How Long Until Illinois Work Comp Benefits Are Approved

A recent caller had a scenario that we hear a lot. He is alleging that he has carpal tunnel and possibly cubital tunnel (elbow) injuries from typing all day for over five years at his current job. His doctor thinks that’s what it is and has ordered a nerve conduction study called an EMG. That test is the gold standard for diagnosing carpal tunnel. Here’s where the problem comes in.

He wants the EMG, but the provider the insurance company wants him to go to for that can’t see him for over three months. So in their world, the case is not approved because the EMG hasn’t taken place yet. And when it does, they then want him to see a doctor of their own choosing for an IME.

So he asked my opinion as to how long it should take until benefits are approved.

The answer is that they should be approved until there is evidence that they shouldn’t be. If his doctor says he has these injuries and they are work related, that should be enough. They have a right to an IME, but they don’t have right to delay this case until they get one.

And even with the EMG, there is no way that test should take over three months to happen. He should see a provider of his own choosing to make it happen. That can usually happen in a week or two.

The problem is that he hasn’t formally filed his case by hiring an attorney and filing an Application For Adjustment of Claim with the Illinois Workers’ Compensation Commission. Because that hasn’t happened yet, he lacks the ability to push back on their unreasonable delay.

The good news is that most work comp lawyers would know a reputable EMG facility he could go to and quick. Beyond that, if the IME was in a week or two that would be one thing, but expecting him to wait many months is unreasonable. And that is generally the standard for what they can or can not get away with. Are their actions reasonable? Here they clearly are not.

My advice to any injured Illinois worker is that you don’t let the insurance company dictate how long things should take or who your doctor should be. You have to look out for your own best interests. I guarantee you that the insurance company is not thinking about what is best for you.

The good news is that it costs nothing to hire a lawyer and file a case. And usually in these nonsense situations, a phone call and/or a trial motion can solve most problems.

In general though, once the insurance company is given medical evidence as well as can confirm how the accident took place, anything longer than two weeks to approve benefits to me is an unreasonable delay. The only exception is when they have a legitimate reason to dispute your claim such as conflicting witnesses, medical records that say you weren’t hurt at work, etc.

If you’d like help with a case or just have questions, please call us any time at 312-346-5578. We cover all of Illinois

Beware Work Comp Lawyers Not In Illinois

Workers’ compensation law is odd. It’s not like any other area of law because it has so many unique features compared to other practice categories. These aren’t lawsuits. We use Arbitrators not Judges. The burden of proof is unique. The law is constantly changing.

Not only that, unlike divorce, traffic or car accidents, the law in one state is likely much different than in other states. In other words, just because you know work comp law in Florida or Pennsylvania, that has almost no relevance to handling a case in Illinois.

For years we’ve received calls from Illinois attorneys who dabble in work comp and had questions on how to handle a case. They are allowed to handle Illinois work comp cases because they are licensed here. It’s not a good idea to hire an attorney who only dabbles in work comp because if something goes wrong on your case and it needs to go to trial, a less experienced attorney means you are more likely to get a bad result.

Recently though we’ve been getting calls from out of state attorneys looking for advice on how to handle a work comp case in Illinois. That is shocking to me. I’d never try to handle a case in another state. There’s one great reason for this. It’s not in the best interests of the client. That should be the guiding principle in what every lawyer does.

While I will give advice to Illinois attorneys who reach out, I have made it very clear to these out of state attorneys that what they are doing is gross and I will not help them. If they want to help the client, they should simply refer the case to an Illinois lawyer. Even a meh firm would be a better choice.

The first attorney that contacted me was from a big Florida firm that also handles many other areas of law there too. He told me that they are starting to make inroads in Illinois and was hoping that “attorney to attorney” I could look out for them and give them some answers to questions they had about the Illinois IME process. Hard pass.

Their questions were so basic to anyone that has been handling Illinois work comp law for a while that I can’t imagine what they’d do if a challenging situation came up. Or what they don’t know that is harming their clients. In fact, I know many injured workers who know more about Illinois law than this attorney does.

Many of the billboards you will see in the Chicago area and sprinkled throughout the State are actually out of state law firms who are just marketing themselves here. Those are mostly for PI cases, but as the calls I’ve received have shown, they aren’t limiting themselves to just car accidents any more. I don’t care if you hire a lawyer through us or some other resource that you find to be a better fit. But I promise you, getting an out of state attorney on an Illinois work comp case is a terrible idea.

Don’t Apply For Short Term Disability If Hurt At Work

If you’ve read this blog for a while, you know that we discuss how a lot of odd circumstances seem to happen in bunches. Sometimes it’s just coincidence. Other times it’s insurance companies or employers trying new strategies in order to screw legitimately injured workers in Illinois out of their rights.

An example of this recently is we’ve seen a huge uptick in people who are hurt on the job and get told to apply for short term disability in order to compensate them for their time off work. They usually end up calling us for one of two reasons. One is that STD benefits are not enough to live on. The second is that those benefits are denied.

We can usually help, but applying for short term disability can make your case more difficult. And that’s why we tell anyone we talk to, don’t apply for short term disability benefits (or long term) if you are hurt on the job. There’s one crystal clear reason for that.

When you apply for these benefits, you have to fill out a form. Every one of these forms has a box to check as to whether or not your reason for being off work is due to a work related injury. If you check yes, you won’t get approved. If you lie and check no, you are now creating a defense that can be used against you in your work comp case.

We’ve seen multiple cross examinations at trial where defense attorneys bring out these forms. It’s their Matlock moment where they can try to spring a gotcha moment on an unsuspecting worker. For most cases the answer is that when you filled out the form you didn’t know your injuries were work related. That makes sense if you have a repetitive trauma problem like carpal tunnel. It’s harder to refute that if you were hit by a forklift or had a wall collapse on you.The most common retort in those cases, when true, is that “my boss made me.” That happens a lot.

The silver lining is that for most people we can get them their work comp benefits. Those benefits pay more than most disability policies and of course pay for your medical care and eventually result in you getting a settlement of some sort. Illinois work comp benefits also don’t expire or have a cap like some disability policies do.

I ask people why they filed for STD and I’d say for 35% of the people lately, they just didn’t know any better. The rest are because the employer or even in some cases the work comp insurance encouraged them to do so. Usually when that happens it’s not a well meaning mistake, but someone who is actively trying to hurt you.

So don’t apply for STD if you’ve been hurt on the job. And if you did, get with an experienced work comp lawyer right away to try and straighten things out. You can call us any time at 312-346-5578 to speak with a lawyer for free.

Frozen Shoulder Illinois Workers Compensation

Adhesive capsulitis, commonly known as frozen shoulder, is a condition whose primary symptoms are stiffness and pain in the shoulder joint. This occurs when the capsule of connective tissue surrounding the shoulder joint becomes tight and thickened, restricting its movement. It feels like your shoulder is frozen stuck, hence the name.

The Three Stages of Frozen Shoulder

Frozen shoulder typically develops in three stages

  1. Freezing Stage: Lasting between 2 to 9 months, this initial stage is marked by limited shoulder movement and pain with any attempt at motion.
  2. Frozen Stage: This phase can last anywhere from 4 to 12 months. Although pain may decrease, the shoulder becomes increasingly stiff, making it difficult to use.
  3. Thawing Stage: Spanning 5 to 24 months, the thawing stage sees gradual improvement in shoulder mobility.
    Given the timelines for each stage, symptoms of adhesive capsulitis may persist for 1 to 3 years. For many people the pain is worse at night and can interrupt your sleep.

Given the timelines for each stage, symptoms of adhesive capsulitis may last for 1 to 3 years. For many, pain is often more pronounced at night, potentially disrupting sleep.

Causes Of Adhesive Capsulitis and Workers’ Compensation In Illinois

The primary cause of adhesive capsulitis is inflammation in the tissues surrounding the shoulder joint. This inflammation can result from a traumatic injury or from keeping the shoulder immobilized for an extended period, such as following surgery or a broken arm. In other words, it’s common that one injury leads to a second injury

If the condition arises from a work-related incident, you may be eligible for workers’ compensation. This is true whether the injury occurred from a specific accident at work or as a result of a prior injury, like a shoulder issue or broken arm, that occurred on the job.

Should your condition impact your ability to perform work duties, your employer may need to provide accommodations or pay you until you are all better.

Treatment Options For Frozen Shoulder

The primary treatment for adhesive capsulitis often includes range-of-motion exercises. Additionally, corticosteroid injections and numbing medications are commonly used to reduce pain and inflammation. In some cases, arthroscopic surgery may be necessary to loosen the joint capsule and restore mobility.

If you’re suffering from frozen shoulder and believe your condition resulted from work-related activities or an accident on the job, don’t hesitate to reach out to us. The good news it that if it does stem from a work related injury, 100% of your bills will be made, you will get compensated for your time off of work and we can help you get a significant settlement when you are all better too. We have an Illinois wide network of great attorneys and can connect you with a skilled workers’ compensation lawyer who has successfully represented clients with similar conditions.

IL Work Comp When Your Boss Won’t Turn Your Case In To Insurance

I had a nice conversation with a really sweet nurse who was injured on the job. She’s worked over 20 years without ever filing a workers comp case. But now she hurt her wrist badly and had to file a claim. She told her boss how she hurt the wrist when a patient got violent. What the boss did next stunned her and led to her call.

He told her that it was unfortunate, but when she asked about workers comp, he told her she couldn’t do it and he wasn’t going to file a claim with their insurance. She called me wondering how to handle this.

First thing to know is this is insane and highly illegal. They can’t just choose not to file a claim.

Second thing to know is that you don’t need their permission to file a claim. You simply hire a lawyer (costs nothing) and we will file an Application For Adjustment Of Claim with the state of Illinois. That’s the official form you have to file to begin a case. We can even look up who your employer has for insurance and notify them of the case that way. Note, your employer is by law also supposed to post this information in a break room or other common area.

The third thing to know is that if your employer waits too long to report your accident, they might have their insurance coverage denied. That would affect you as there would be nobody to pay for your medical bills or time off of work. This nurse needs surgery and likely will be out for two months. The surgery is expensive and not one she should have to pay for herself. The owner could lose coverage permanently if they don’t report it. So you are protecting your interests and those of the company and others by filing a case.

Beyond all of this, it really is a huge red flag as to what type of employer you have if they try to pull this nonsense. Illinois workers compensation claims are not lawsuits. You are NOT suing the company. You are making a claim for benefits for being injured while doing a job that benefits your employer. It’s a right guaranteed by law and there is no acceptable reason for your employer to ever interfere with you exercising those rights.

The good news is that this type of thing doesn’t happen a lot. But it happens enough that it’s concerning and was worth writing about. Our goal with this blog is to educate Illinois workers so you can make good decisions as to what is best for you.

If you have any questions or want a free, confidential consultation with an attorney, please call us any time at 312-346-5578 for help anywhere in Illinois.

Why We Couldn’t Help An Injured Worker Who Needed Neck Surgery

We LOVE to help people. While Illinois work comp law is generally great, many workers get screwed or taken advantage of, even if they don’t realize it. There aren’t many better feelings at work than knowing you helped turn a bad situation into a good one. Our state wide network of experienced Illinois work injury lawyers has done this thousands of times.

Sometimes someone comes for you to help and you can’t help them. That sucks, but it’s often out of our hands. Generally speaking, we make more money on very serious injury cases than we do with moderate injury cases. So when a worker with a neck fusion who needed another surgery came calling, we were disappointed to have to turn him down. Understanding why could help other workers.

First off, his case was very old. He was hurt in 2016. A lot has happened since then, but the age of the case makes it really messy. But the bigger factor is that we’d be his fourth law firm in that time. The first was only on the case a month, but even if you disregard them, having two other firms withdraw from the case indicates that there are problems with the case. The worker told me he had no idea why the lawyers quit which in my experience is him not being honest. It’s ok to tell a lawyer what the problems are. But given that the case has been around for almost eight years and those lawyers did most of the work, they’d get most if not all of the 20% fee.

This caller wants to get an additional surgery which means taking the case to trial. We don’t shy away from that when cases are clean, but as stated this one is a mess. His original surgeon said he didn’t need another surgery, but a new doctor he found disagrees. It’s hard to win a case at the Illinois Workers’ Compensation Commission when you are doctor shopping and a credible doctor has found against you.

Beyond all of that, there is a mid six figure settlement offer on the case. The previous attorneys would be entitled to all of the fee from that offer. In other words, if we took the case to trial, won and then settled, we’d have done all of the work and get paid nothing.

The lesson is that if you pick the wrong attorney or see red flags, if you wait too long to switch lawyers, you’ll probably be stuck. You certainly won’t be able to find a new, good one to take over. I’m afraid that this worker could be without representation and might lose out on some of his rights.

So what some of the big red flags to look out for? A lawyer not communicating or treating you rudely is one. Another big one that happened here is when your benefits get cut off and they don’t have a plan of attack they will share with you. On one case we reviewed, in more than 14 months after benefits ended, the lawyer hadn’t done anything to get the case ready for trial and the worker lost his home. It can take a few months to get ready for trial, but if your lawyer isn’t doing anything or doesn’t tell you the plan, you might want to look elsewhere.

Had this worker come to us any time between 2016-2020 and there wasn’t a settlement offer, we probably could have helped. But this far down the road, with that many other lawyers on the case and the big offer, there’s simply nothing we can do. And I promise you that doesn’t make us happy at all.

Cauda Equina And Illinois Work Injuries

Most Illinois workers’ compensation injuries aren’t catastrophic. You may have a severe injury that requires surgery like carpal tunnel, a rotator cuff tear, etc., but eventually you should make a full recovery.

Some injuries are unique or have severe complications. And if those complications aren’t addressed right away it can have life long, tragic results. One such problem is cauda equina. And some lawyers and employers could be making the situation worse.

Cauda equina is an injury that occurs when nerves in the spinal cord get damaged. So you might lift something at work (e.g. a nurse lifting a patient, laborer lifting something heavy, etc.) or do another activity and get a back injury. That is probably the most common injury we see. With some of these injuries though, the pain and symptoms are unusual. We’re talking tremendous back pain, loss of feeling in your legs, significant numbness, urinary incontinence and other problems.

With normal back injuries, a delay of a couple of days to get treatment is no big deal. With the nerve injuries in cauda equina, if you don’t treat it with surgery within around 48 hours of the problems they can become permanent or get worse. For most people this means having a fusion right away.

The way cauda equina syndrome is diagnosed is your subjective complaints which leads to the doctor ordering a MRI. The MRI should take place without delay. The problem we’ve seen is that many employers insist that their workers go to company medical clinics after they are hurt and make them feel like they don’t have a choice to go to an ER or doctor of their own choosing (they do).

These clinics make a lot of money off of referrals from employers. So it’s been my experience that they are extremely conservative in their initial treatment of some injured workers. If you have a torn rotator cuff, it’s important to see an orthopedic doctor ASAP, but if the company clinic delays that by a week or two, it probably won’t change much ultimately. But if they delay you getting a MRI because it’s “too costly” it could result in you having irreversible damage.

When this happens, you may have a medical malpractice lawsuit. And it wouldn’t just be against a company clinic, it would be against any medical provider that delayed a diagnosis of it. You have two years from when that happens, so time is really of the essence.

And that leads to the second problem we see. Some of these lawsuits are against orthopedic doctors or other medical providers that your work comp attorney has a relationship with. They may get referrals from these doctors or use them for testimony in other cases, so they don’t want to piss the doctor off. In the work comp attorney’s mind, they are only representing you on the work comp case. So they don’t tell you to go look for a medical malpractice attorney because it’s not in their best interests.

The truth is that if your lawyer recognizes a legal issue, they should point it out to you, even if it’s not one they can help with. If they don’t it’s possible legal malpractice and either way it’s terrible representation.

We have helped a lot of workers with cauda equina and work with multiple Illinois medical malpractice law firms when there’s negligence that could have prevented things from getting so bad the problem is permanent. If you’d like a free consultation, please call us any time at 312-346-5578. We help everywhere in Illinois.

When The IME Doctor Disagrees With Your Doctor

Under Section 12 of the Illinois Workers’ Compensation Act, your employer has a right to send you to an independent medical examination which is known as an IME. This is a one time medical exam by a doctor of their (usually the insurance company) choosing. You have to go to this exam. If you don’t you could automatically lose your right to any work comp benefits.

This doctor isn’t your doctor. They aren’t looking out for you. They don’t owe you confidentiality or even a duty of care. They are paid to examine you and write a report. Often these “exams” last less than five minutes, they review your medical records and offer an opinion. Many of them are hired guns who make hundreds of thousands of dollars doing these exams or even millions. There are some doctors who dedicate one day a week to doing nothing but IME’s. It’s a cash cow for them.

Because it’s a cash cow, don’t be surprised if their report is a bunch of bullshit and they disagree with what your doctor has to say about your injury. They might say you are fine when your doctor thinks you need surgery. They might say your injuries aren’t work related. They may say you can work full duty when your doctor has you on lifting restrictions. They can and will say anything even if it puts your health at risk.

Some people worship money and can sleep at night without thinking about the people they are harming. I couldn’t do that and I think you need to be a little bit psychopathic to know that what you are writing about someone’s health or case is nonsense.

It of course can be really frustrating for an injured worker when the IME disagrees with your doctor. It can mean all of your benefits are cut off and you can’t get the medical care you need, at least not right away. It can also seem insane that they can derail your care in a five minute exam when you’ve treated for hours with a treating doctor who knows you and your injury really well.

So what do you do if/when this happens?

First off, this is why we always advise injured workers to have a case officially on file ASAP. It will allow us to prepare you for the IME and with some doctors, anticipate how to respond. After that, we will get the deposition of your doctor and the IME hack, err doctor, scheduled ASAP. Following that will be a 19(b) petition for immediate hearing which will get your case before an Arbitrator.

At that time you will testify and then an Arbitrator will make their ruling. But before that even happens, we can also do a pre-trial with the Arbitrator and each side can state what they expect the evidence to show. Sometimes the IME report is so ridiculous or the doctor has such a bad reputation that the Arbitrator will make clear to the defense attorney that they will lose if this goes to trial. Other times we can get settlement advances to put some money in your pocket while we are getting the trial ready.

And when the IME is truly indefensible, we can also file a motion for penalties and fees which will punish the insurance company for their bad behavior and unreasonable denial of benefits.

In other words, an IME can hurt your case and in some cases cause you to lose if you don’t have a credible doctor in your corner. But it’s also a common thing that good, aggressive lawyers know how to overcome. So don’t freak out if that doctor disagrees with your doctor, even if it makes no sense at all. The fact that it doesn’t make sense is probably why you will win in the end.

Hurt At Work In Illinois But You Have No Insurance

The best thing about Illinois workers comp law, in my opinion, is that you don’t need to have insurance in order to get medical care. If your employer has work comp insurance, that insurance is essentially your health care for any work related injury. Better yet, it pays for everything. Meaning 100%. Meaning no co-pays or out of pocket costs to you.

As long as the care is reasonable (e.g. not experimental) and related to your accident, it should be covered. That means if you tear your ACL, they should pay for your knee surgery at a doctor of your choosing. And if after surgery using crutches causes an elbow injury, they should pay for that too. It’s all reasonable and related. But if you are pregnant or have cancer or slam your hand in your car door, that treatment is on you.

It’s really the best part of the Illinois Workers’ Compensation Act, but unfortunately not everyone knows about it. Your employer is supposed to post signs that advise you of your rights under Illinois law. Those signs make clear that you don’t need medical insurance. Unfortunately some employers break the law and don’t post these signs and others do, but not in an obvious place. And some workers don’t read them which can happen especially if you work in the field versus the same place every day.

As a result, I get a lot of phone calls from injured workers who were hurt on the job, but delay getting medical care because they have no way to pay for it since they have no insurance.

Some delay by a few days before learning the law. That’s not a huge worry for the case as once they learn the law they get into a doctor right away. Others will self medicate for weeks or months because they don’t want to get a big medical bill. Unfortunately often when they do learn the actual law it’s either too late or has at least created a big issue in their case. The longer you go without seeing a doctor, the harder it is to prove your problem is related to a work accident.

If it’s a repetitive trauma situation like a back injury from continuous heavy lifting, the delay might not matter a ton. On the other hand, if you were physically attacked or hit by a forklift or have some other one time accident, the longer you go without seeing a doctor, the harder it is to prove there’s actually a work related injury. There’s no specific delay that bars you from having a case, but generally speaking more than a month will create a problem.

I encourage everyone to make sure that there co-workers are aware of this law. Even some union members we meet and help aren’t aware of it which is a bit shocking to me. Not having health insurance doesn’t mean a thing when it comes to work related injuries. Get to the doctor and know that if you have a legitimate case your company’s insurance will have to cover all of it.

Illinois Work Comp Laws Are Great, Why You Should Care

My son had a great English teacher who made everyone in the class do a presentation on various topics once a month. It helped him be comfortable with public speaking and made him a good writer as well. There was only one guiding principle in doing these presentations. You had to answer the question, “Why should I care?”

I love that concept. It’s something I try to remember in my daily life. Often it gets me to not say anything because I think to myself that nobody would care.

When it comes to Illinois workers’ compensation law, you definitely should care. Illinois has the best laws in the country for workers who get hurt on the job. There are a lot of politicians and others who are trying to gut those laws. It’s incredibly important that that doesn’t happen.

As we all know, life is really expensive these days. If you get hurt at work and don’t have the protections of the Illinois Workers’ Compensation Act, you could quickly be homeless or bankrupt. States like Indiana, Kansas, Texas and others limit what you can get from a work related injury and make it very difficult to find a lawyer to help you if your benefits are disputed. And there are either caps or low benefit amounts in many states where the rights and needs of workers aren’t considered.

People that don’t care don’t envision themselves getting hurt on the job or needing work comp benefits. It’s obvious a heavy duty laborer, truck driver or factory worker should care about these laws. Those jobs are high risk and have injuries all of the time. But why should a low risk job like teacher, business person or bank teller, you might not think this will ever effect you.

Aside from the fact you should have empathy for others, I can tell you that we have helped thousands of teachers, bank tellers, business people and others who are in seemingly “low risk” jobs. Any job can and does lead to an injury. Stuff happens that is often beyond your control. Bank tellers get robbed at gun point or have a cabinet fall on them. Teachers slip on wet floors or fall while breaking up a student fight. Business people get into car accidents while traveling or fall in the hotel shower.

I remember a call from a supervisor at a big Chicago area warehouse who told me that he used to hate his workers who filed for work comp, but now that he was hurt, he got it. His benefits were denied for about six weeks. During that time he was in tremendous pain and ended up being late on a mortgage payment because he didn’t have any money coming in.

Beyond the financial reasons you should care, if you are injured while working, without work comp benefits you could be facing tens of thousands of dollars in out of pocket expenses even with great insurance. But with work comp on your side, 100% of your bills are paid for and you don’t have to worry about a medical provider being in network. In other words, you don’t get punished because you were injured in a way that benefited your job. In fact, these great laws give you the best chance possible at getting all of the treatment you need and a full recovery.

Beyond all of this, if your injury is so serious that you need to change careers and suffer a wage loss, Illinois work comp laws account for that. You could be making $125,000 today, but find yourself two years from now only able to make $30,000. You don’t lose out in that situation. Even if you have no income change, you can also get compensated for how the injury will affect you later on in life.

The bottom line is that a work related injury could be life altering to you, someone you care about or a fellow human being. Someone who is legitimately hurt at work shouldn’t be made to suffer or have their life turned upside down. The Illinois Workers’ Compensation Act helps prevent that and gives workers remedies to fix it. It’s important and we all should be glad that it’s this way and not like states where injured workers get cast aside with welfare as their best resource.

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