Illinois Workers’ Compensation Laws You Need To Know

By Mike Helfand on Posted in Benefits

An injured worker in Chicago called me with a very generic question. She asked what laws do I need to know. I told her it was too vague because what I’d recommend for her would be based on her case facts.  She doesn’t need to worry about TTD benefits for example if she’s not missing any time from work.

When the call ended I thought it would be a good idea to highlight laws and tips related to your IL work comp benefits that I think everyone should know.  So in no particular order, here are some things you need to know if you were hurt on the job in Illinois:

1. Your employer or the insurance company has a right to medical records related to your injury, but not your life long medical history.

2. If they ask for you to give a recorded statement, you should refuse.  It can’t help you and if they say you will only get benefits if you give one they are lying.

3. After you are hurt at work and can’t work, you are entitled to 2/3 of your average weekly wage tax free. You get paid based on calendar days missed, not actual work days missed.  So if you are taken off work starting on Monday the first until Monday the 22nd, you are owed 21 days of benefits even if you were only scheduled to work 15 days during that time.

4. Under Illinois law, not only is the insurance company not allowed to talk to your doctor without your permission and any information they get in doing so can be barred from trial.

5. 100% of your medical bills are to be paid for anything related and reasonable.  No co-pays, no out of pocket expenses.

6. There is no pain and suffering payments under Illinois work comp law.

7. These cases are not lawsuits.  They are claims for benefits.

8. It’s illegal to fire someone for pursuing a work comp case.

9. It’s legal for the insurance company to follow you around, do surveillance, etc.

10. They can send you to a doctor of their choosing for a one time exam, but have to pay your travel expenses to and from the exam.

11. The money you receive from your work injury is tax free.

12. It doesn’t take years to get to trial despite what some lawyers say.

13. Attorney fees can not exceed 20% of the settlement (unless they make you an offer before you hire the lawyer) and in some cases it ends up being less when the settlement is in the six figures.

14. You have by law at least three years from the accident date to file a case, but for many strategic reasons you should it ASAP.

15. You have to tell your employer you were hurt at work within 45 days of it happening, but again should do it ASAP.

16. If you were hurt in Illinois you can file the case here no matter where the company is based out of.

17. Eligibility for work comp benefits begins the second you start working.

18. Your employer can’t force you to waive your rights to work comp benefits even through a severance agreement.

19. Once you settle your case you can not re-open it.

That’s 19 tips which seems like a good number for 2019. But if you have any questions about anything, call us any time at 312-346-5578 or fill out our contact form and we’ll call you.

IL Work Comp – How To Beat An IME Exam

By Mike Helfand on Posted in Tips if Injured

A caller to my office told me that he was hurt at work and receiving benefits for a knee injury.  His doctor wants to do surgery, but before the insurance company would approve it, they want him to see an IME (independent medical examination) doctor.

He’s heard stories about how many of these physicians are hired guns and is worried that he’s about to get screwed.

His concerns are valid.  In fact, the other day I heard that one IME doctor was charging $11,000.00 for an IME!!!  That’s an insane amount of money, especially when some of these exams take five minutes or less and the doctor doesn’t ask many questions.  You can bet that this doctor doesn’t want to ruin the gravy train of money by telling the insurance company something they don’t want to hear.

So the very hyped up caller asked me, “How do I beat the IME Exam?”

As much as I believe that a lot of these doctors are hired guns, I would never suggest a client do anything dishonest or try to “beat” an IME.  You have one thing in your favor in every good case; the truth.

So if you go to an IME (or trial) and embellish or say something that you think will help you win your case, you are probably setting yourself up to screw yourself.  Arbitrators aren’t expecting every detail of your case to be perfect.  You don’t need to be in crying pain 24/7 to show that you are injured.  Just tell the truth.

The worst thing you can do at an IME beyond lying or embellishing is to be confrontational.  I’ve seen cases where injured workers have yelled at the doctor or even tried to record the whole session and it’s just made them look crazy to the Arbitrator and insurance company.

So what can you do besides tell the truth? Here is what I suggest:

1. Be friendly.

2. Bring someone in to the room with you if they allow it.

3. When you get to your car after the exam, write down what your experience was.

So why these three things? If you are friendly and they know that your injury is really work related, they might be less inclined to find against you.  If someone is in the room with you, they can corroborate at trial how long the exam lasted and can support you.  If you write everything down (how long the exam lasted, what they asked you, what you told them, etc.) it will lend credibility to you if the doctor testifies he saw you for 30 minutes when you timed it at four minutes.

Are any of these suggestions home runs?  No, but again, you shouldn’t try to beat the IME.  It’s just one piece of a case and in most cases if you are credible and your doctor is credible, you will win.  So trying to “beat” the IME can turn a good case in to a bad one.

These are things your attorney should be discussing with you.  If they aren’t or if you don’t have one and want a free consultation, call us any time at 312-346-5578.  We help all over Illinois.

Is Your Work Comp Attorney Giving You Love?

By Mike Helfand on Posted in Tips if Injured

Happy Valentine’s Day!  It’s unethical (and gross) for an attorney to be in a romantic relationship with a client.  But that doesn’t mean your lawyer shouldn’t give you love.

By “give you love” I mean your attorney should care about you.  How can they do that?

  • Do they return your phone calls?
  • Are they talking down to you?
  • Will they answer your questions?
  • Do they remember details of your case and how you got hurt?
  • Have you caught them lying to you?
  • Do they keep their promises?
  • If your benefits are denied are they working to get you paid?
  • Have they shown you any empathy?

You aren’t dating your lawyer and you don’t have to become friends with them, but the qualities you’d look for in a friend or companion can often be what makes a great Illinois work comp attorney.  If someone treats you like garbage in a relationship, you probably aren’t having a great Valentine’s Day.  If your attorney treats you terribly and raises a bunch of red flags they aren’t the best choice to give you success in your case.

And just as you don’t have to stay in a terrible relationship in your personal life, if you hired the wrong attorney or discovered that they treat you like garbage or don’t fight for you, you can “break up” with them and get a new attorney if you don’t wait too long.

We try to treat callers, readers and clients like family.  That includes giving blunt, honest advice even if it’s not what you want to hear. I’d tell a relative in a bad relationship that they should get out and I’d tell you that if you have a bad relationship with your attorney or they aren’t in your corner to get out.

In life, you need to look out for you.  Your work comp attorney doesn’t have your back, stand up for yourself and find someone better.

 

Illinois Law Change When You Slip And Fall At Work

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

Another snowy and wet winter in Chicago.  That means a lot of slip and falls.  In general the law in Illinois has been that if you are working and on your employer’s premises when you fall, you have a case.  On the other hand, if you are in a place where you work, but it’s where the general public is, you wouldn’t have a case.

The Illinois Appellate Court, in an unpublished opinion, has clarified things.  A secretary for the City of Springfield fell on snow and ice while walking in to her building.  It was an entrance accessed by her employee badge, but the general public was allowed to enter there as well.  There was one other entrance to the building.

She fell almost five years ago on a snow covered walk way that connects one of the entrances with the main sidewalk.  Her case went to Arbitration and the Arbitrator ruled that the case wasn’t compensable because she fell in an area accessed by the general public and since she wasn’t at work, doing her job, she had no increased risk of injury

Bravo to the lawyer who stuck with this case (it wasn’t our office, I just read about this case) because it got appealed twice and denied twice before reaching the Appellate Court.  They made a common sense ruling that because the employer’s premises were unsafe and hazardous.  There were only two entrances and one main one for workers.  To get there put her through a huge risk of injury.  That per the Court was enough to win the case.

It’s important to know that in general under Illinois law you don’t have an obligation to remove snow and ice.  But Illinois work comp law is different in that you aren’t trying to prove negligence, but rather that your job put you at risk somehow.

So the law has essentially changed as falls outside an office building in areas where the general public can be used to not be covered under the Illinois Workers’ Compensation Act.  Bottom line is you should always talk to an attorney to see if you have a case and getting one who is a fighter can clearly be the difference between winning and losing your case.

If you have any questions or want to chat for free, fill out our contact form, click on the chat box or call us at 312-346-5578 any time.

What To Do If Your Case Isn’t Going Well

By Mike Helfand on Posted in Tips if Injured

A reader of my blog got in touch and asked a really good question:

“My case isn’t going very well.  What should I do?”

Now as you can imagine, we had a longer conversation because I needed to know specifics, but the fact that this worker even asked at all is a good sign.  Too many people see that their case isn’t going well and just assume that’s how it goes or that the legal system should take a ton of time.  Sometimes that’s true, but if you don’t ask questions or don’t seek out information, you are making a huge mistake.  You have to be your biggest advocate.

So if you have a lawyer, ask them why your benefits aren’t being paid, what’s a reasonable time line to get in to court, what the strategy is, etc.

Beyond that, my question to you if you asked this would be “why isn’t it going well?”  Let’s figure out the problem and find the solution.  If the problem is something like:

  • My lawyer won’t call me back.
  • I’ve been without pay for six weeks even though my doctor has me off work.
  • They won’t approve my surgery even though the IME doctor says I need it.
  • There is a nurse manager that keeps on interfering with my doctor’s appointments.
  • I’ve been waiting for a settlement for a year and there is no offer.

The good news in any of these situations is that the problems are all solvable.  If your lawyer won’t call you back, fire them.  If you’ve been without pay or surgery can’t get approved, a 19(b) motion by your lawyer should get you to trial. If the nurse manager is talking to your doctor that is illegal and one phone call by a lawyer can stop it.  If there’s no settlement offer then motion the case up for trial and the Arbitrator will make them pay.

These are just five examples, but the bottom line is that there is an answer for almost every problem under the sun.  That doesn’t mean that you will 100% for sure win your case.  It means that steps can be taken to give you the best chance for success.

Above all else though, you have to be your biggest fan and fight for you.  And when it doesn’t appear to be going well, ask questions and get informed.

Odd Lot Permanent Total And Illinois Work Comp

By Mike Helfand on Posted in Benefits

To be permanently and totally disabled under Illinois law means that there is essentially no job you can do because your injuries and physical restrictions due to the injury are so severe that they prevent you from being able to work.  The standard to show that under Illinois work comp law is different than showing you are disabled from working for purposes of social security.

People who are declared permanently and totally disabled under IL work comp law are usually the most physically injured people around and they can receive for life benefits to compensate them for their injury.  But there is another category of people who also qualify for permanent disability benefits.  They are called “Odd lot permanent totals.”

Essentially an “odd lot” is someone who was injured at work, has permanent restrictions, but also has limited vocational abilities so there is no reasonably stable job market for them. That is usually someone who has a very low education level, doesn’t speak English well, is older and not suitable for re-training for a new job, has a work history in something they can no longer do like manual labor or someone who has looked for a job for a long time and can’t find one.

These workers aren’t so physically damaged that they can’t do any work, it’s that they have other factors that are also working heavily against them.  An employer “takes you as they find you” so you don’t get punished for having only been a laborer your whole life or not having had much education.

Once you establish that you fall in to this odd-lot category, the burden shifts to the insurance company to prove that there is some stable job market for you based on your background and limitations.  So if you dropped out of school in 8th grade and have been a welder for the last 40 years, you can’t be reasonably expected to take a data entry job.  The insurance company could try to prove some other job is available (maybe if your able to stand all day you could work security or be a greeter at a store), but they can’t just make up some job.

Bonus tip.  You don’t have to take some crap job that they say is available.  It ultimately comes down to whether or not you are eligible for permanent disability benefits, wage differential benefits or regular permanency benefits.  In other words, your case is worth something, but how much depends on what type of work you can realistically do.

Is this confusing?  It can be.  Call us with any questions.  And whether you hire us or some other firm, if your injury is this serious it would be a huge mistake not to have a lawyer who knows what they are doing.  Not doing so could be the difference of hundreds of thousands of dollars.  Fill out our contact form or call us at 312-346-5578 for a free consultation.

Ford Motor Workers Compensation Case Brings Knee Replacement

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

We are Chicago based workers compensation attorneys who through our State wide network handle cases throughout Illinois.  We have over 20 years experience and will fight for you.  Fill out our contact form, click on the chat button or call us at 312-346-5578 to talk or free with a lawyer.

We have been involved in a lot of claims against Ford Motor Company in Illinois for work injuries.  I just read about a case against them (that we didn’t handle) which is a great example of how Illinois work comp law works with pre-existing conditions.

Ford Motor workers have a lot of injuries.  There is a lot of lifting and repetitive movement and that’s a recipe for accidents and injuries.  In this case, the worker had a long term knee problem and had even talked to his doctor about getting a knee replacement some day.  He worked as an assembler in the body shop and ended up slipping on a part that was on the floor.

The case was denied because of the pre-existing problems. At trial he testified that when he stepped on the part he heard a pop and felt pain in his knee.  He did some physical therapy which didn’t help and then his doctor recommended a total knee arthroplasty (knee replacement).

The case came down to the treating doctor stating that even though there was osteoarthritis in the knee already, the worker was able to work full duty up until the accident at which time his problems were aggravated causing him not to be able to work anymore.

The reason this Ford worker won his case is that there was a sudden change in his ability to work.  If your job aggravates or accelerates a problem you were already dealing with, you are entitled to benefits under Illinois law.  It certainly helped that while he had problems before, he hadn’t received any treatment in a couple of years, passed a work physical and sought medical attention right away.

What we would emphasize to you is that you shouldn’t be surprised if your case gets denied, especially if you have a history of injuries to the same body part or if you work at a place like Ford Motor where a lot of accidents occur.  They don’t want workers to think that these cases are easy so one way to discourage claims is to fight them whenever they can.

You Are Told They Will Make A Settlement Offer, But They Don’t

By Mike Helfand on Posted in Benefits

A reader of my blog asked the following:

My husband was hurt at work in Chicago and missed four months with a knee injury.  He’s been back at work for six months.  Three months ago the adjuster said she was going to make a settlement offer, but she never did and she hasn’t returned our calls?  Do you think they will make an offer an if not how long do we have to bring a case?

One of the myths about Illinois workers’ compensation law is that an insurance company has to make a settlement offer.  They have to pay your medical bills.  They have to let you choose your own doctor.  They have to pay you for all of your time off of work.  If they don’t do those things they can be punished as they are mandatory.  Settlements are not.

The reason insurance companies make a settlement offer is to close out your case so you can’t get any more medical treatment and your file can be put away.  They don’t like variables, they like things to be known.  At the same time, if your case is worth a lot of money, they’d often rather not offer anything at all or if they do, low ball you, as they are a bottom line business.

If they don’t make an offer the only way to get one is to formally file a case against them. It’s not a lawsuit, it’s an official claim for benefits that will result in an arbitration if you can’t reach an agreement.  Usually once you file though they want to settle because if you go to arbitration your medical rights for the injury will remain open for life.

Time wise, you have three years from the date of the accident or two years from the last payment of benefits, whichever is longer, to bring a case.  But waiting to file is foolish because once you are done with your medical care, you are entitled to pursue a settlement so the longer you delay the more time they are earning interest on your money.

Surprisingly to some, it’s common for insurance companies to say that they are going to make an offer and then just disappear.  They do what’s in their best interests and if that means ignoring you or lying to you then that’s just the cost of business to them.

Stress Fractures And Illinois Workers Compensation Law

By Mike Helfand on Posted in Injuries

It’s official: The most common cause of workplace injury is working too hard. Okay, perhaps that is an extreme way to put it, but records continuously show through the years that the most common cause of workplace injury is overexertion. Overexertion includes tasks involving repetitive motion, which in turn, can temporarily, or even permanently, injure muscles, nerves, ligaments, tendons and even your bones.

Yes, that is right. Overexertion can be a culprit of injury to your bones. The bony skeleton is a remarkable organ that serves as a strong structural function, however, like most tissues in the body your bones has its limits and can break or fracture. One of the major types of fractures is stress fractures also commonly known as a micro fracture. Stress fractures differ from micro fractures in the way they occur. Stress fractures being more of an issue of overuse or misuse where micro fractures are caused mostly by trauma.

Like most tissues in the body, bones are constantly renewing and replacing itself, a process called bone remodeling. With stress fractures, the name says it all: these fractures occur when bone tissue has to absorb more weight and impact than it can handle, tiring the muscles over time and allowing more force on the bone. The bone becomes stressed causing it to crack in the bone. This can occur over time in a well-conditioned bone that is overused, or suddenly in an under conditioned bone that is placed under undue stress in a short period.

It is a partial fracture rather than a complete fracture and they mostly occur in the weight bearing-bones of the feet, ankles, and lower legs, though they can occur in other parts of the upper body.
Sure, stress fractures are commonly associated with athletes, but the truth is certain professions are at risk. Workers in the medical profession, hosts and servers, dancers and performers, laborers and anyone who spends an extended amount of time on their feet and moving as part of their job are at risk of a stress fracture.

These stress fractures are usually tiny injuries that later become compound, making it difficult to diagnose. Even more so, it can be difficult when proving the stress fracture occurred because of an employees work. Being able to identify the specific activity that caused your stress fracture may entitle you to worker’s compensation benefits under Illinois law.

If you are experiencing foot pain as a result of your employment, it is important to let your employer know. A failure to report your problem within 45 days of when you know or should know it’s work related could cause you to lose your benefits.  Symptoms can include localized pain or pain with weight bearing does eventually go away with rest. Consulting your physician can help address the problem early. If your pain does persist, please contact us for free after seeking medical attention to learn more about your potential workman’s compensation case.

How Long Does It Take To Get The IME Report – IL Work Comp Info To Know

By Mike Helfand on Posted in Tips if Injured

Someone who recently clicked on my chat button (which I assume you’ve seen already) and asked a really good question.  She wanted to know how long it would take to get her IME report.  An IME report is an “independent medical exam” finding. Basically, the insurance company gets to pick a doctor to examine you and offer their opinions on:  your medical condition, the care needed and whether or not your problems are work-related.

We didn’t chat long, so I don’t have all of the case facts, but for purposes of this post, let’s assume that the IME was a month ago.  The insurance company is paying a decent amount of money for the IME, and most doctors want to keep that gravy train rolling, so they usually provide a quick turn around to add some customer service to the experience.  Some doctor’s offices do so many of these, that they essentially use a template so every report looks similar, and a nurse plugs in the doctor’s notes to customize the report.

So why doesn’t this injured worker or her lawyer have the report yet?  There are three likely reasons, all of which are good for her in the long run.

1. After the IME the doctor called the insurance adjuster or defense attorney who ordered the exam and said that he agrees that the problems are work related and a surgery is needed.  Since it didn’t help their case, they told the doctor not to write a report at all.

2. The report was written and provided, but they don’t want to turn it over because it’s bad for them.  At that point your option is to nag or to subpoena the IME doctor.

3. The worker’s attorney is being lazy and hasn’t asked for it.  The insurance company knows the report is bad for them, but also know that it’s not their job to advocate for the injured worker.  If her lawyer gets pushy they will send the report, but until then their strategy would be to try and settle the case as if the report will be in their favor.

These are the three likeliest scenarios.  Most IME reports go against you so it’s kind of a good news, bad news situation.  You are delayed, but it will likely work out in your favor.  At a time like this though, especially if benefits are being delayed or denied, you really need an aggressive attorney.   When the IME goes against them and you get punished, it’s just cruel, and you need someone who will push back.

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