IDOT Worker Injuries

By Mike Helfand on Posted in Tips if Injured

The Illinois Department of Transportation (“IDOT”) employees over 4,800 workers and while some of them are paper pushers, most are working to make sure that our bridges and roads are safe.  Their work can be as simple as removing roadway debris to as serious as making repairs.

Because these are often heavy labor jobs there are a lot of injuries.  Working on a roadway maintenance crew is dangerous.  A lot of work is done within a few feet of speeding motorists.  While the most worrisome safety threat is being hit by a speeding car or truck, the reality is that most IDOT employee injuries are from their other daily activities. We see a lot of back injuries from moving materials, slip and falls from working on wet or uneven pavement, shoulder injuries from overhead work, lots of bad cuts, ankle and leg injuries from stepping in holes and even psychological injuries from seeing victims of bad crashes.

Because your employer is the State, you are not dealing with an insurance company when you are hurt while working for them.  The Illinois Attorney General defends these cases and it’s not like being in a case with a regular law firm.  A private law firm is worried about getting fired by an insurance company if they do a bad job, so you can expect they will return phone calls, be prepared and be working on the case.  Attorneys that defend these cases don’t have those worries and often we find they are overwhelmed with work and uninterested in many of their cases.

The point of saying all of this is that if you work for IDOT and are hurt on the job, you better hire a law firm that has a track record of going to trial.  Often that is the only reason to make the State pay or at least get their attention.  If you have a lazy lawyer you could get punished by having to wait for them to get their act together and get the case ready for a hearing.  We find that when you are ready to try the case, the State pays attention.

Another issue is that years ago there was a phony “crisis” where some downstate newspaper noticed the State was paying out a lot in work comp benefits to State workers.  As a result, some higher ups try to fight some of these cases without good reason.  The reality is that when you are an IDOT worker you are putting your life on the line every day and risking great bodily harm from most activities.  It’s not unusual for you to have a serious injury.  If the State wants to play a game with it, it’s just one more reason why you need someone in your corner who can protect you.

Via our Illinois wide network of lawyers, we have tremendous experience and success with helping injured IDOT employees.  If you would like to speak to one of our attorneys for free, fill out our contact form or call us at 312-346-5578.

Look Out For This Unpaid Medical Bills Trick

By Mike Helfand on Posted in Benefits

Under Illinois workers’ compensation law, you are entitled to reasonable medical care related to your injury and 100% of it is to be paid for by the employer or their insurance company. Seems pretty straight forward, right?  You get hurt at work, they pay for your care and if you don’t have health insurance it doesn’t matter.

Of course insurance companies aren’t known for doing things in a straight forward manner. The issue to them isn’t your health.  The issue is how little can they pay and get away with it.

As an attorney it’s a constant game of cat and mouse as you really have to be on the lookout for the games they will play to reduce their costs and try to stick you with the bills.

The latest one I noticed was language inserted by an insurance company attorney in to a settlement contract recently.

Respondent accepts liability for medical bills that are reasonable, necessary, and related pursuant to the fee schedule or agreement, whichever is less, through the date of MMI of —– presented prior to settlement contract approval.

In plain English this means that if you can’t prove you gave them a bill before the settlement contract is approved and it comes up later, it’s your bill to pay.

If healthcare in this country was straight forward, this clause wouldn’t be a problem.  But if you have had a surgery you know that you don’t just get a bill from the hospital, you get one from the doctor who does the surgery some times, the anesthesiologist sometimes as well as other providers and vendors. You might think you’ve paid all the bills, but you could then have one pop up out of the blue.

So what are you to do in this situation?

First, this is a bad contract if you have a lazy lawyer.  To protect yourself I recommend that you personally call every medical provider BEFORE you sign a settlement contract and ask them for an itemized bill and physically prove that nothing is owed.  If you had a surgery, call up the hospital or surgical center and ask if there is anyone else that could be sending a bill and get it in writing.

The other strategy is to refuse to sign off on this type of contract and instead ask the language in the contract to state that they will pay for related medical bills for treatment from before the contracts are approved.

This is all about protecting yourself.

Bonus tip, if you have medical bills that aren’t paid while you are still treating, that can hurt your care.  Your attorney can file a trial motion to make them pay and for penalties and fees for their bad denial.  Your health shouldn’t suffer because the insurance company is playing games.

Second bonus tip.  It’s illegal for a health care provider to report you to a credit bureau for an unpaid bill or try to collect from you while you have an active case pending.

And as always, if you have any questions or concerns, call us for free.  We cover all of IL.

How Long Does An Illinois Workers’ Compensation Case Take?

By Mike Helfand on Posted in Benefits

The number one Illinois workers’ compensation law question we get is “What is my case worth?”  The second, especially of late, is how long will my case take?

The two questions are similar, in that the answers really depend on your case facts, as well as your lawyer.

By far, the most important part of an Illinois workers’ compensation claim is making sure that you get the medical care that you need and that it’s paid for.  So before you can know how long your case will take, you have to know when you will be better and need no more treatment. If you have a torn meniscus and get it surgically repaired, in most cases you’ll be as good as new in three or four months.  On the other hand, if you have a herniated disc in your back and end up with a fusion, you are looking at a minimum recovery time of a year.

Usually injured workers in Illinois recover with treatment, but some need additional surgeries, therapy or pain management. Others need vocational rehabilitation or work hardening to get them back in to the work force.

So an average case will take around 12 months, but it’s not unusual for a case to take three or more years.

In some cases, you want to settle, but the insurance company won’t.  In that situation you need to go to Arbitration and how long that will take depends on how quickly you can take a deposition of your doctor as well as how long it’s been since you formally filed your case with the Illinois Workers’ Compensation Commission.  Older cases get priority which is one reason to get a case filed soon after you are hurt with an attorney.  If you ever need to go to trial down the road you will have a better place in line.

A big factor in how long as case can take is how lazy or aggressive your lawyer is. I’m shocked at how many attorneys, usually due to being disorganized or incompetent as well as not hard working, delay cases that can be resolved.  You don’t want to settle too soon if you need treatment, but you also don’t want to wait another 18 months to get a settlement check if you could get the same amount today.  Why lawyers do this is beyond me as they don’t get paid until the case is over.

A recent caller from Chicago was frustrated that her case was still going on after six years, but a closer look showed that she’s still receiving treatment for her injuries and being paid for her time off work. So from our viewpoint, her lawyer was doing everything out and if he tried to settle he’d be selling her out.  On the flip side, we got a call from a woman who was mad that her case hadn’t been settled yet after more than two years from her accident. It turns out she was justified as she hadn’t received treatment in over a year and her lawyer hasn’t made a settlement demand.

Bottom line is that every case is different and you have to look at the facts.  You don’t want to wait forever to settle or go to trial if there is no reason to delay, but you also don’t want to sell yourself short if you need medical care.

If you have any questions about any of this, contact us at any time for a free consultation. We cover all of Illinois.

Some Good Illinois Workers’ Compensation Questions

By Mike Helfand on Posted in Tips if Injured

One of the things that makes us unique is that we will talk to anyone about their Illinois work injury and will answer your questions.  A lot of those questions end up as blog posts, but some of them are great questions that wouldn’t make a great blog post.  So every now and then we like to compile a list of those questions and tell our readers what our answers are.  So in no particular order, here are some great questions we’ve received over the last few months.  If you have any questions, fill out our contact form or call us for free at 312-346-5578.

Can my attorney pay me out of his pocket for my injury?

This person was frustrated that their claim had been denied and since his lawyer promised him it would be an easy case when he signed up, he wants the attorney to advance him the money that he is owed.  This is illegal and if a lawyer does this, they can lose their license to practice law.  Technically you can go to a “lawsuit loan” type company, but we advise against that as they charge ridiculous interest rates.

I have an old injury that has gotten worse lately. Am I able to file for workers comp on that old injury?

The answer to this one depends on whether or not you are within the statute of limitations for filing a case.  But more importantly, we’d want to know if your current job duties have aggravated this pre-existing problem.  If so it might make more sense to file a new claim based on the repetitive nature of your job activities making your injury worse.  What we would recommend would be influenced by a lot of things including when you last saw a doctor, how long you’ve been in the current job, your age and a bunch of other factors.

Is it normal to have an IME if you are hurt on the job?

An IME or independent medical examination is when the insurance company sends you to a doctor of their choosing to make opinions on whether or not you were hurt at work and what treatment is needed.  It doesn’t happen in every case, but it is normal.  They are often hired guns, but it’s nothing to freak out about if you are being asked to go to an IME.

What are the odds of my lawyer winning my case?

Well, that depends on how experienced and hard working your lawyer is, but also on the facts of your case.  A crappy lawyer can win a case where the injury is clear and obvious.  The best lawyer in the world can’t help you if you are caught lying about how your got hurt.  Every case is different, but encourage people to increase their chances of success by hiring an attorney who is almost exclusively handling work injuries, has experience, can show a history of taking cases to trial and gives great customer service to you.

How much money do you get for a back injury?

That depends on how serious your injury is, the treatment you’ve had, the recovery you made, your average weekly wage, your age, the future treatment you need, etc. In other words, if you want a real answer you need an attorney to have a lot of information that they can’t get in 30 seconds.

I fell while at work and hurt my knee, but my claim was denied, do I have a case?

In order to win a slip and fall on the job you either have to know what you slipped on (or at least that the floor or stairs were slippery), be hurrying for work (e.g. running to a meeting), be carrying items for work and have that lead to the fall or show something else about the job contributed to the problem.  If you say you were walking and the next thing you know is you were on the ground and don’t know why, you will lose your case.  If that’s the truth then it’s ok, but for most people they need to pause, look at their surroundings and figure out what happened.

 

If you have any questions, please do not hesitate to get in contact with us at any time. We cover all of Illinois.

Illinois Work Comp – When The Insurance Company Won’t Respond To A Settlement Demand

By Mike Helfand on Posted in Tips if Injured

A settlement demand is the process in which your attorney writes to the insurance company and/or their attorney and tells them what they think your case is worth and why.  In some areas of law like medical malpractice, attorneys will ask for way more than what they think the case is worth.  There are some Illinois work comp attorneys who take that strategy and think they are negotiating geniuses by giving themselves “some room to negotiate” but most attorneys we know ask for something realistic in the hopes of getting the most for their clients as soon as possible.

Insurance companies don’t have to make an offer or respond to your settlement demand. They often do because to them a settled case is a good case. In some claims though, usually those with neck, shoulder and back injuries, they can be hesitant to settle.

This happened to a recent caller of mine.  He hurt his neck at work and had a surgery.  All of his bills and time off work were paid.  The mistake he made was that the attorney he hired was a general practice attorney who handles car accidents, probate, divorce, DUI’s and a whole bunch of other cases.  I assume that he took the case on because he thought it would be easy, not because it was in the client’s best interests.

What happened is the attorney made a settlement demand and the insurance company has been ignoring him.  The client has been waiting for months for an answer.  At first the attorney told him the truth and said he didn’t know what to do other than wait, but lately he’s just stopped returning calls. So the insurance company won’t call the lawyer and the lawyer won’t call the client.  Tons of red flags going on here.

It’s a bad news, good news situation.

The bad news is that he hired a terrible attorney.  The good news is that there hasn’t been a settlement offer so getting a new one was not a problem.  If the insurance company doesn’t want to settle, you can still get paid by simply going to trial. Usually just preparing for trial will push them along to make an offer and if not, an Arbitrator will award you an amount.  You’d be shocked at how many cases drag on because an attorney is just too lazy or inexperienced to get the job done.

Bottom line is that the insurance company doesn’t have to make an offer or return phone calls but if they don’t, an aggressive attorney can get things done for you and get your case closed.

When You Need Plastic Surgery From An IL Work Injury

By Mike Helfand on Posted in Benefits

If you have ever had surgery, you know that you’ll likely have a wound scar and additional scar tissue will develop.  For most people other than the visibility of it, it’s not a problem.  Every now and then though it can cause excessive itching and some pain. In those cases where the surgery is from a work injury, under Illinois work comp law you’d be entitled to plastic surgery to try and stop the problem.

This happened in a recent case where a woman severely injured her arm when it was trapped in a machine.  She suffered a really deep laceration and had a surgery and then had two more revision surgeries after that.  Those treatments were all accepted and paid for by the insurance company.

The insurance company, however, didn’t want to pay for another surgery to relieve her pain and itching from the scar and got the opinion of a hired gun doctor to say her problems could be solved with desensitization therapy.  The problem was that she had already tried that and it didn’t work as she still had pain and an ugly scar.  This additional surgery would remove scar tissue.  Fortunately the Illinois Workers’ Compensation Commission used common sense and found that this treatment recommended by the treating doctor was reasonable and approved it.  They also ordered the insurance company to pay her for her time off work following this additional surgery.

I’ve been involved in other cases where insurance companies have told injured workers that cosmetic surgeries aren’t covered.  This isn’t you asking for a boob job or butt lift or something like that.  This is you asking for them to improve the look of a work related scar or reduce the discomfort of a work related scar.  If your doctor says it’s reasonable and necessary, it should be covered.

Bottom line is that you shouldn’t be surprised if they fight a cosmetic or plastic surgery, but like any other bogus denial, if the facts are in your corner you should ultimately prevail.

An Illinois Workers’ Compensation Scam

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

Most of the work comp lies I’ve written about involve insurance companies not telling the truth about Illinois work comp law or lazy attorneys telling clients how hard it is to go to trial (it’s not) because they don’t want to do the work needed to get the job done.

The other day I heard a new one though.  A woman called me after receiving a text from someone that told her there is money waiting for her from a workers’ compensation claim.  This was surprising to her as she had never been hurt on the job or filed a claim.  She called them and the person they talked to made it sound legit, even giving her a claim number, docket number and telling her a dollar amount that she was entitled to.

Fortunately this woman thought it was odd and called me to see if it was a scam or not.  Regrettably, it is.  Much like people who are told by an email or call that they’ve won the lottery or inherited money from an unknown relative, this woman was being preyed upon and part of her hoped it was legit because she could really use the money.  It’s a sad situation and that’s how these scammers get you.

It didn’t get this far, but at some point they would have sent her a fake check and then told her either that she owed taxes on it and to send them money or that they paid her too much and she needed to send some back.  Their check would eventually bounce and if she sent money back from her account she’d never see it again.

Plain and simple these are crooks who are doing this.  Insurance companies don’t text people out of the blue.  They don’t offer money to people who have never been injured. They’d never ask you to send money back to them.

If this ever happens to you, my advice is to ignore it and/or report them to the police or FBI.  The people who do these scams hope that if they target 1,000 people they will get 2-3 to fall for it. If they do they make a bunch of money.  These scumbags belong in jail.  If you have any questions about these types of calls, you are welcome to contact us for help at any time.

Why Your Illinois Work Injury Isn’t Going To Trial Next Week

By Mike Helfand on Posted in Tips if Injured

In what may ironically be good news, if you were hoping to go to Arbitration in the next week or two at the Illinois Workers’ Compensation Commission, you might not be.

That’s because Governor Pritzker has essentially fired six Arbitrators who were appointed but not confirmed by previous Governor Rauner.

Elections have consequences and the reality is that Republican Governors are more likely to appoint Arbitrators who are not as friendly to workers.  There is a Democrat in charge now and he’s going to put people in that aren’t as biased toward workers in his opinion.

That’s not to say all of the removed Arbitrators were bad or biased, but that perception is often a reality.

So the bad news is that some cases won’t go to trial in the next couple of weeks because there aren’t enough Arbitrators to hear them.  There also may be cases that have already gone to trial that will get delayed verdicts because the old Arbitrators won’t keep working and the new ones will have to read transcripts in order to make a decision.  That’s not fair to you as your credibility and that of others who testified will be harder to judge.

But in general you’d expect that more worker friendly appointments are coming which I believe is a good thing.

If you were expecting to go to trial next week, talk to your lawyer and figure out if waiting is OK and what it will mean for you life and your case.

In the big picture this is why it’s important to have an attorney who really knows the work comp system and stays up to date on not just the law, but also behind the scenes developments.

Have a great and safe Memorial Day weekend, and as always, please feel free to contact us any time with questions or concerns about a case.

UPDATE:  In an unexpected twist, all of the Arbitrators got reinstated.  My guess is that they don’t want to leave spots vacant while they get ready to put new ones in. We’ll see what happens next.

What Is Your Case Worth When You Need More Treatment?

By Mike Helfand on Posted in Benefits

The most popular Illinois work comp law question we get is, “What is my case worth?”  I get it and we try to answer that question when we can.

The thing to know is it’s not black and white and every case is different.  So if you call us and want to know how much a torn bicep tendon is worth, we need to ask a lot of questions to give you an accurate answer and sometimes we can’t do that without seeing your medical records.

A recent caller wanted to know what his case was worth after tearing his meniscus and having surgery.  That injury is usually fairly straight forward and most people make a good recovery.  In this case though, the recovery wasn’t great and his doctor told him that he’d likely need a total knee replacement down the road and in the mean time would need injections to his knee every year.

This is a classic case of there’s no way to tell you what it’s truly worth without seeing your medical records.  The major issue is that this worker needs to be compensated for his future medical care.  This can be done by leaving his medical rights open, but insurance companies don’t like to do that when they give you a settlement.  It can also be done through a Medicare set aside which requires the insurance company to get an estimate as to what the future medical costs will be and give you that money now.  You have to pay for your care out of that fund until it runs out and if you don’t and ever need Medicare you could be out of luck.

Another way around this is to not settle, but go to Arbitration.  If you d this, you keep your medical rights open and may have a way to be compensated in the future when you can’t work when you have the knee replacement surgery.  It’s probably a smart play and you’ll still receive money similar to the settlement amount through the Arbitrator making an award. If you aren’t concerned that the case could be lost for some reason, you should seriously consider this option.

Big picture is that when you need more medical care in the future, especially if it’s for something serious like replacing a fusion, knee replacement, etc, your case is unique and you have to really have someone look at this from all angles.  You might think the settlement they offer you sounds great, but in our experience, the cases are usually worth much more because they are trying to close your case while limiting what they are obligated to do in the future.

If you’d like to talk with one of our attorneys about this for free, call us any time at 312-346-5578.  We cover all of Illinois.

Does Your Employer Need To File The Case So You Can Get Treatment?

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

A woman called my office with a pretty typical sounding work injury.  She had been hit in the head by a falling box and sustained a concussion and neck injury.  The concussion seems better, but she has shooting pains going down her arm which is a sign of a herniated cervical disc.  That can be a really serious injury and could go from bad to worse if she doesn’t get treatment right away. At a minimum she should be getting physical therapy.

While she was able to go to the emergency room without a problem, getting follow up care with her preferred neurologist has been a challenge.  Long story short is that the employer hasn’t reported the case to their insurance carrier so the worker can’t get a claim number.  The neurologist, who wants to get paid, won’t provide any treatment without a claim number because he wants to bill someone he can collect from.  No treatment means no recommendation for physical therapy, no MRI and her injury gets worse.

As often is the case, the only person losing out here is the one everyone should be worried about, the injured worker.

There is no legal reason for the company not to report the claim other than hoping to frustrate their employee with the hopes she goes away. They are risking a ton though as if they delay too long they’d lose their insurance and still be on the hook for all the bills.

In a situation like this you need to force their hand and file an Application For Adjustment Of Claim with the Illinois Workers’ Compensation Commission. This is the first thing an attorney does.  Doing so makes the case official, gets you assigned to an Arbitrator and gives the employer no choice but to report the claim.  That will generate a claim number and in a case like this should allow you to get medical treatment. You can get on the road to getting better and put the nonsense and games they are playing behind you.

Bottom line is that there does not need to be a case number in order to get treatment, but it can help.  If there isn’t one it means that somebody is playing games with your health and that of course is a big red flag.  If you have any concerns, questions or want help with a case, contact us at any time for a free consultation.

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