the more reason to make sure the lawyer you are talking to focuses on work comp because if they aren’t up on the law they will give you the wrong answer and in some cases, like this one, the law one day is not the same the next day.

If you have any questions about this or anything else and want a free consultation, please get in touch with us.

 

Should Your Lawyer Take 20% Of Your TTD Benefits?

By Mike Helfand on Posted in Benefits

When you are hurt on the job in Illinois and hire an attorney, every lawyer uses the same attorney representation agreement.  Here is what it looks like.

Under Illinois law, attorney fees can not exceed 20% of what is recovered and for almost every case that means 20% of the eventual settlement they get you when you are all better.  But that contract does state that the lawyer can take 20% of “any compensation for temporary total disability (TTD) that the employer refused to pay in a timely manner or in the proper amount.”

So the question is, when can your work comp lawyer take a fee off of your weekly checks, and should they do this?

I bring this up because there is a scummy work comp law firm in Chicago that, from what I’ve been told, has been taking 20% of their client’s money any time benefits get cut off or are late and then get reinstated.  Technically under the Illinois Workers’ Compensation Act they can do this, but no lawyers I know or work with would ever take money from your check for getting benefits reinstated by filing a motion, writing a letter or making a phone call.

What this unethical law firm knows is that insurance companies cut off benefits without good cause all the time, or purposely will be late with them just to mess with you.  It’s the hope of the insurance companies that they will get away with it or make you settle, either before you should or for less than you should.  What ends up happening in most cases, is that a lawyer can solve the problem just by threatening a trial motion or making a phone call.

Those lawyer efforts usually take 1-3 hours of time.  We view that as part of the job and would never take part of your money for doing that.  We’ll get compensated in the end when we get a settlement.  This one Chicago firm reportedly views things differently and not only takes money from the back pay, but also from future pay.  That’s just wrong.

This is an issue that you should ask a lawyer about before hiring them and if they do this to you, you should fire them.  To me, the only time that a lawyer should take a percentage of your back benefits is if they have to go to trial – not just file a trial motion – as that requires a lot of work.  But even then, their fee should be on past, not future benefits.

I would not expect anyone to be thinking about this issue before they hire a lawyer and that’s why I’m writing about it.  Attorneys that do this stuff give the rest a bad name.

If you have any questions on lawyer fees or anything else and want to talk to an attorney for free, click the chat button, fill out the contact form or call us at 312-346-5578.  We help all over Illinois and will talk to you for free and in confidence.

LexBlog