IL Work Comp – “They are pressuring my doctor”

By Mike Helfand on Posted in Benefits

I recently had a chat with a nice woman who had gone through three leg surgeries after badly tearing her ACL on the job.  That’s a lot of leg surgeries.

She had no guidance when she got hurt and had never even heard of workers’ compensation. So after she got hurt when she got a call from an insurance adjuster who told her what doctor to go to for treatment, she thought that was normal and was just happy not to have to pay the bills.

Following the third surgery her doctor released her to light duty which really doesn’t exist on her job.  She contacted me because she’s a bit wiser on the process now and upset that “they are pressuring my doctor” to release her to full duty.

I explained to her that it’s against Illinois Workers’ Compensation Law for the insurance company to talk directly to the doctor about the case and treatment and certainly against the law to try and get them to modify work restrictions. She asked them about this before she called me and was told that since they chose the doctor they can talk to them.

In this case, the hired gun doctor became the treating physician. So even though the insurance company chose him and likes him, once he became the treating doctor (as opposed to an IME doc), they lose their rights to ask questions about medical care, make suggestions, demands or anything else. Once they are a treating physician it’s as if you chose them yourself.

These rules exist so insurance companies can’t pressure doctors in to doing things that are not in the best interests of their patients.  This woman could be at risk if she is forced to work in her full duty job.  She is only a couple of months from recent surgery and while she wants to get back and is expected to get back to full health, she’s not there now.

So don’t let anyone, except you, ever pressure your doctor. 

Bonus point for this post. While this woman seems to have lucked out with a good doctor. Almost every other time I’ve seen an insurance company try to tell you who you have to treat with, it’s worked out badly.  You don’t have to do that in Illinois. Sometimes they pick these doctors because they can pay them less.  Other times it’s because they can make the doctors say what they want them to say.  Whatever the reason, you can bet they aren’t picking them because it’s best for you and your health.

If you have any questions about any of this, fill out our contact form, start a chat or call us for free at 312-346-5578 and you will speak with a lawyer right away. We cover all of Illinois and have been helping people with work injuries since 1997.

Chicago Worker Falls Off A Truck And Gets $21 Million

By Mike Helfand on Posted in Injuries

Last month, a truck driver was awarded $21,600,000.00 in a lawsuit that stemmed from him falling off his truck, hitting his head and getting a traumatic brain injury (TBI).  How is this possible?

This case happened because it wasn’t just a workers’ compensation case and his lawyers did a great job of identifying that not only was the injury the result of a truck design error (the handle he held on to came loose causing the fall), but also that the company that made the truck was out of Chicago, allowing the lawsuit to be brought in Illinois instead of Texas where the juries are not as plaintiff friendly

We write on here all of the time about the danger of lazy lawyers. This is a classic example. It would have been so easy for some attorney to get the phone call on this case, assume it’s just a work injury and file that case only.  Under Illinois law, a case this serious would probably be worth less than a million dollars if it was just a work comp case.  Instead the case was worth 21 times that.

In general, you can not sue your employer for negligence so sadly many workers who are terribly injured don’t get the same type of compensation that this truck driver received.  But part of being a great lawyer, and you deserve to be represented by a great lawyer, is getting a law firm who will look at every possible possible angle to making a recovery.

We see this most with car accidents, but those are the obvious ones.  Good law firms look for the not-so-obvious situations.  If a worker says they fell off a truck, a bad lawyer will say “got it”, a great lawyer will probe further and focus on why you fell as what else was going on around you that could have contributed to the problem.  It may be nothing, but it also might be something huge.

The first attorney I ever worked for, gave a lesson on how to do this wrong. He specifically wrote up his contracts with his clients to state that he was not responsible for anything but the work comp case.  Essentially he was lazy and was writing in a clause to cover his butt for his laziness.  I learned from that more than 20 years ago that the much better approach is to look for everything.  That doesn’t mean we are experts in everything or responsible for everything, but it does mean we care about our clients and are fighters who do whatever we can to get the best result possible.

If you have questions about your case or anything else call us at 312-346-5578.  We cover all of Illinois and will always talk to you for free and in confidence.

Getting Second Opinion Approval, Illinois Workers Comp

By Mike Helfand on Posted in Tips if Injured

Per the Illinois Workers’ Compensation Act, you have the right to two medical opinions when it comes to your care.  As long as the medical care is “reasonable” the insurance company has to pay for it.

This comes up a lot from clients/callers who want to know how to get a second opinion and more specifically, how to make sure that bill gets paid.

The most recent call I had on this issue shows that some Illinois work comp insurance companies just play ridiculous games.  The caller had hurt his shoulder at work and had a recommendation for surgery.  He wasn’t sure if he wanted the surgery or if he wanted his doctor to do it, so he found a different orthopedic doctor and made an appointment.  He called the insurance adjuster as a courtesy and was told that he couldn’t get a second opinion because he hadn’t been on the job long enough to earn that right.

Uhm, that’s not how it works.  It was a completely illegal and shady thing for the insurance company to do, but fortunately an easy problem to solve.

Another caller in recent months wanted a similar second opinion, but was told by the insurance company that the IME doctor (who found that her problem was work related) was the second opinion and that no approval for another opinion would be given.  Again, that’s just not how this works. You get to choose two chains of referrals (unless your employer fits in to a very rare exception) and the IME is not one of them.

The one time when getting approval for a second opinion isn’t automatic is if your treating doctor says your problem is not work related. Essentially their opinion is held against you and getting a new doctor is usually seen as doctor shopping which hurts the credibility of the 2nd opinion doctor.  That doesn’t mean you can never get a second opinion but it does make it much harder.

Bottom line is that you shouldn’t get pushed around if you are hurt at work, especially when it comes to your medical care. If you don’t get better nothing else matters and you have a right to seek out the best care possible.  If you have questions or are having trouble getting medical care approved, please contact us any time for a free consultation.

What A Paralegal Should Do On An Illinois Work Comp Case

By Mike Helfand on Posted in Tips if Injured

After Thanksgiving last year we had a crazy snow storm and got 13 inches of snow in one day or as those of us who have lived most of our lives in Chicago call it, a Tuesday.

It was a mess for sure, but nothing you haven’t seen before. It was later that week when I got contacted by a pissed off injured worker.  His case was supposed to go to trial, but he received a call that due to the snow, the paralegal had lost power at his office and was not able to prepare for the trial.  As a result it would have to be postponed.

I had a two thoughts after I heard this.  First, it sounded like a made up excuse. Second and way more importantly, why should the availability of a paralegal impact your case in any way?!?!??

When you hire a law firm, you are hiring a lawyer.  They might have a paralegal or clerk or secretary that they rely on and those are important people to any successful law office.  Those people might communicate with you from time to time about your case (although I personally believe any relevant info should come from the lawyer, that’s why my direct line is on this site).  But when it comes to legal advice and preparing for trial is legal advice, it should all come from a lawyer.

A paralegal may have seen trials and they might even know some things, but they will not be asking questions at the trial, won’t be presenting motions, raising objections, talking to the Arbitrator, etc.  In fact they most likely won’t even be there.  Your attorney should go over how the day will work, what questions they will ask, what to do when you hear an objection, who else the witnesses will be, what the defense attorney will ask you and anything else that’s relevant to the trial.

If they aren’t doing this you’ve quite frankly hired a bad law firm. The paralegal shouldn’t be doing anything related to the trial beyond gathering and sorting medical records and perhaps calling you to schedule a time for you to come in and meet.  Most work comp law firms in Illinois don’t even have paralegals.  While I respect them and their training, they aren’t really necessary for this line of work.  Sadly you do see this in some firms, often one man shops where they are over worked but won’t pay another attorney to help or in the firms that advertise a ton and take every case that comes through the door so their attorneys are overwhelmed.

All of this is one huge red flag and when the injured worker asked if they should get a new law firm I answered honestly which was yes they should.  Your attorney fees are going to be 20% no matter what firm you have.  Why would you give that 20% to someone who is punting on their basic responsibilities.

Can The Insurance Company Subpoena My Taxes?

By Mike Helfand on Posted in Tips if Injured

I don’t want to say that the people who run insurance companies are cartoon villains, but sometimes their minions sure act like there is a crazy evil hand controlling all of their moves.

At the start of the case you are likely to get a request for medical record authorization form.  It’s usually a broad request that asks for permission to get history on every piece of medical care you’ve ever received.  They don’t have a right to that.  If you have a back injury, they don’t get to know about your pregnancy. If you need your ACL repaired they don’t get to look in to your treatment with a psychologist.  They can only ask for medical records that are related to the injury you’ve sustained.

A lesson common request, but one we’ve seen lately is when they ask you for your taxes.  Why would they do that?

It happens for a few reasons: 1. They might suspect that you are working a second job while collecting work comp benefits. That could be illegal and they are hoping to catch you. 2. They are trying to lower your average weekly wage for payments. 3. They want you to be uncomfortable and feel like they are looking for any way to catch you doing something wrong.

So do you have to turn over your taxes?

I wouldn’t. It’s pretty invasive.  They need to prove that it’s relevant to the case and while I don’t believe in making battles when they don’t need to be there, I also don’t think it’s a good idea for workers to just roll over and say “yes sir” every time the insurance company wants to look under a rock to see if something is there.  And of course many tax documents include things like rental properties, investments, your spouse’s information etc that could never be relevant to a case.

If they do want it by subpoena, the subpoena needs to be properly served and items turned over at a hearing.  There is no discovery in Illinois work comp cases. So unlike other civil cases such as a car accident, they can’t just ask for documents or ask you to answer questions under oath in writing or in person.  If they want this information they should get it at a trial.

If they are looking for this type of info, it’s a sign you have a battle on your hand.  That says to me that you need to prioritize when to fight and how to fight.  So while giving up access to medical records is part of every normal case, giving your private financial information isn’t and should only be done after a serious talk with an attorney who’s experienced at trials and prepared to do so if needed in your case.

Can They Make Me Have Surgery With The IME

By Mike Helfand on Posted in Tips if Injured

I’ve written before about the Illinois work comp law principle that says the insurance company can’t make you have surgery if you don’t want to.  Having something like a spine surgery is a big decision and it’s your decision.  If not having the surgery leaves you with permanent restrictions and costs the insurance company more money, that’s their problem.

I recently had a caller though with a different question.  He needed shoulder surgery per his doctor and as is their right, the insurance company sent him for an IME.  That doctor agreed that he needed a surgery and that it was work related. The case should be simple from there, right?

In this case it wasn’t.  The adjuster said she’d authorize the surgery, but only if the IME doctor could perform it. The caller was furious of course because he liked his doctor, only saw the IME for five minutes and really wants the surgery.

First things first, this is not how Illinois work comp law works.  They can’t make you have surgery and they can’t choose your surgeon.  It’s a simple problem for a lawyer to solve.

In the bigger picture you have to ask why is this happening at all. There are a couple reasons.

1. Often times insurance companies will see what they can get away with.  If this worker pushes back it’s cost them nothing.  If he doesn’t push back it’s a sign they can take advantage of him on other areas of the case including a settlement.  It’s possible they’ve already pushed him around on other issues.

2. My educated guess is that the adjuster wanted to do this because they could get the IME doctor to do the surgery for a cheaper amount.  Now more expensive doesn’t mean better, but I sure wouldn’t want the guy responsible for fixing my arm get the job only because he had the lowest bid. It wouldn’t surprise me if they send so much business to this doctor that they can kind of push him around on the price.

3. If you make the IME doctor the surgeon then they are no longer working on behalf of the company in theory.  That means the potential for the insurance company to get another IME exists.

4. The insurance company might know that the IME doctor rushes people back to work which will save them a few bucks.

Bottom line is that you have to look out for you and letting some random do your surgery, even if the insurance adjuster thinks they are great, is probably not a good idea.  But however you feel about it, it’s your call, not theirs.  They are interested mostly in money and not your health.

Any questions?  Click on the chat box, fill out the contact form or call us at 312-346-5578 for a free consultation.

Workers Comp In Illinois – “Am I Going To Win My Trial?”

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

If you are reading this, there’s probably been some sort of pop up box that invites you to chat with me.  When I’m in the office, you get to chat with a real live lawyer.  When I’m out, we have an answering service that will immediately send your questions to me, and we call back right away.

Anyway, a recent chatter was nervous because he had a trial coming up.  He told me that he was hurt at work and tore his rotator cuff. He hired his lawyer because the union told him to, and now he was scheduled to go to the Illinois Workers’ Compensation Commission for an arbitration hearing.  He asked me, “Am I going to win my trial?”

I explained to him that I had almost no facts about the case including:  how he got hurt, what he told the doctors, what treatment he’s had, whether or not there was a failed drug test, has there been an IME, has there been surveillance, when he reported it to his supervisor, what his job duties are, how credible his doctor is, how many cases has he had in the past, did he give a recorded statement, what the medical records say and were there any witnesses.

All of these things and more go in to whether or not you will win your trial.  I didn’t know any of the answers, but you know who should have the answers?  His lawyer.  That’s why that guy is getting paid, and it’s his job to come up with a strategy, prepare you for trial and evaluate how likely it is that you are going to win or lose.

This happens sometimes with union recommended lawyers as some can be more worried about keeping the union happy than actually doing a good job for their real client.  I can’t imagine having a client who thought they couldn’t ask me these questions.  A lawyer should be approachable. A lawyer should want to help.

Beyond all of that, if your lawyer really is taking your case to trial, he should be reaching out to you.  I am a runner and I can’t imagine doing a race without training.  In the same regard I can’t imagine going to trial without doing whatever I can to prep my client.  I don’t like to lose and if I’m not doing that it greatly increases the chances of losing.

And that’s really what it’s all about. Preparation. You can have all the facts on your side, but if your lawyer doesn’t ask the right questions you lose.  If they are fumbling through papers and it hurts your credibility, you lose.  If you give the wrong answer because you didn’t understand the question, you don’t win.  The facts are the most important but if you aren’t prepared a winning case quickly becomes a loser.

If you want to talk about ANYTHING, just get in touch with us for a free consultation any time.

A Free Illinois Workers’ Compensation Lawyer

By Mike Helfand on Posted in Tips if Injured

I’m an attorney and the times I’ve had to hire an attorney and pay them up front I haven’t been happy about it. Their service was great, but just like anyone else, if I don’t have to spend money for an attorney I don’t want to.

Once every other week or so, someone calls me who has been hurt on the job in Illinois, but doesn’t think they can do anything because they can’t afford a lawyer.  Some will ask me if I know any free work comp attorneys.  What I would tell you if you are worried about this, is the same thing I tell them.  You’re in luck.

Not only don’t we charge anything up front to represent you in your case, nobody does.  It’s against the law to take money from a client for an Illinois work injury.

Beyond all of that, we only get paid if we make a recovery for you and that is at the end of the case. By State law our fees are capped at 20% of whatever we can get you for a settlement.  If we spend hundreds of hours on your case and go to trial and lose you will owe us nothing.

This is how we work, this is how all good firms work and this is even how the bad firms do it. Well, some bad firms will try to take 20% of your weekly benefit checks even when they’ve done almost nothing to earn that.  We don’t do that and nobody we work with does either.

The value of a lawyer is of course to make sure that your case goes smoothly and if you are already getting benefits to make sure it stays that way  For example, the insurance company might try to send a nurse to talk to your doctor and interfere with your treatment.  We wouldn’t let that happen.  If benefits do get cut of at some point or are late, having a case filed allows us to get before an Arbitrator sooner and make things right.

Even with the fee in the end you will almost always end up with more when you have a lawyer than when you don’t.  Insurance companies don’t have to make settlement offers and when they do, if you aren’t represented it’s common for them to cut 25% off the top and quite often they will only offer half of what the case is worth if you don’t have an attorney.

Bottom line though is that you don’t need to pay a penny out of pocket to get an Illinois job injury law firm.  If you have questions about that or a case you can contact us for free at any time.

Merry Christmas!

By Mike Helfand on Posted in Uncategorized

No post today.  Have a safe and happy holiday. We’ll be back with a new blog post on the 28th.  But like any other day of the year we don’t take the day off.  So if you want to talk about a work injury case today (or any day) please call us at 312-346-5578 and our answering service will page us or fill out our contact form and we’ll call you.

What To Do When Your Workers Compensation Payments Are Late

By Mike Helfand on Posted in Tips if Injured

A lot of different problems can come up in an Illinois workers’ compensation case.  Most of them stem from the fact that the insurance company is looking for any way possible to not pay money on your claim, even at times if doing so is against the law.  As a result the number one question we get from people with issues on their case is something like:

My work comp check is late.  It’s been four weeks since I’ve gotten paid.  The adjuster hasn’t returned my calls. What can I do?

This happens all of the time. The reality is that a big insurance company “strategy” is to make life hard on you.  If you live paycheck to paycheck, you are probably already  struggling to live off of what you get for work comp payments when you are off work. If that money doesn’t come for a month, it could make you desperate.  The insurance company is hoping that you’ll ignore your doctor and go back to work.

This of course is very risky, but if you don’t do it you could lose your house.  If you do it and get hurt your case could get denied because you ignored your doctor. It’s a real catch 22 and really sleazy of the insurance company to do.

Not every case needs a lawyer, but this is the type of situation where we earn our money.  By formally filing a case with an attorney, it gives you the ability to fight back. If your checks are late we can file a petition for penalties and fees.  This is a legal strategy that punishes the insurance company when they act in bad faith and deny or delay benefits without a good reason.

It’s not just payments we can do this with.  We can also file for penalties when they unreasonably deny your medical care.  So if you are waiting on an MRI to be approved or a surgery or anything else your doctor wants, there is a way to fight back.

We also can file a 19(b) petition which is a trial motion for an immediate hearing.  If your lawyer does their work, your case can soon be in front of an Arbitrator.  Often just the threat of penalties or a trial is enough to make the insurance company do the right thing.

These aggressive strategies cost the insurance company money.  And since they are acting this way to try and save money, they will often give up when they know they have no defense because in the long run it costs them more to fight.

The bottom line is that if they are messing with your life you need someone who will fight back for you.  If you’d like our help with this, fill out our contact form or call us at 312-346-5578 to talk about your case for free and in confidence.

 

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