CCMSI Won’t Tell Me If My Claim Is Covered!

Here’s a comment I got from a chatter recently. This one has to do with CCMSI and his Illinois workers’ compensation case, but it really could be with any work comp insurance company:

I was injured on the job and it has been over 6 weeks and Ccmsi has still not determined if my claim will be covered.

This like I said is not unusual for CCMSI or anyone else. You see it with Travelers, Gallagher Basset, Sedgwick, ESIS, etc.

They aren’t telling you no and they aren’t telling you yes. They say things like, “It’s under investigation,” or “We are gathering records,” or “We are gathering information,” or maybe they just blow you off and don’t get back to you. Let me tell you that it’s all nonsense and BS.

Your work injury isn’t a murder case. It’s a simple investigation. Typically talking to a supervisor and/or looking at a medical report is all that they really need to do. It’s almost always a pretty straight forward situation. A worker types all day and has been diagnosed with carpal tunnel. A worker was hit by a forklift and broke their leg. A worker lifts heavy objects all day and has a back injury.

Certainly it’s possible that there are other causes for these injuries. But it’s not probable and they can’t delay and delay until they find something. If they follow the law, they are supposed to begin providing work comp benefits. They can always stop payments if new information arises and seek to be reimbursed what they paid. Of course they don’t follow the law.

And if you don’t have a case filed with the Illinois Workers’ Compensation Commission, they can screw around with your health and life by not approving benefits. They get away with it because if you don’t have a case filed, there is no way to hold the insurance company accountable for their bad behavior.

You’d be shocked at how quickly benefits can be approved and delays end when you actually put pressure on an insurance company and file a case. There are motions a lawyer can file that can punish their bad behavior. Insurance companies quickly decide the cost of having to pay for a lawyer and penalties on your case, outweighs just doing the right thing and approving your claim.

That doesn’t mean that they won’t still try and deny your case at some point. They’ve already made their intentions clear. They do this stuff all of the time. It’s not personal to you, it’s just business to them.

The bottom line is that good cases are supposed to be covered. Delays can greatly harm your health and your life, especially if you have no money coming in. By waiting them out, you actually reward them and hurt yourself. It’s shameful how these insurance companies can act. But the great news is turning around a denial or no response is usually not that hard.

How Soon Should You Return to Work After A Workers’ Comp Injury in Illinois?

A lot of the questions I get about Illinois workers comp law happen because employers put crazy thoughts into the heads of their employees. One recently didn’t think he could go to the ER without a co-worker driving him because his boss said so. Another thought that if you got injured on the job it was a requirement that you sit out for two weeks. He thought that because it’s what his foreman said.

So how soon should you return to work if you get injured on the job in Illinois?

The answer is relatively simple. Listen to whatever your doctor says. If they say you can’t work due to your injury then you don’t. That could be days, weeks, months or with terrible injuries even years. Usually they’ll initially authorize you off work for 2-4 weeks and then re-evaluate you. If you’re in physical therapy or receive a steroid injection, they’ll probably take you off work for another 2-4 weeks and see where you are at after that. If you have a surgery, there’s usually a minimum period for your body to heal. So if you have a back surgery, it wouldn’t be unusual for your doctor to state that you have to be off work for three months.

In other words, even if you end up being off work for many months or years, your doctor won’t state that at the beginning and the hope of course is that you’ll get healthy sooner rather than later.

In some cases, you can do work, but not your full duty job. You might have a restriction that says no lifting over 20 pounds for example. If you are a teacher, secretary or (gasp) a lawyer, you can probably do your normal job still. But professions like nursing or construction usually will prevent you from returning to work. If your employer can’t or won’t accommodate your work restrictions, you won’t be able to return to work, but you should continue to get work comp TTD benefits as you recover.

Other times your doctor will tell you that you can return to work full duty, but your body is telling you otherwise. In those situations, you should express your concern to your doctor and have a hopefully thoughtful discussion about it. You need to make clear the pain you are experiencing and what your job duties are. If they still want to send you back to work, you don’t have to go, but if you don’t, you also won’t get TTD benefits and could lose your job. We usually advise people in those situations that if they can to give it a shot and see what happens. If the pain is too great you can then you can go back to your doctor and discuss it from there.

The bottom line is that every case is different and your health should be priority number one. Beware an employer who tries to pressure you to return to work or one that says they’ll accommodate your restrictions, but doesn’t. Those are the ones that make a short term injury into a serious, life altering one.

And as always, if you have any questions, please call us to speak with a lawyer for free any time. We cover all of Illinois.

Degenerative Disc Disease Doesn’t Mean You Don’t Have A Work Comp Case

A great piece of advice for anyone who may have an Illinois workers’ compensation case is to not take every medical term that you hear literally or to assume what one means. A lot of medical terms can be confusing or not apply to work comp law in Illinois the way you’d think they would. A great example of that is degenerative disc disease.

In general, as you get older your joints will wear down a bit. That can happen in your knees, your arms and of course your back. It’s basic wear and tear that results in a form of arthritis which can cause pain. Sometimes the pain is minor and other times it’s life altering and requires significant medical treatment.

This type of wear and tear arthritis in the back is called degenerative disc disease (DDD). There is no one cause of this problem, but it’s often just from acts of living. Over the course of your life, you do a lot of lifting, you could be in an accident or have a fall, you could sleep wrong, etc. All of these activities together can cause arthritis and your spine to break down.

Because it says “degenerative” and is a breakdown of the spine, I’ve seen work comp insurance adjusters and employers tell their workers that this problem isn’t part of work comp. It most recently happened to a nurse who called me and had been told she couldn’t file for work comp.

Of course this is a lie and anyone can file for work comp. And for people like this nurse who have been lifting patients on a regular basis for 20+ years, it of course is common sense that part of the breakdown of her body that has been diagnosed as DDD is caused by her job.

Now the job isn’t the only factor of course as she’s done lifting in other parts of her life and was in a car accident as a teenager. But the job has clearly been a contributing factor and under Illinois law, that is all she needs to show in order to be eligible for work comp benefits. Your job doesn’t have to be the only cause or even the main cause. It has to just play a role.

In this case I’d argue that her work has been the main cause and she also first noticed pain when lifting a heavy patient without help. But even without that, her job involves so much lifting and has been going on for such a long time that it would be absurd for anyone to claim it had nothing to do with her back breaking down.

We love these cases as they are ones that can often be turned around quickly and where we can help injured workers. If you’d like a free consult, please call us at 312-346-5578.

College Athletes And Illinois Workers’ Compensation

We are attorneys for injured Illinois workers in Illinois. We believe college athletes should be getting work comp benefits. If you are an injured athlete from a division one school, please call us any time at 312-346-5578 for a free, confidential consult.

A lot of companies try to get away with not paying Illinois work comp benefits by claiming workers aren’t actually employees. The most common way they do that is by calling workers independent contractors. If they don’t actually work for you, then you don’t owe them work comp benefits, right? That’s actually wrong if we can prove the company has control over you and treats you like an employee.

I think of this control test any time I see a college athlete get hurt while playing. I’ve often thought that if you really know the schedule of a college athlete, you’d realize they are really employees even if they don’t get paid beyond the scholarship. From limiting what classes they can take, to threatening to take away a scholarship, to forcing athletes to play through pain, pumping players with drugs, barring studying abroad, etc., the college coaches and universities have always had control over them.

The schools also provide uniforms that the players have to where and make them follow a certain schedule. These are all hallmarks of actual employees.

But now more than ever it’s clear that college athletes, especially football and basketball players are about to really become employees. Due to the settlement of an anti-trust lawsuit over the NCAA taking away money making opportunities, players in the top conferences are going to begin receiving upwards of $20 million a year as soon as the fall of 2025. And that number can go up.

While scholarships aren’t taxed, I see no way this money could possibly avoid taxes. It’s no different than the NIL money that many of these great athletes are fortunately receiving now. Speaking of which, it’s very common for the schools themselves through their NIL collectives to broker deals for players to entice them to play for their team.

So this fall when you see a football player tear their ACL on a tackle or miss a game with a shoulder injury or medically retire due to a neck or back injury, those players, in my opinion, are owed Illinois workers’ compensation benefits.Same will be true this winter when you see a basketball player get hurt. And I’d argue it holds true for even non-revenue athletes who are on scholarship or receiving other financial consideration due to their participation.

These benefits of course can really be significant for these young men and women. Not only would they get 100% of their medical care related to the injury taken care of, it can potentially happen for life and they’d get to choose their own doctor. A lot of injured college athletes get forced onto the school doctors and they often get pressured to release an athlete to play before they are truly ready.

Beyond that, if compensation was taken away due to the injury, these athletes could make up some of that money through Illinois work comp benefits. And they could eventually be entitled to a settlement. If they have a career ending injury, that settlement could be worth well into the mid six figures.

It’s going to take one athlete willing to be the first to come forward and file a claim for benefits to prove we are right that they deserve these benefits. If you are willing to discuss being that person, we’d love to speak with you.

Illinois Work Injuries When Not Clocked In

Insurance companies who handle Illinois workers’ compensation claims LOVE LOVE LOVE to deny cases. It’s how they make so much money. The little secret is that it’s very common for them to deny a claim and try and take away your rights when they know they are doing so wrongly. They hope that you will just go away.

As part of this, we see insurance companies all the time telling injured workers things that aren’t true as the basis for denying their case. A prime example of this is saying that an injury isn’t covered because it happened when the worker was off the clock.

Here are some cases I’ve been called about in the last year where accidents happened off the clock. See if you can guess what they all have in common.

  • A worker went to use the bathroom before she clocked in and slipped on a wet floor, resulting in a torn ACL.
  • While getting coffee before starting a shift, a worker injured his back while lifting a box that was on the break-room table.
  • While leaving for the day, a worker fell in the employee only parking lot on ice and hurt their back and hip.
  • Before punching in, a factory worker was asked by a co-worker who had started their day to help them move some overflow items and tore their rotator cuff.
  • During a lunch break while off the clock, a worker was assaulted by an angry customer and suffered an orbital fracture.
  • While at home after a work day, a salesman who had taken boxes home of inventory smashed his hand while carrying one in to the house.

Do you know what they all have in common? It’s two things actually. First, every example I listed involved someone whose case was denied by an insurance company for being off the clock. The second thing they have in common is that they are all great cases.

It’s a myth that you have to be “on the clock” in order to get Illinois work comp benefits. If you are doing an activity that benefits your employer and get injured, it’s likely a compensable work comp case. All of the examples listed benefit the employer. Even going to the bathroom does as it’s expected that workers will need to use the bathroom and this worker was doing it in a way that didn’t disrupt work.

And yes, even being at home can be work comp if you are doing something for the employer such as bringing work home with you. You are essentially “on the clock” when you are at your place of employment or doing actions for the employer. You stay on the clock until you do something that clearly takes you away from that. An example would be a bartender who finishes their shift and sticks around to drink after and gets drunk and then falls down. Or someone who leaves their place of work to meet friends for lunch and gets in a car accident on the way to the restaurant.

Bottom line is that you shouldn’t trust the insurance company when they say you don’t have a case. You are always welcome to call us for a free consultation with a lawyer to see if you have one. We cover all of Illinois and can be reached at 312-346-5578.

Advances Against Settlement, Illinois Work Comp Law

One potentially hard fact about pursuing an Illinois work comp claim is that if it’s disputed, you can be left without income for a bit. That can lead to a choice of having no money coming in or working when your injury dictates that you shouldn’t.

Many insurance company denials are bogus and if you get a good attorney who is willing to take your case to trial (surprisingly not all will), you’ll likely eventually win and get paid for everything you are owed. And eventually you’ll get a settlement which can be really significant depending on how bad the injury is.

The problem is that going to trial can take time. Even if it goes fast, it will be 3-4 months most likely before a hearing actually happens and then can be 1-3 months or more before the Arbitrator makes a ruling. And that would be super fast and doesn’t even take into account a possible appeal. So when determining whether or not to go to trial, what a good Illinois work comp trial attorney should say to their client is, “I’ll take your case to trial and get it done as fast as I can, but I’m not the one who will have to go without money for all that time.”

A lot of cases simply have to go to trial. When workers are facing a financial crunch, the first thing they will ask about is getting a law suit loan. There are companies out there who will give you money now that gets paid back when you make a recovery on the case. And typically if you don’t win the case, you owe them nothing.

The problem is that a lot of these loans are predatory. In other words, you could get a loan for $5,000 and end up paying back $20-30k or more depending on how long your case lasts. The interest rates are extraordinarily high. I hate most of these companies. And I really hate lawyers who push these loans on their clients and suspect that some attorneys are getting kickbacks for doing so. Just as an attorney shouldn’t insist you treat with a certain doctor, they shouldn’t force a loan company on you.

Again, this isn’t my life, and I understand some people have to go this route. But before you do, you should ask your attorney if an advance against your settlement is possible.

What this is, is a situation where the insurance company knows they are going to owe you some money in the end, but is disputing part of your case now. Usually it’s a surgery or a dispute about whether or not a worker needs restrictions. The insurance company might want to buy time to delay a trial, schedule an IME or do something else.

So at times they’ll pay in advance part of what your eventual settlement would be. It won’t be a huge amount, but could be something like 5-10 weeks of permanency benefits which if you are a high wage earner it could be $5,000-$10,000 give or take. It’s not a loan so there’s nothing to pay back and no interest taken out of it.

Now there’s no law that requires the insurance company to do this and as you know, they don’t typically act out of the goodness of their cold, black heart. This is where having an experienced attorney who has developed relationships comes in. Either through talking to opposing counsel or if necessary the Arbitrator at pre-trial, your lawyer can take an aggressive stance that there shouldn’t be delays or agree to a delay if an advance is offered. If the total case isn’t in dispute, most Arbitrators will make a non-binding recommendation that this happen. And most defense attorneys will go along with it.

A typical example would be that the insurance company wants you to see an IME doctor, but they can’t get you in for an appointment for six weeks. So the request would be six weeks of benefits until the IME happens. Another situation would be where they need to arrange for a witness to fly in to testify so they need a trial delay. You also see this when doctor depositions are needed for trial and can’t be scheduled in a timely manner.

This is one of those situations where it doesn’t hurt to ask and doing so can be a huge benefit to you as you don’t have to pay the ridiculous interest.

I get that this topic isn’t necessarily common sense, especially if you haven’t dealt with work comp before. So if you have any questions about an advance against settlement, please reach out any time.

Are You Giving Your Work Comp Lawyer “Just One More Chance”

There’s a great scene at the end of “Animal House” where one of the fraternity brothers asks the dean for “one more chance.” This is after they were kicked off campus and responded by destroying the town’s parade.

I think of this scene every time I talk to someone who is represented by a terrible work comp lawyer, but can’t quite pull the trigger to fire them and get a better law firm in their corner.

Just the other day a worker whose TTD checks are late every time they are due, sometimes as much as a month, called me to see what can be done about their attorney refusing to try and solve the problem. They went on to say that the attorney usually doesn’t respond to calls or emails and can be verbally abusive. They also said the lawyer forgets basic facts about the case such as how they were injured and what the injury even is.

This scenario screams red flags. The accident was only six months prior and they are getting almost no representation. I referred them to a great work comp attorney in their area who wants to take the case over. And of course it costs nothing to switch. When offered new and better representation the worker said, “I want to give my lawyer just one more chance. If it doesn’t get better in a week, I will switch.”

An attorney asking for just one more chance in that scenario is just as ludicrous as the “Animal House” guys asking for one more chance. Things aren’t going to change or get better. No lawyer wakes up and says, “I’ve been terrible to that client, but I’m going to turn things around and give them the best service possible.” To expect that they are suddenly going to start trying to get you your TTD on time or talk to you as an equal is not realistic. These miserable attorneys aren’t just that way to you, but usually to most/all of their clients.

That’s not to say that a lawyer doesn’t occasionally have a bad day or that they will always deliver perfect service that shows they are fighting for you. We are human and can have bad days or make mistakes. Good attorneys will try to correct those errors. But when it’s a pattern of behavior over many many months, they are showing who they are and it’s up to you to recognize the red flags and solve the problem. You have to advocate for you and you do that by confronting them on your concerns and then getting new/better representation if they don’t fix things.

Usually by the time we get a call from an unhappy injured worker it’s because they’ve asked for the problems to be fixed and they haven’t been. That’s the time to pull the trigger, fire your lawyer and get your case going in the right direction.

Teachers’ Injuries And Illinois Workers’ Compensation

Teachers in Illinois do an incredible job. For many of them the work is very rewarding. It can also at times be a thankless, dangerous job. We have helped hundreds of Illinois teachers and other school workers such as janitors, teacher’s aides, school nurses, administrators, etc. with their Illinois workers’ compensation claims.

There are so many different reasons that teachers get injured on the job. It can be as simple as throwing out your back or shoulder while lifting school materials. We often see teachers hurt this way. It doesn’t even have to happen on school property. If you bring home a big box/bag of papers to grade and hurt yourself while lifting them at home, that would be a workers comp case because it’s part of your job to do this.

Another common way teachers get hurt is breaking up fights between students or even being attacked by a student. It’s not uncommon for someone to get hit trying to break up a fight and we actually see a lot of knee, ankle and arm/wrist injuries from falls that happen while breaking up a fight. And there have been a lot of concussion cases we’ve helped with from teachers and other school workers who have been hit by students.

Some of the other big causes of teacher injuries include slip and falls from wet floors, tripping over cords, being hurt picking up a kid, falling over loose carpet and trying to hang with the kids at various activities. The last one happens a lot. I’ve seen a lot of blown out Achilles injuries from school workers playing basketball, tag or other games with the kids. Those injuries, since it benefits the school, are almost always covered.

While generally speaking you can’t get work comp in Illinois for the general stress of working in a tough school environment or not being supported by your administration, there are a lot of mental health related work injury cases we’ve seen. The compensable ones are typically from one time events such as seeing a student pull a gun on someone or even being present for a school shooting. In those cases we can usually make sure you get the psychological care you need with no out of pocket expenses. And if that doctor believes you are not mentally ready to return to work due to PTSD or some other issue, you should be paid TTD benefits for your time off work.

Speaking of teacher pay, we’ve seen a lot of teachers get shorted what they are actually owed for weekly pay as well as for their eventual settlement. Those payments are based on your average weekly wage (AWW) which for most workers is 52 weeks of pay, but for teachers should be actual weeks worked. Not having an attorney who has experience with this issue could literally cost you tens of thousands of dollars.

And while there are many great teacher’s unions in Illinois and some not so great ones, being in a union doesn’t change what rights you have under the Illinois Workers’ Compensation Act. So even if you are a contract employee who is non union or working at a private school, you all have the same rights.

If you have any questions, want representation or even just want to see if you have a case, contact us for free any time at 888-705-1766. We cover all of Illinois.

Blommer Chocolate Work Comp Claims After Plant Closing

The reputation of big cities, especially from people who don’t live in one, is that they smell. Well, if you’ve been in the River North area of Chicago, you know that it does smell. Smells awesome that is. That’s because if you are near there, you will get a whiff of the Blommer Chocolate Company factory and their delicious products.

Unfortunately, Blommer has decided to close that plant location after almost 100 years of making Chicago smell great. It’s going to shut down at the end of the month and I can’t imagine walking in that area and not getting a whiff of their delicious chocolate.

About 250 people work there and from a quick check of the Illinois Workers’ Compensation Commission website, there are about 18 active cases officially filed against them as the time of this writing. That number doesn’t include people who have yet to formally file a case. It’s not surprising that about 8% of the workers are injured as it’s a repetitive, labor job.

So the question is, what happens to those cases or to anyone who works for a company that goes out of business or closes a plant location.

First off, it doesn’t appear that Blommer has any other Illinois location except the corporate headquarters at the Merchandise Mart. So assuming those who are injured are laborers, to them it’s as if the company has gone out of business.

That means that if they have any work-related restrictions from their job injury, they should begin to receive TTD benefits. That’s true even if they were previously working a light duty job within those restrictions before the last day of the plant being open. These benefits can continue until they are able to work without restrictions or they find a job within those restrictions. You can bet that a lot of Blommer workers are going to be sent to IME doctors who will say that no restrictions are needed. This being done to try to cut off TTD benefits.

As far as medical benefits go, when this happens to you, it doesn’t change your medical rights in any way. There is still insurance to cover these injuries and you can still get all reasonable and related medical treatment that you require.

Aside from TTD, the big affect from this closure will be on the settlements of some cases. If you had a major injury that Blommer could work with, but nobody else can (or nobody else can without a big cut in pay), it could make the case worth tens or hundreds of thousands of dollars more in the end. It will depend on what your injury as and what your ultimate recovery is.

The bottom line is that while it’s probably stressful for your job to go away, if you are work comp when that happens, in Illinois it actually provides you with more protections and possibilities.

If you are an injured worker from Blommer Chocolate or anywhere else, we’d be happy to talk to you for free and in confidence. Call us any time at 312-346-5578.

Illinois Workers’ Compensation When You Get Wrongfully Terminated

We and the lawyers we work with on cases are Illinois workers’ compensation attorneys. That’ what we focus on.

If you get wrongfully fired from your job or have compensation issues, you don’t need a work comp attorney, you need a labor lawyer. BUT……. if you think you were illegally fired while on workers’ compensation, you should talk to your work comp attorney first. This is how every lawyer we know views it.

There are a couple of reasons I say that. First off, if you get let go for any reason, if you have work related restrictions from your job injury, you should immediately begin to get TTD benefits or continue to get it until you have no restrictions. There’s no limit to how long that can last. At least once a week I talk to an injured worker who got fired and should be getting TTD, but isn’t because they didn’t know their rights.

The second reason is if you are on work comp and get let go, it’s so inter related to your work comp case, that your labor law attorney (assuming you have a good case) and your work comp attorney having a good relationship can only help each respective case. Each may end up having information that can be useful in maximizing what recovery can happen for you.

As a result, if you call us looking for help, please know that we won’t do one case without the other. We say that because it’s in your best interests.

A lot of the calls we get about this come from people who have a lawyer for their work injury and have seen that we know good labor attorneys too. These calls can drive me crazy because I often hear about lazy work comp attorneys who refuse to do anything for their clients that isn’t directly part of the work comp case. I argue that it is and even though they don’t handle labor cases, if you’ve been doing this long enough you should know someone.

When an attorney refuses to help you with this, it shows that they don’t care about you. Not every wrongful termination case is actually a case. But if they won’t help you at least investigate it and talk to you about how getting fired affects your work comp claim, they are terrible at their job.

We will take over from these attorneys and when we do, we will get you help getting a proper evaluation of your rights in suing over being fired. But we won’t do one case without the other for the reasons mentioned above.

So if you are in this situation and you like your work comp attorney and think they are fighting for you, go to them for help. It’s their job. If you don’t think they are doing a good job and want to switch firms (or at least talk about it), get in touch with us and we’ll do whatever we can for you.

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