Don’t Wait For Someone To Rescue You

By Mike Helfand on Posted in Benefits

One of the guiding principles of my law firm and this blog, as well as any call I have with an injured worker, is to remember that you can’t be expected to be knowledgeable about Illinois work injuries. For most people I talk to, they have very minimal, if any, experience with the Illinois Workers’ Compensation Commission.

For some people, this lack of experience isn’t a big deal because they are smart enough to get an attorney in their corner who knows what they are doing. Others seek out information pro-actively. But some people make mistakes that doom their case.

This was the situation with a nice woman I talked to. She was looking for representation three years after a shoulder and neck injury happened. She said that she hasn’t worked since. When I asked her what medical care she’d had, she said she saw her primary doctor who prescribed her some opioids and ordered some physical therapy. She hasn’t had any treatment beyond drug renewal check-ins for two and half years.

I asked her why she never saw an orthopedic doctor or got additional therapy or medical care. She told me that she’d been waiting on her employer and insurance company to give her a doctor and that when they never did she assumed she wasn’t able to get one. That’s unfortunately very far from the truth.

Now we are three years later and there’s no logical way for us to argue that any pain she’s having is due to a work injury. That’s because there is a HUGE gap in her medical care.

In life, not just a work comp case, you have to be your biggest fan. You have to look out for you more than anyone else does. You definitely can’t wait for someone else to come and rescue you, especially if they have a competing interest like an insurance company or employer does.

It’s a very sad situation she’s gotten herself in to. Like anyone else that calls me, I don’t blame her for not knowing the law. But some part of you has to take responsibility for getting help or finding out answers. I hate going to the doctor and don’t even like talking to other attorneys when it’s not part of my job. But if you are injured, you are risking your health and life if you don’t get help.

Now she’s hoping to get social security, has been without pay for three years, is in terrible pain and may lose her house. If she had come to us within a month or even two after her accident, it’s likely none of those bad things would have happened. It’s a really sad and unfortunate situation.

Happy Thanksgiving! We Are Open If You Need Us

By Mike Helfand on Posted in Uncategorized

Short post today. Happy Thanksgiving! I’m on track to talk to around 1,500 injured workers this year. I’ve met a lot of great people, and I’m thankful for you all.

While nobody is in our office today, we have a 24/7 answering service. So if you call us at 312-346-5578 and leave a message, you’ll likely hear back from an attorney within 10 minutes or less. That’s how it is every day of the year. Or feel free to click on our live chat feature.

And if you are reading this not on Thanksgiving, know that it’s the same way every day of the year.

Should I Get An Illinois Work Comp Lawyer?

By Mike Helfand on Posted in Tips if Injured

Because we are experienced Illinois workers compensation lawyers and because we have a state wide network of great attorneys, people come to us for all sorts of questions. One of the big ones isn’t just, “Who should I hire?” but also, “Should I get a work comp attorney at all?”

The God’s honest truth is that in almost every case, the insurance company is looking for a way to terminate your benefits if they can. This can be done in a variety of ways. They use recorded statements, nurse case managers, IME’s, surveillance and other tactics. They might be nice, they might be mean, they might be neutral in how they treat you. But make no mistake, the goal is to limit what they pay you.

If you get hurt at work and just have an ER visit and a few days off, you likely don’t need a lawyer. There’s not much we can do for you, but we are happy to give a free consultation and offer advice.

On the other hand, if you have an injury that is more than a contusion or minor soft tissue injury, it’s worth at least having a conversation with a lawyer. For example, the other day we talked to a southern Illinois injured worker who tripped on the job. He has a back injury and his doctor has him out for a month. Work comp won’t return his calls. It might be a big case, it might be a small one, but he needed to understand his rights.

The bigger the injury and the longer the case is going to drag on, the more important it becomes in my opinion to have an attorney. Even if we don’t have to go to court right away, you need an attorney to make sure things don’t happen that shouldn’t like recorded statements or the nurse manager talking to your doctor.

And if things to go bad, having a case on file can help you solve the problem sooner. So if your doctor says you need surgery and the IME doctor says you are fine and can go back to work, your case likely needs to go to Arbitration. If you have a case on file already with a lawyer, that will allow you to get into court faster. And priority for hearing cases is based on how old the case is. The older cases get preference. In other words, if you wait to file, you might delay your case by many months.

The biggest reason people don’t hire an Illinois work comp attorney is because they don’t want to give up 20% of a potential settlement. Few things about that. First off, the insurance company doesn’t have to make you an offer and often won’t if you haven’t officially filed a case with a lawyer. Second, if they do offer you something, it’s almost always more than 20% less than what a lawyer could get for you. And often they try to settle before you should (meaning you still need medical care or to prove you can do your job) or without things you are entitled to like future medical care in some cases. Finally, we’ve seen countless cases where not only you get more with a lawyer, but in some cases that amount is $100,000 higher or more.

The risk you run in not getting a lawyer is twofold. First, your case can get screwed up in ways that we could have prevented that you didn’t see coming. Second, if they make you a settlement offer and it’s low, it might be high enough that no attorney will take the case. I’ve seen a bunch of cases where a settlement offer was $50,000, we felt we could get them $70,000, but it’s not worth the time as we only get paid based on how much we increase the offer. So an injured worker gets stuck with a low amount and worse, they often have medical bills or lost time payments they are owed that the insurance company won’t compensate them for.

So the bottom line is that if you have an injury, it’s likely worth at least having a conversation. If you’d like a free, no commitment and confidential consult, call us any time at 312-346-5578.

Best Of The Illinois Workers’ Compensation Handbook

By Mike Helfand on Posted in Tips if Injured

The Illinois Workers’ Compensation Commission publishes a 25 page handbook. It’s a general guide that helps employees understand their rights if they get hurt at work. It has 11 sections, much of which is great information. Some of it is confusing and I’ve seen it cause some injured workers to make bad decisions. For today, let’s focus on the good. Here is one good tip from each section.

  1. Are workers’ compensation benefits taxable? No. Workers compensation benefits are not taxable under state or Federal law and need not be reported as income on tax returns.
  2. What are an employee’s options if the employer refuses to pay for workers’ compensation benefits? The employee or the employee’s attorney should contact the employer directly to determine why benefits are not being paid. Poor communication often causes delays and misunderstanding. If the employer still does not pay any benefits, the employee’s other option is to file a claim at the Commission. Please note that an accident report does not trigger any action by the Commission. The Commission becomes involved only if the employee files a claim and follows the procedures to request a hearing.
  3. Is there a filing fee for filing documents at the Commission? No. There are no fees for the forms or to file a claim.
  4. Does the employer have to pay the award for benefits while the appeal is pending? While an appeal is pending, the employer is not required to pay the benefits awarded by the arbitrator. If the case is ultimately resolved completely in the employee’s favor, interest will be added to the award, based on governmental bond rates at the time of the decision. There is also a 1% per month interest charge on medical bills, payable to the medical provider.
  5. Can the employee choose a doctor or hospital from which to receive treatment? Generally, the employee may choose the provider where he or she seeks treatment. However, there may be some limitations both on the number of providers seen by the employee or on which particular providers that an employee may choose. The employee must choose carefully so that he or she does not end up becoming personally responsible for medical bills. The employee’s choice of provider will be limited to a selected network of providers if an employer has established what is called a Preferred Provider Program or “PPP.” If there is a PPP, the employee has a choice of two physicians from the network within the PPP. If an employer does not have a PPP, then the employee has a choice of any two providers. This does not include referrals from those two providers. First aid and emergency care are not considered to be one of the employee’s two choices. Non-emergency care obtained before the employee reports the injury to the employer does not count as one of the two choices.
  6. How long can an employee receive TTD benefits? The employer pays TTD benefits to an injured employee until the employee has returned to work or has reached maximum medical improvement or “MMI.”
  7. What are temporary partial disability (TPD) benefits? TPD is the benefit that may be received during the period in which an injured employee is still healing and is working light duty, on a part-time or full-time basis, and earning less than he or she would earn in the pre-injury employment. The employer pays TPD benefits to an injured employee until the employee has returned to his or her regular job or has reached maximum medical improvement.
  8. What is vocational rehabilitation? Vocational rehabilitation includes but is not limited to counseling for job searches, supervising a job search program, and vocational retraining, including education at an accredited learning institution.
  9. Is an employee eligible for compensation for pain and suffering for a work-related injury? Employees are not compensated for past pain and suffering, only for the residual pain that is part of the permanent disability.
  10. Can an employee receive both PTD (permanent total disability) and Social Security? Yes, if the employee qualifies under the terms of each program. If an employee receives both benefits, the Social Security Administration will apply a formula that may result in a reduction in the Social Security benefit.
  11. What is the burial benefit? For injuries resulting in death that occurred before February 1, 2006, a benefit of $4,200 is provided to the survivor or the person paying for the burial. For injuries resulting in death occurring after February 1, 2006, the benefit is $8,000.

The biggest problem with this book is that it’s not well updated and isn’t always plain English. For example, the burial benefit is for people killed on the job. It means your family will be reimbursed $8,000 for burial costs. This rule was amended in 2006 which isn’t relevant to know anymore. It’s a good idea to have this book, but my take is that it’s not well executed.

All that said, if you have any questions about anything related to Illinois workers’ compensation law, please call us at 312-346-5578 for a free consultation with an attorney.

Travelers Is Driving Me Crazy!

By Mike Helfand on Posted in Tips if Injured

I got a call the other day from a really funny injured worker who was hesitant to get a lawyer involved. I asked him why he called after having been dealing with it on his own for the prior months, and he said:

“Travelers Insurance is driving me crazy!”

I laughed out loud. He had what should be a very straightforward Illinois work comp case, but they were nagging him about everything. They called before and after doctor’s appointments. They said they didn’t get copies of off-work slips or that they couldn’t read them. They asked for a recorded statement which he gave (bad idea) and then asked for another one apparently.

This isn’t an issue unique to Travelers of course. We see it with The Hartford, Zurich Insurance, Gallagher Bassett and all of the other ones. They are not in this to help you get better or make the process easy for you. Insurance companies make billions a year because they limit what they pay on good cases if they don’t just outright deny them for no reason.

Among many others, this is a top reason why getting an attorney makes so much sense for most injured workers. An experienced work comp lawyer knows how to deal with these insurance companies. It allows you to focus on your health and recovery. That doesn’t mean an insurance company will do things right just because we are on the case. But they know that we won’t allow them to get away with nonsense. They also know that we can file motions in court that can hold them accountable when they act badly. This can include petitions for penalties and fees.

Travelers didn’t get to be one of the biggest work comp insurance companies in the world (they might be the biggest) by paying out every claim they are supposed to. They didn’t get there by being buddies with every injured worker or making sure workers get healthy above all else. Same goes for all of these other insurance companies. Their job is to limit what they pay out on claims so they can make money. Period.

A good Illinois work comp firm can make sure you get the most out of a case. That doesn’t just mean getting you the most money possible for a settlement. It also means making sure the case goes smoothly in the months or years before your case is ready to settle. Our number one focus is your health. We want to make sure you get better and get all of the treatment you need in a timely manner. We also want to make sure that you get paid for your time off of work due to the injury. And again, we want to make sure that happens in a timely manner.

And when you are all better and your case issues have resolved, we of course do whatever we can to make sure that you get the best settlement possible. This includes payment for future medical care if needed. So the bottom line is you end up with more money in your pocket, the best medical outcome and way less stress. If Travelers or any other insurance company is going to drive someone crazy, it will be us, not you.

If you’d like a free consultation with an attorney for help anywhere in Illinois, please call us at 312-346-5578.

Work Comp When You Can’t Get Into A Doctor

By Mike Helfand on Posted in Benefits

I recently had a call with a Walmart worker in Illinois who told a nightmare story about their work injury. Sadly it’s a story we hear a lot with so many companies. Long story short is they had a knee injury a while back and couldn’t get in to see a doctor who could do a MRI for a few months. The end result is that they were walking around with a partially torn ACL. They needed to work so they had a brace on. I’m sure the delay in treatment made their condition much worse.

This is a common situation. So what do you do as an injured worker in Illinois if you get hurt on the job and your employer or their insurance company is delaying or denying your ability to get in to see a doctor?

The first thing to know is that you don’t have to wait on them to let you see a doctor. If you are hurt, go to a doctor. For most people that means go to the emergency room. If you have a back, neck, knee, arm, foot or hand injury, ask the ER for a referral to an orthopedic doctor. Go to that doctor and listen to what they have to say and recommend.

You can also see your family doctor and ask them for a referral to an orthopedic if needed. The key is to get timely medical treatment and report your work injury to your employer and the doctors you see.

When insurance companies and employers (usually very large companies) delay your medical care or deny it without reason, it’s often done as an actual business strategy. You see, the longer you take to go to a doctor, the easier it is for them to create a defense to your case. If you hurt your shoulder in January, but don’t see a doctor about it until May or get limited care, they will argue in court that you must have been hurt some other way. They will say that if you were really hurt, you would have gotten more medical care.

It seems absurd when they are the ones preventing you from getting the care you need. But sadly it works. So what do you do?

You take control over your life and your health. Go to a doctor of your own choosing. Someone independent who’s not a vendor of the company. A truly independent doctor will give you the best advice for your health. They don’t change their opinion of what care is needed based on whether or not you were hurt at work.

I do realize for some people this is easier said that done and that employers can be intimidating. That said, if you have a work related injury you don’t need health insurance to get into a doctor. Work comp pays for 100% of your reasonable medical care.

We can help you if you are having trouble getting medical care for a work related injury. We have a state wide network of experienced Illinois work comp attorneys and aren’t afraid to get involved against any company, big or small. Call us at 312-346-5578 for a free consultation.

Housekeeper Injuries And Illinois Workers’ Compensation

By Mike Helfand on Posted in Injuries

One really disgusting truth about Illinois workers’ compensation law is that employers and insurance companies often try to take advantage of injured workers who may be less educated or originally from another country. This is especially true with injuries to housekeepers, maids and other cleaning workers in hotels and motels.

These workers bust their butts. Many of them are immigrants and not all of them are paid well. A lot of them are fortunately union, but even those can get taken advantage of. With the push to get hotel guests to refuse service, many cleaning people get punished with less shifts.

This has many side effects including forcing some of the workers to have to do more than their fair share of the work. If only five workers are present and you need them to do the work of eight workers, this puts them at risk.

As a result we see a lot of housekeeper injuries including:

  • Back and shoulder injuries from lifting heavy objects.
  • Repetitive trauma injuries, often to the elbow or hands.
  • Slip and fall accidents. This often happens due to rude customers who leave a wet floor or other mess.
  • Exposure injuries or chemical reaction problems.
  • Injuries from assault and battery, often from spoiled or drunk guests. This includes sexual assault.

This is a limited list and really workers at hotels in Chicago and throughout the state can have just about any injury imaginable.

Some of these employers and insurance companies will make these workers feel like they don’t have the right to bring an Illinois workers’ compensation claim. That is simply not true. No matter your job, country of birth, or anything else, if you are an employee and get injured on the job, you are entitled to Illinois workers’ compensation benefits. That means all of your bills get paid, you get paid for your time off work and you are owed a settlement when you get better.

In the last 27 plus years we have helped over 100 workers from chains such as Hilton, Marriott, Hyatt, Four Seasons and others as well as housekeepers at smaller hotels/motels and even bed and breakfasts. We know how to protect you and make sure that you get the best result possible on your case. If needed, we have attorneys who can speak to you in Spanish or Polish as well.

If you’d like a free, confidential consultation, please call us any time at 312-346-5578.

IL Work Comp – If I Miss A Doctor’s Appointment Can They Cut Me Off?

By Mike Helfand on Posted in Benefits

Under Illinois workers’ compensation law, you as an injured worker are required to cooperate with reasonable medical care. That’s kind of a vague statement, but in general you are supposed to follow what the doctor recommends, although you can’t be forced to have surgery. If you don’t like what they have to say, you are entitled to a second opinion.

Part of cooperating means showing up to appointments. A recent caller to my office missed two physical therapy sessions and wanted to know could his work comp benefits get cut off because of that? I think this calls for a bigger blog post on what can happen if you miss a doctor’s appointment.

Generally speaking, you could be cut off for missing a doctor’s appointment or a PT session, but it’s really rare that a one time miss would cause a suspension of your benefits. So how many appointments can you miss? There’s no right answer, but the more you miss, the greater at risk you are. Insurance companies don’t like paying anything on your case and they certainly don’t want to pay for missed appointments. There’s also the issue that you not going causes the case to drag on longer.

So I’ve seen people cut off for as little as two missed appointments, but in my experience it’s usually somewhere between 3-6 where it becomes a problem. Missing a doctor’s appointment is worse than missing a PT session for sure. If the worker is represented, their lawyer will often get a call to find out what is going on, although it’s possible the benefits just get suspended. In my experience, if you have a good reason for missing you are less likely to be suspended. That would include being sick (COVID especially), having a funeral, car breaking down, etc. If you are going to miss, we highly recommend that you call the doctor ASAP to notify them.

The insurance company has a right to send you to an IME which is a one time doctor’s visit of their choosing. Even though a lot of these doctors are hired guns, you have to go to the exam if they provide you proper notice and travel expense. If you don’t, missing that one time exam will usually be enough to get your medical and TTD benefits cut off and they usually can get away with it.

So how do you get your benefits back if they get cut off for missing medical appointments? The answer is you show that you will be compliant. If you miss an IME, we try to get you in to the next open date. If you have missed some physical therapy or a doctor’s exam, we let them know why and make clear that it won’t happen again. They do have a motivation for you to get healthy, so often that’s enough.

But if you say you won’t miss any more and do without a valid reason, you are likely looking at a termination of your benefits that might hold up in court. In other words, you could have a great case otherwise and an Arbitrator won’t be sympathetic and will side with the insurance company. They may even say your case is over beyond getting a settlement.

The bottom line is that work comp in Illinois is the best healthcare you can get. There are no co-pays. No out of pocket expenses. You can typically pick your doctor. Don’t screw it up by not making your appointments. If you do have to miss one, let the doctor and your lawyer (or the insurance company if you don’t have a lawyer) know why ASAP and don’t make it a habit.

ComEd Workers’ Compensation Lawyers

By Mike Helfand on Posted in Tips if Injured

If you live in the northern part of Illinois, chances are you get your electricity through Commonwealth Edison, or ComEd for short. ComEd is the state’s largest electric utility. The company employs a significant number of people and is responsible for their safety while at work.

There are inherent risks when working for an electric company. When working in the field with electrical contacts, even the most careful workers who have been properly trained can experience an accident. Here are some of the common ones:

Electrocution. Both overhead and buried power lines pose a serious safety hazard due to the high voltage they carry. Direct contact to exposed energized conductors or circuit parts can cause death or serious bodily injury.

Falls. Linemen are at risk of falling when working on overhead lines. Equipment malfunctions or even being startled can cause a worker to fall from a ladder or aerial bucket. Fractured bones, concussions, and internal injuries often result from falls.

Electric Shock and Burns. A lineman who sets up power lines, maintains the existing ones, and responds to power outages during natural disasters is at risk for electric shock. Burns are the most common injury from electric shock. Thermal burns, flame burns and contact burns are three serious types that can cause permanent disabilities or even death.

Vehicular Accident. Time not spent working with power lines is often spent in a vehicle driving to and from work sites. Collisions can obviously cause a wide variety of injuries. If you are driving to/from a customer’s location, it’s likely a work comp case even if you are at fault for the accident.

Lifting Injuries. There are a lot of tools required to do the field jobs which often means carrying and/or lifting heavy equipment. We see a lot of back and shoulder injuries.

Slip And Falls. Part of being a field worker means going to new locations on a daily basis. Many of these places are littered with debris or have hidden defects. And in the winter there’s of course a lot of icy properties. So slip or trip and falls can happen and injuries can occur.

If you or someone you know has been seriously injured as an employee for ComEd, we can help. We have helped many workers and would be thrilled to help you. Call us at 312-346-5578 to speak with a lawyer for free.

When The Insurance Company Wants A Second IME

By Mike Helfand on Posted in Tips if Injured

Under Section 12 of the Illinois Workers’ Compensation Act, the employer/insurance company has a right to send you to a one time doctor’s visit of their choosing. This is called an independent medical exam or IME. These are quite often doctors who makes hundreds of thousands of dollars a year from seeing patients for what are usually five minute or less exams. They review your medical records and then write a report which commonly says whatever it is the insurance company wants them to say.

We know who the hired guns are and fortunately so do most Arbitrators. Not every IME doctor is a hired gun of course and sometimes they give an honest evaluation which agrees with your doctor. Other times there is literally no way they could say you don’t need a surgery or that your problems aren’t work related. That’s typically when you’ve gone through a lot of physical therapy and failed and/or your MRI shows a clear cut problem.

When this happens it pisses off insurance adjusters. Those companies don’t like to give money away. Usually they’ll just deal with it and approve your treatment. But every now and then they try to send you for a second IME. The question is, can they?

This case up with a recent caller. He had a back injury and his doctor wants to do surgery. The insurance company sent him to an IME with a neurologist who agreed with everything the treating doctor said. That should be that. But now the insurance company wants to have another shot at an IME saying that they should have had an orthopedic doctor look at it. Of course the one they picked is a well known hired gun who likely will say whatever the insurance company wants them to.

The caller wanted to know if they have to go to the IME. In this case I think it’s a BS second IME. That said, if he skips it, his benefits will get cut off, at least temporarily. When push comes to shove though I don’t think any Arbitrator would let them get away with it. So the worker is damned if he does, damned if he doesn’t, but I personally think the best course of action in this case is not to go.

The law basically is that they can have a second IME if the exam is addressing a new question. At times that can mean having a different type of doctor look at the case. If their first IME, the neurologist, had said that an orthopedic doctor is what is needed that would be one thing. That didn’t happen.

The common time when a second IME can happen is something like you had surgery after an IME and now six months later your doctor wants to do another one because you haven’t recovered. That’s a new issue. Or maybe they want to put in a spine stimulator. That’s also a new issue.

In this case though, the 2nd IME is just them trying to get another bite at the apple. They think they can push this worker around because he’s not represented. In a way they are right. If you don’t have a case filed with the Illinois Workers’ Compensation Commission, you don’t have any remedies when they break the law. The good news is that it’s an easy problem for a lawyer to solve.

In general, if an insurance company is seeking a second IME, it’s a clear cut sign they are trying to do whatever they can to end your right to benefits. That’s their goal in almost every case, but this is a hyper aggressive way to do it. It’s also a sign you have a serious injury and a lot on the line, so not hiring an attorney would be a huge mistake.

LexBlog