Can Your Attorney Take 20% Of Your TTD Check?

By Mike Helfand on Posted in Benefits

We have a live chat feature on our site and a recent chatter stunned me.  She was injured at work and her case was accepted.  When she hired a lawyer she was receiving TTD benefits and those benefits never stopped.  The lawyer took on the case and started taking 20% of the TTD checks. When the worker asked why, the lawyer said it’s because she had to read through hundreds of pages of medical records.

This is grossly illegal.  It’s flat out theft.  It’s also unlike any attorney I’ve ever come across.  Even the scummiest ones I see will only take 20% when benefits are denied and then reinstated.

While this is clearly not allowed, the question is when can your attorney take 20% of your TTD check?

To me, the question really is when should they do this.  By law, it can technically happen when there is a dispute in your case and your benefits get reinstated.  But there are different levels of dispute.  Here are some scenarios.

1. You are on TTD benefits for an injured back.  You see the doctor once a month and the doctor always faxes an off work slip to the insurance adjuster.  This month the adjuster claims she never got the note, so she doesn’t issue a check. Your lawyer calls her, finds out the problem and then gets an off work slip from your doctor. They fax it in and benefits are reinstated. Technically there was a dispute, but it was so minor that in our opinion your attorney shouldn’t take anything.  If they do, they should only do it for the pay that was missing.  Some scummy attorneys will try to take it from every check from here on out.  That shouldn’t happen.

2. Your doctor has you off of work.  A previous IME had said your condition is work related.  A year goes by and they send you to a new IME who says the injury is not work related.  The insurance company uses that report to cut off your benefits.  Your lawyer files a 19b trial motion and the insurance adjuster, realizing their position isn’t strong, reinstates your pay.  This is just slightly more work than the first example.  We’d take nothing for this. Some firms would take 20% of the disputed period.  Anyone who takes more than that is wrong in my opinion.

3. After a back injury your doctor takes you off of work. You are scheduled for surgery and are receiving TTD benefits.  The insurance company does surveillance on you which shows you working on a car in a manner that appears to go beyond what your doctor said you can do.  As  a result they cut off your benefits.  We take a deposition of your doctor and their IME doctor.  We then do a pre-trial before the Arbitrator who says if it goes to trial he will likely rule in your favor.  Based on this the insurance company agrees to pay back all of the owed TTD and reinstate you going forward.  We’d take 20% of the back TTD, but nothing going forward.  A lot of firms would take 20% of everything and we think that is inappropriate.  The reason we’d take anything at all is because of the work put in by taking the depositions and doing the pre-trial.

4. Same as number three, but the case goes to trial.  When the result comes back, you win the case and are awarded six months of back TTD benefits.  The result also means that they have to start paying you going forward.  We’d take the 20% from the six months, but nothing else.  Not all firms would do that, but instead would try to take 1/5 of everything from here on out.  We disagree with that still.

In our opinion, if you have a lawyer who is taking money off of future benefits, not past benefits, you should fire them.  They will still get paid when the case is settled.  Taking more than what they’ve earned, in our opinion, is close to theft.

If you have any questions about what we think is appropriate when it comes to Illinois work comp attorney fees, please do not hesitate to contact us.

Why You Will Win Your Illinois Work Comp Trial

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

No attorney can guarantee anything, but we can certainly say what is 99% likely based on years and years of experience.

I thought of this the other day when I read about an injured worker who took his case to trial.  He was lifting a case of product when he felt a pop in his back.  He was employed through a staffing company and had only been on the job for about six weeks.  If you know anything about temp agencies, they feel no personal connection to their employees and deny work comp cases as a matter of routine.

Sure enough they denied this case even though he reported it right away, went to the doctor right away, told the doctor it happened at work and there was no evidence that he was hurt in any other manner.  The staffing company denied the case because it was unwitnessed.  Having a witness is not needed to win your work comp case.

The Illinois Workers’ Compensation Commission ruled in his favor.  They noted the following:

1. Not having a witness does not bar recovery.

2. The medical records were consistent with his testimony.

3. The written statement he gave to his employer was consistent with his medical records and testimony.

4. He had no physical complaints or treatment prior to the date of accident.

5. The insurance company offered no evidence to rebut his testimony.

All of these things taken together made the case a winner.  This is how it goes in most Illinois work comp trials.  Surprisingly, the biggest reason people win trials, in my opinion, is reason number five.  When there is no one else to testify as to why your story isn’t true, it surely makes it seem more likely, especially when you come across as credible.

Arbitrators aren’t dumb.  They are suspicious of people whose stories have changed.  Suspicious of people who have filed many cases in the past, especially when it’s to the same body part.  And they are suspicious of people who seem a little too slick.

However, if you honestly were injured on the job, get treatment, report the accident and listen to your doctors, unless there is some mystery witness to call you a liar, you should win your case.

It doesn’t always go that way. If your attorney isn’t prepared things can fall apart.  If you haven’t been 100% honest things can fall apart.  If someone is out to get you and will lie on a witness stand, you could lose your case.

In most cases though, if you are honest, credible and nothing is really against you, you should win the case.

As always, if you have ANY QUESTIONS, call or email us any time for a free consultation.

How Not Having A Top Work Injury Firm Can Ruin You

By Mike Helfand on Posted in Tips if Injured

A caller to my office had a shameful Illinois workers’ compensation story.

She works in the Quad Cities and was injured there, but hired a (in my strong opinion) shady Chicago work comp firm that does a lot of TV advertising to represent her.  These are lawyers that seem to try and sign up as many cases as possible but don’t care what happens on the case.

In her claim she had a fall and someone from the company lied and claimed she said that she told them she wasn’t hurt at work.  As a result her benefits were suddenly cut off.  It put her in a real financial crunch.

What her lawyers should have done is filed a trial motion. What they did do is tell her to settle the case since it’s disputed.  They said this despite her having a real serious injury, needing more treatment and the value of the case if they saw it through likely being 20 times what they got for her.

She didn’t know any better and thought this is what work comp is.  The truth is that they had a young lawyer on the case who doesn’t know what they are doing and doesn’t want to travel three hours to a hearing in Rock Island.

So the client settled and now wants to know how to get medical treatment.  The sad truth is that there’s nothing we or anyone can do for her now.

There is no such thing as the “top” or “best” work injury firm in Illinois.  You need to hire whoever is best for your case.  But there is a clear difference between good firms and those that don’t care about their clients and put their clients at risk.

This is a sad example of what can happen when you don’t have a good firm. It’s not the injured worker’s fault.  They listened to their attorney.

To make matters worse, she still hasn’t been paid even though I could see that settlement contracts had been approved by the Arbitrator. When she asked her lawyer why she didn’t have her money yet they lied and said that the defense attorney hadn’t returned them yet.

I will never get how a law firm can operate this way.  You have to have something majorly wrong with you to blatantly lie to people over and over.  I think part of it is these types of firms are run by terrible people and the young attorneys they train either don’t know any better or are desperate to have a job.  It’s probably a little bit of both as these young lawyers usually don’t last more than a year which just makes matters worse for the clients of the firm.

Your Doctor Shouldn’t Tell You What Lawyer To Hire

By Mike Helfand on Posted in Tips if Injured

A nice, somewhat naive, Illinois woman called me recently.  She had hurt her back at her job and had quite the serious injury.  What she told me was that she had a lawyer and he never called her back and was rude when he did so she wanted a new firm.  That’s a good reason to switch lawyers for sure.

I referred her to an attorney who handles cases in the county where her case is being heard.  He then contacted me to let me know something she didn’t share.

When she was first injured, she actually hired the lawyer that I recommended. They filed the case and everything was going great.  He then got a call out of the blue telling him that she was switching law firms.

It turns out that the doctor who ran the MRI clinic where her back exam took place decided to talk to her.  Now I don’t know if you’ve ever had a MRI, but in most cases you will never actually speak with a doctor.  That’s because they don’t actually perform the tests.  They just read the results and collect the big bucks.

In this case though, when the doctor was alerted that this woman was hurt on the job, he became very interested in her case.  He was so interested that he told her that his friend is the best work comp attorney around and that she should go hire him.

Even though her case was going fine, she agreed to switch firms.  She hired the attorney who now doesn’t call her back and was rude to her.  The attorney I know of course has no desire to right the ship.

As you can probably guess, it’s a slam dunk guarantee that the MRI owner and the crappy attorney have a quid pro quo going on.  They expect each other to send business their way.  And if this means interfering with a client who likes their lawyer they don’t care.  They aren’t looking out for their patients/clients.  They are looking out for themselves.

Maybe this nice woman will find a lawyer willing to be the third attorney on her case.  That’s not easy to do because the three law firms would have to split the 20% attorney fee.  At some point it becomes not worth it.  I don’t think she was doing anything wrong, but not questioning why a random doctor was talking about her work injury has really caused her some problems. Hopefully it all works out in the end.

Can They Accept My IL Work Comp Case And Then Deny It?

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

A caller to my office had an unusual, but not unheard of situation.

He injured his back at work in Chicago and reported the accident right away.  The accident was on a Tuesday.  He, as required by law, took a drug test and failed.  He admits he had been partying the previous Saturday.

Normally these cases get denied right away, but in this case they paid his medical bills, including a surgery and all his time off work.  He did get fired from the job though for the failed test.

Fast forward nine months later and he gets a letter in the mail from the insurance company that says they’ve reviewed his claim and now are denying his case.  To them they consider the case closed.

His question to me was can they do that?

The answer is that payment of benefits is not an admission of liability.  In other words, just because they paid my mistake doesn’t  mean that they have to pay you forever. In this case, the failed drug test gives them a right to deny benefits.  What will happen is that he will hire a lawyer, go to trial and testify (honestly) that he got high on Saturday, was sober by Sunday and completely fine when he was injured 72 hours after he used drugs.

Unless the insurance company has some evidence that he really was high when he got hurt, which they surely don’t, he will win.

The more common example is when someone gets hurt on the job, starts receiving benefits and then is sent to an IME doctor who says the injuries aren’t work related.  That gives them the right to stop paying your bills and lost time.  It doesn’t mean you lose the case, it just means you likely have to go to arbitration.

What I think happened in this case is that it was assigned to an adjuster who applied common sense.  The way this worker was hurt was by being run in to by a co-worker.  Even if he was high, he was literally just standing when someone knocked him over.  So drugs or not it had nothing to do with the accident.  The way insurance companies work though is that once they spend a certain amount of money on a case, a higher level person usually takes over or at least looks at it.  They probably saw the failed drug test and decided to act.

It’s a short term inconvenience that is easily solvable with the right lawyer.  The good news in this case is that he’s almost done with his treatment so he won’t really suffer.

These things happen.  Employers and insurance companies do have rights and they will certainly use them to their benefit when they can.  That’s alright because workers have rights too and when the facts are on their side they win in the end.

 

Hernia From Working In Illinois

By Mike Helfand on Posted in Injuries

If you’ve never had a hernia before, you may not know exactly what it is or may just think of it as a pulled muscle. But a hernia is a bit more serious than that. Put simply, a hernia is a hole in the muscle layer of the abdominal wall. Through that hole, tissue, fat or part of a displaced organ can bulge through. And it happens all of the time from job injuries in Illinois.

A hernia can occur when tissue weakness combined with pressure, pushes an organ through a tear or opening in the tissue. Hernias often occur after heavy lifting or a fall. Simply based on their anatomy, it’s more common for men to develop hernias.

If it sounds painful to you, that’s because hernias can be extremely painful. There are different types of hernias, but the most common are inguinal hernias. Symptoms of an inguinal hernia may include pain or discomfort in the lower abdomen, especially when bending, lifting, or coughing.

Firefighters, law enforcement, warehouse workers, mechanics, and furniture movers are some of the most common occupations that develop hernias of some type because of their work. This is because these jobs (and others) require a lot of physical activity and movements.

Even if a strain that produces a hernia is not work-related, the work may have indirectly contributed to the muscle weakness that allowed the hernia to develop. For example, if muscle weakness was caused by repetitive heavy lifting, or by abdominal surgery necessary to correct an unrelated work injury, these could be an indirect cause of a hernia.  In that case you would likely have a valid work com case.

Even work environments can play a part in the cause of a hernia. Work environments that cause a worker to cough repeatedly, work injuries that lead to weight gain while unable to work, or medication for work injuries that are a cause of constipation, might all contribute to weakened abdominal muscles, often then causing a hernia.

Very few hernias are life threatening, but the only way to repair a hernia is surgically. Hernia recurrence rates are rare. The most common hernia surgery has a 90% success rate.

Hernia cases can be complicated because you are usually required to notify your employer within a certain amount of time after the injury. However, some cases are not diagnosed immediately or are initially misdiagnosed as just a strain. If you feel you have a hernia that is work-related, you should report it to your employer as soon as possible.

The good news is that if it happens at work in Illinois, all of your hernia related medical bills will get paid, you will be compensated for your time off work and you are entitled to a settlement.

If you have any questions about a hernia on the job or anything related to Illinois work comp law, please do not hesitate to contact us.

Injured At Work And Your Company Files For Bankruptcy. What Happens?

By Mike Helfand on Posted in Tips if Injured

We are Illinois workers compensation attorneys who have a state wide network of lawyers that can help you with your case. Fill out our contact form or give us a call for a free, confidential consultation.

Bankruptcy laws when used well can help individuals get out of massive debt and get a fresh start.  Unfortunately, sometimes businesses can use it to screw over their employees who are owed wages or vendors who are owed payments.  You can be owed thousands of dollars and end up with nothing.

For injured workers in Illinois, a bankruptcy can affect your case.  Unlike workers who are simply owed wages, injured workers don’t usually end up getting shut out of compensation they are owed.

For most companies that go under, they, as required by law, carry workers’ compensation insurance.  So even if they are out of business, their insurance will still cover your injuries.  When they file for bankruptcy it could put a temporary pause on your case.  That is called a “stay.”  If that happens, your lawyer can go in to court and get an order that allows the work comp cases to be processed because the employer isn’t paying any money toward the case.  In other words, your receiving work comp benefits isn’t unfair to the workers and vendors who are owed money.

One the stay is lifted, the case will proceed as normal. And quite honestly, in some cases there is never even a delay.  So for most injured workers, you don’t have to stress that your employer is bankrupt.  In fact, if you have any restrictions about your job duties due to your injury you can receive TTD benefits because there is no job to return to.  This is true even if your employer was accommodating your restrictions before they shut down.

Some bigger employers are self insured.  I’m talking about Amazon, United Airlines, The City of Chicago, UPS, etc.  These are organizations that are not likely to go bankrupt, but if they did there are protections in place that make sure injured workers don’t get denied the benefits they are owed.

The one work comp scenario where a bankruptcy can affect your case is when the work comp insurance company goes bankrupt.  That doesn’t happen a lot, but it does happen.  When it does, your benefits will be stopped for a while, but eventually the State of Illinois takes over through the Illinois Insurance Guarantee Fund.  They pay on cases when an insurance company goes out of business. It’s way better than nothing, but when they get involved cases tend to slow down and you lose some rights such as the ability to file for penalties when there is a delay in your payments.  Those cases can be frustrating because injured workers can rightly feel like they are being treated unfairly and we as lawyers don’t have the ability to solve problems as quickly.

The bottom line though is that no matter who your employer is, a bankruptcy doesn’t end your rights at all if you’ve been injured on the job.  Don’t listen to any employer, friend or insurance adjuster who tells you otherwise.

And as always, please contact us with any questions.

Injured At Work. What Happens Next?

By Mike Helfand on Posted in Tips if Injured

A reader of our blog contacted us and asked the following:

I hurt my back the other day while working in Chicago.  I reported it to my boss and went to the doctor. Do I wait to hear from the insurance company or should I do something else?

That’s a good question. There is no right answer, but I do think there is a best answer, especially if you think the injury might be serious.

Insurance companies aren’t scummy in every case, but they do have a goal of limiting what they pay in every case.  One way they do that is by delaying the approval of your case. So if you get hurt and need a MRI, they might say the case is under investigation.  This could cause needed medical care not to happen right away.  Ultimately that can hurt you.

So for me, if an injured worker has what could be a serious injury, I encourage them to file the case with the State.  This is done, typically through a lawyer, by filing an Application For Adjustment Of Claim with the Illinois Workers’ Compensation Commission.  What this does is get your case assigned to an Arbitrator in case there is a dispute and puts you on the offensive instead of being at the mercy of hoping an insurance adjuster does the right thing.

Getting proper medical care right away is often the difference between a minor injury not becoming a long term problem.  Filing a case doesn’t guarantee anything, but it lets the insurance company know you are aware of your rights and beyond that allows you to address an unreasonable denial by them much faster.

Beyond filing, the most important thing to do is get medical treatment. You have a right to choose your own doctor and should.  Don’t fall in the trap of treating with the company clinic or a doctor that the insurance company says you should go to. You want someone who is independent and will look out for your health.

If you are unable to work due to your injuries, you should start receiving temporary total disability benefits or TTD.  To get this you need a note from your doctor that takes you off work or says you can work with restrictions that your employer can’t accommodate.  TTD is 2/3 of your average weekly wage and is tax free.  Checks should come at least every two weeks.  This is another good reason for formally filing a case because it’s common for insurance companies to delay payment or “forget” to pay you.

What happens after that really depends on the case issues and how serious your injury is.  If you have any questions about the Illinois work comp process, please contact us any time for a free consultation.

When You Get A Settlement Offer, Don’t Do This

By Mike Helfand on Posted in Benefits

In every Illinois workers’ compensation case, when you are all better and back to work, you want a settlement.  Getting an offer is exciting, but the lure of money in your pocket can often lead to mistakes. If you get a settlement offer, these are things you shouldn’t do in most cases.

1. Don’t say yes right away.  Even if your case is ready to settle, you almost never get the best offer on a first offer.  So while getting an offer of $50,000.00 might sound great, if you can get to $70,000.00 by countering and having a little patience, it’s worth it.

2. Don’t worry that the offer is going away if you don’t accept. It is against the law for a settlement offer to be made and withdrawn.  Often an insurance company as part of their “tough” negotiation strategy will tell you that you have until a certain date to accept.  The reality in Illinois is that even if they take it away, they’ll almost always give it back.  They want the case to be over or they wouldn’t make an offer.  The only times we see this not happen is when new information comes to light that gives the a defense.  For example if they discovered a Facebook post you made stating you pretended to be hurt at work, they’d surely take the offer away.

3. Don’t think about settling until you are ready. Insurance companies like to close cases because it gives them a fixed cost.  As a result, one of their new, sneaky strategies is to make an offer soon after you are injured.  Once you settle the case, your medical rights get closed out.  So if you are going to need any additional medical care or miss any time from work, thinking about settlement is a bad idea.

4. Don’t settle as soon as your doctor sends you back to work. You can start thinking about settlement when released to work, but if an offer was made I’d suggest you respond by saying “I want to see how things go at work for the next two to three months.  If I’m feeling good then, I’d be happy to start negotiating.” If you settle right away and your injury flares up, you might not have any way to pay for your medical care.  Make sure you can work without problems.  Also, if you settle quickly and then discover you can’t do the job, you might lose out on hundreds of thousands of dollars of value on the case.

5. Don’t forget to think about future medical needs. If you had a major surgery, are still taking pain medication, going to periodic therapy, etc., you can settle your case, but the insurance company has an obligation to pay for anticipated future medical care.  This is done through a Medicare Set Aside.  It takes some time, but this is additional money that should go in your pocket and can be tens of thousands of dollars if you had a major injury. For smaller cases it’s not needed.

6. Don’t get so excited about the offer that you forget what else you are owed. We take over a lot of cases where people call us and say that they haven’t received TTD benefits for over a year and that their lawyers hasn’t done anything about it. In some cases those people come to us after an offer has been made.  We’ve had a lot of calls where the worker has been offered a fair settlement for the injury itself, but nothing for the $40,000 in TTD they never got paid or outstanding medical bills.  If you are owed 40k in TTD, getting a 40k settlement isn’t likely a good thing.  Maybe the case is reasonably disputed, but before settling I’d certainly want to at least negotiate the money that you might be owed if the case went to trial and you win.

7. Don’t forget to call all of your medical providers. If there are any unpaid medical bills, you want them either paid before you sign the contracts or entered in to the contracts themselves.  Call EVERY medical provider you’ve been to and see if there is an outstanding balance.  Get this done before you sign because if something turns up after the fact, you could be stuck paying the bill.

I hope this helps, if you have any questions please contact us for free at any time.

Should You Apply For Work Comp Or Long Term Disability?

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

A caller to our office wanted to know if they should be getting workers’ compensation benefits or long term disability benefits through a policy their employer provided.

They were injured on the job in Chicago and filed a workers comp claim with their employer.  Although there was no basis for it, the insurance company denied the case saying it was not work related.  As a result he filed for long term disability (“LTD”).  That too was denied because on the application it asks if you were hurt on the job. He answered honestly and sad yes, so he didn’t get LTD either.

Although it sounds like it burned him, the reality is that by answering honestly, this worker will end up with work comp benefits.  His case was denied without reason.  Had he filled out a form stating that his injuries weren’t work related, he would have created a defense to his case.  Once he gets a lawyer to file his work comp case, he should immediately get paid and have his medical treatment covered.

The point of this post though was should you file for work comp or LTD? It’s actually a simple question.

You can’t get both.  If you were injured on the job, you should file for workers comp.  First off, it’s the truth as to why you can’t work. Second, unlike many LTD policies, there is no cap on benefits and usually you get paid more. Third, it covers your medical care.  Fourth, you will get a settlement at the end.

On the flip side, if you weren’t really hurt at work or don’t know (e.g. a repetitive trauma situation), you should file for LTD until a doctor states that your problems are work related.  That said, if you think it might be work related, you should make clear on your application that you aren’t sure.

If you do start to get LTD and then it turns out that it’s work comp, the work comp insurance would have to reimburse the LTD insurance.

On the other hand, if you go to trial or in some other way it’s determined that you didn’t have a work injury, you should be able to get short or long term disability.

Whatever you do, we recommend two things. One, be honest.  It’s people that lie for short term gain who lose in the long run.  Two, don’t sign anything or fill out a form without having an attorney look at it.  By doing this you protect yourself and give yourself the best chance of a great result in the end.

LexBlog