Illinois Work Comp, When You Are Hurt On A Lunch Break

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

Under Illinois work comp law, you are entitled to medical care and compensation for accidents that “arise out of and in the course of your employment.”  In plain English this generally means that if you are hurt doing your job or something that benefits your employer and get injured, you have a case.

When it comes to injuries while at lunch, the question as to whether or not you have a case usually comes down to were you hurt in the course of your employment?

The biggest factor as to whether or not you will win the case is often where were you when you got hurt?  If you are in the company lunchroom for example and slip on a wet floor and hurt your knee, that would be a case as your employer gets a benefit from you refreshing at lunch and the risk that caused you to get injured was in the workplace.  So even though you are on a break, you are in the “zone of employment.”

On the other hand, if you leave the building to pick up lunch and get in a car accident or slip and fall at a restaurant, that would probably not be a case because you chose to leave the grounds and nothing about your job contributed to this happening.  Your employer benefits by you taking your break at the office.  They don’t when you leave, unless….

If you were picking up food for multiple people, that is a work errand and that would be a case if you got hurt.  If you are going to lunch with a client and get hurt that is also a case.  If you travel from client to client all day and get hurt while stopping for lunch, that could be a case.

Of course you can expect that the insurance company will deny your case and hope that you go away.  Don’t panic.  Just talk to us or some other qualified law firm and explain what happened.  We’ll tell you if you have a case or not and there is no fee to talk or for us to represent you unless we win the case.

Illinois TTD Benefits When You Are Out Of Work Less Than Two Weeks

By Mike Helfand on Posted in Benefits

Illinois workers’ compensation law says that when you can’t work due to a work injury, you are entitled to temporary total disability benefits (TTD) for the time you can’t work.  That is 2/3 of your average weekly wage, tax free.

Under Illinois law the first three days you miss from work do to a work injury are not paid.  Starting on the 4th day benefits start. If you miss a total of 14 days or more then the first three days get paid retroactively.

So if you work Monday to Friday and Monday morning you get hurt at work, if your doctor tells you not to return until the following Monday how many TTD days are you owed?

Most people would think it’s just one day, but it’s actually three.  While you are technically only missing work on Tuesday, Wednesday, Thursday and Friday, TTD payments are based off of calendar days missed, not work days because theoretically you could work any day.

So if you are hurt on Monday and can’t get back to work until the following Monday, you are missing six calendar days of work so you should be paid for three days of TTD benefits.  If your average weekly wage is $900 then your TTD rate is $600.  You are entitled to 3/7 of $600 for the time you missed, tax free, or $257.14.

It’s important to remember that while initially you may only miss a few days, if later on you miss more time and it brings your total to 14 or more, those first three must be paid.

But the biggest point is to remember that it’s calendar days missed that matters not actual scheduled work days.  It seems odd until you remember that your TTD rate is based off of a seven day work week, not five.

It’s not the biggest issue in the world, but we think it’s important because even if it’s $250, that’s money in your pocket that you are entitled to and if you miss a few days of work it can be extremely important.

So if you have questions about TTD benefits in Illinois or anything else, call us at 312-346-5578 for a free consultation with a lawyer.

Why Hire A Lawyer When Benefits Are Being Paid?

By Mike Helfand on Posted in Tips if Injured

A caller to my office said that she was injured at work and the insurance company was paying all of her medical bills and lost time payments.  She said the adjuster was very nice.  However, all of her friends were telling her that even though her case was accepted, she should hire an attorney.  She wanted to know if that was true.

First off, there is no Illinois workers’ compensation law that requires you to have a lawyer.  It’s just the safest play.  Even if your case is accepted now and nothing is going wrong, if things do go bad, and you can bet the insurance company wants to cut off your benefits, having a case already on file allows you to get in to court quicker to get justice.

Even if things are going well today, they may not tomorrow or the next day so you need to put yourself in a position now to benefit  later. Going it alone is not the smart way to accomplish the outcome you want.

While you may think it’s going well, it might not be.  Your bills might be getting paid, but if a nurse case manager is going to your appointments and talking to your doctor (that’s against the law) it’s not going as well as you think. If they are delaying MRI’s, limiting the amount of therapy you get or not approving a surgery, it’s not going well.  If you are only treating with their doctor, it’s not going well.  If they haven’t included overtime in your TTD rate or your check is much lower than what you are used to taking home, it’s not going well.

If you gave a recorded statement, it’s not going as well as it could.  If you are an older worker and the adjuster is asking your future plans it’s not going well. We had one older client who got an offer to settle their case that was about half of what the case was worth.  We discovered that he had told the adjuster he was planning on retiring in six months to collect a pension so that killed his chance at a wage differential claim.  That error in what seemed like a casual conversation with a “friendly” adjuster cost him over $50,000.00.

Everything you do in the case on your own puts you in a position for what happens later on in the case.  When you make errors in judgment like telling the adjuster you are going to retire, it affects your case greatly.

When it comes to settlement, the insurance company doesn’t by law have to offer anything.  The insurance company has a budget in mind on what your case will cost them and the adjuster is going to get a bonus, raise or promotion at the end of the year based on a number of things, including how much under budget they were able to resolve cases she/he is handling, and that if “you” the claimant is going it alone rest assured they will see this claim as one where they will be saving money. It is an uneven playing field and will remain and perhaps become more uneven and the only way to level or to, ideally give yourself an advantage is to hire a lawyer.  When you do so the adjuster budget goes out the window because we make sure you get what you are entitled to.  Even after our 20% fee you will end up with more.

So you don’t have to hire an attorney and we understand why some people don’t want to.  But the bottom line is that it’s the safest play for you.

If you have questions about anything related to Illinois work injury law, please contact us any time for a free consultation.

IL Work Comp – The First Report Of Injury

By Mike Helfand on Posted in Tips if Injured

A caller to my office was hurt that day and had been told to fill out a first report of injury and was wondering what he should put on it as well as if he should grant the employer or insurance company permission to access all of his medical records.

This sounds like a form the company has created, perhaps at the request of the insurance carrier.  There is a first report of injury form that is supposed to be filled out in every case that is called a Form 45 report.  It’s supposed to be filed with the State, but it’s supposed to be done by the employer.  Bottom line is that while you should report your injury, you don’t have to fill out every request you are asked for.

Starting with the request to access medical records, you don’t have to do that.  By law the insurance company can get access to any medical records related to your injury.  This would include treatment for the work accident as well as records related to prior treatment for a similar problem. So if you tear your rotator cuff today, but also had shoulder problems five years ago, they can see those records.

What they can’t see are records that have nothing to do with your job accident.  If you have been treated for substance abuse or mental health or cancer or anything else not related to your job, those records are none of their business and you don’t have to give them permission to get them.

With respect to the details of the injury itself, you have to remember that anything you say or write can be used against you, so you should be careful.  Rule #1 is to tell the truth. Rule #2 is to not go off on some tangent of information that either isn’t relevant or could paint you in a bad light.  We tell our clients to never give a recorded statement for this reason but also not to write forever.

So do say: I was walking down the hall and slipped on the floor because it was wet and when I tried to catch myself I jammed my arm and felt pain in my shoulder.

Don’t say: Well, don’t say much more than that.  Short.  Sweet.  Honest.  That’s all you need if you put anything in writing.

The safest play is for us to do if for you, but if you do it definitely keep it simple.

Beyond all that, the more they ask the more likely they are looking for a “gotcha!” reason to deny your case on a technicality.  So be careful and whether it’s us or someone else, get someone in your corner who knows what they are doing.  And as always, there is no cost to hire an attorney unless we get a settlement. If you want a free consultation, contact us at any time.

Illinois Work Injuries, Don’t Resign

By Mike Helfand on Posted in Tips if Injured

The number one job of anyone who works for an insurance company is to limit the amount of money that they pay out on any given case.  To them if they’d have to pay out a total of $200,000.00 in your case under their worst case scenario, if they somehow get away with only paying $70,000.00 it’s a huge win for them.

So as you can imagine, insurance companies will do whatever they can to limit what they pay you. You are focused on your health and getting back to work, they are focused on their bottom line.

A crystal clear example of this was shown in a case we were recently called about.  The worker has a really bad had injury that required a major surgery that will leave the worker with permanent restrictions.  Most of the bills and lost time had been paid, but suddenly they were having trouble getting therapy sessions approved and the TTD checks were late for no reason.

They called the insurance company and long story short they got told some b.s. about the TTD being late over confusion about whether they can work on restrictions and if they would just resign the job then there wouldn’t be an issue.

Fortunately this set off red flags with the worker and they called us. Never resign your job while you are still getting TTD benefits. If you do and you are on work comp your benefits will be cut off.  If your restrictions are permanent and you would have been entitled to a wage differential that will go away.  This was really one of the most unethical things we’ve seen an insurance company do.

Bottom line is that resigning your job can cost you potentially hundreds of thousands of dollars.  Don’t do it without consulting with a lawyer first.  You need to understand what you could lose by doing so.  We get that it might be a relief to be done with the job that is treating you like garbage, but you also must understand the long term problems that could be created.  It may be that you have a new job lined up and often it’s ok to take that job, but at the same time you need a risk analysis of how it could hurt your work comp case.

If you want to talk about resigning or anything else, call us any time at 312-346-5578.  We help all over Illinois.

Tips On Getting A New Illinois Work Comp Attorney

By Mike Helfand on Posted in Tips if Injured

In an ideal world, if you do get injured the attorney you hire is a rock star who has your back and you get to focus on your health and return to work.  That’s certainly our goal when we take on a case.

Unfortunately not all cases go like that because there are a ton of attorneys who hate their job or just suck at it.  So you end up with a lack of returned phone calls or an attorney who doesn’t do anything when your benefits get cut off or a lawyer who yells or lies, etc.

So if you do have to switch lawyers you want to get it right because while many firms are willing to be the second lawyer on a case, it’s much harder (although not impossible) to get someone to be the third firm on your case.

I recently got a call from someone asking me to be the third lawyer on their case.  We didn’t take it because the conversation started with him telling me how stupid all attorneys are and how he is smarter than all of us.  He also told me that his main goal was to get his previous attorney disbarred from practicing law.  I’ve had others in similar situations tell me that they have thought about shooting up their company.

I understand how these cases can be emotional and I’m generally sympathetic of that, but of course not when it comes to going and hurting some innocent people.  It’s tough when you are getting screwed over and the person you went to for help seems like they are working for the other side.  Switching lawyers in that scenario is a good idea, but just as you have to want to hire an attorney, they have to want to work with you.

So here are some tips that can help you get the right firm to take over your case:

1. The new lawyer knows nothing about your case. Keep it simple.  This is when I got hurt, this is my injury, this is the treatment I’ve had and this is the reason I’m thinking about switching about lawyers.

2. Keep it short. The new lawyer will ask questions that they want answered.  If you want to switch lawyers because your current firm isn’t fighting for you, it’s enough to say “They haven’t done anything to get my benefits.”  You don’t need to tell them 40 examples.  We know who the bad firms are and if you have a good firm and it’s not going well, we will ask probing questions.

3. Be honest.  Nothing makes me turn down a client quicker than catching them in a lie.  We aren’t looking for a perfect story or perfect case.  We are looking for people that we want to represent and can help.

4. Set expectations. If your last attorney hasn’t returned your calls for a month, ask the new lawyer about what you should expect for how long to hear back from them.  If your benefits are suspended from an IME or some other reason, ask how long it will take to get your case ready for trial.

5. If you don’t have a good conversation or a good feeling with this new firm, don’t hire them.  Talk to as many other firms as needed until you feel comfortable.

I hope this helps. I know it can be tough, but keep your eyes on your real goal which is to get the case going in the right direction. If you’d like to talk to us about what’s going on, please contact us at any time. We cover all of Illinois.

IL Work Comp – You Can Get Hurt Opening A Door

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

When you think of opening a door, you don’t think of any risks being associated with that.  My office door is so light that it’s almost comical.  In fact I don’t think there is any time of day when I come across a door that provides any challenge to me.

Of course not all doors are like that.  Some are really heavy and require a lot of effort to open.  These doors are usually designed that way for a reason although occasionally they are just crummy doors that nobody has bothered to fix.

In a recent case decided at the Illinois Workers’ Compensation Commission, a man was awarded benefits after rupturing a tendon in his leg while stepping back to open up a heavy door.

As you can imagine, the insurance company denied the case originally, arguing that opening doors was an act of every day life.  Basically they were saying that there was no increased risk of injury.

This type of insurance company strategy shows why making sure the facts are known and presented properly makes the difference between winning and losing a case.  At trial it was proven that this worker had to go in an out of this heavy door multiple times a day.  The testimony of the injured worker was very specific and talked about how tight the door was, the configuration of the door and the area leading to the laundry room where he worked and information that using both hands was required to open the door.

The worker further explained that he must step back to open the door because of the way it was hinged.  A witness testified that the door was heavier than typically found in homes.  Because of this, the Arbitrator found in his favor.  Most doors don’t require two hands to open nor for you to step back when doing so.

Bottom line is that facts and how you present them matter.  Whoever was the trial attorney must have done a good job of preparing the testimony and making sure that details were provided.  You’d be surprised at how many attorneys don’t know the facts of a case and don’t help their clients provide detailed information that gives them the best chance of winning the case.

While doing activities that the general public has to do is typically not a case, your work may be unique or pose some risks that can allow you to obtain benefits.

If you’d like to run the facts of your case by an attorney for free, call us any time or fill out our contact form and we’ll call you.  We cover all of Illinois.

Injuries While Working At Home In Illinois

By Mike Helfand on Posted in Injuries

It used to be that you woke up, got ready for work, got in your car and headed to the office or job site.  That still happens, but now more than ever people wake up, turn on their computer and are at work.  That’s because more and more industries are offering their employees the ability to telecommute and work from home.

From sales jobs to customer service to marketing to even some nursing positions, most jobs these days can be done over the phone and via an internet connection.  The number of people working in their boxers has never been higher.

Employers do this to save money.  What this doesn’t do though is end your rights to bring an Illinois workers’ compensation claim if you are injured while working at home.

The Illinois Workers’ Compensation Act provides medical care and compensation for employees who are injured while furthering the interests of their employer. An employee injured during the course of work is entitled to workers’ compensation regardless of where the injury occurred.  While the lines between work and personal business can be blurred when working from home, it’s really not much different than the rules for when you are hurt at your employer’s primary place of business.

For a telecommuter injury to be covered under the Workers’ Compensation Act, telecommuters must show that their the injuries arose out of and occurred within the course of employment, during ‘routine’ work hours that would normally be conducted in the office setting.

In the same way employers must ensure safe working conditions on company property, employers must also provide a safe work environment for telecommuters.  If you get carpal tunnel from excessive typing at home, it’s a compensable case.  If you trip on a computer cord while working or a wet floor, even at your house, if you suffer an injury it’s a case.

There have been cases of professors slipping on papers, a sales rep injured while building shelving in his garage and even interior decorators who have tripped over their dogs while viewing samples in their garage kitchen have all been found to have workplace injuries that qualify for workers’ comp.

Because you are not likely to have any witnesses to an accident at home, we strongly urge you to immediately report anything that happens to a supervisor.  This is best done by email as it proves that it was reported.  And of course you should also immediately get medical care and let the doctor know that while you were hurt at home, it was while doing job activities.  The insurance company is looking for any reason possible to deny your case and if a medical report says hurt at home without more details, it may be used to cut off your benefits.

Bottom line is that all employees are covered for work related injuries no matter where they happen.  In fact, even if you normally work in an office, but bring work home with you and that leads to an injury, you are covered.

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

Osteoarthritis And Illinois Workers Compensation Cases

By Mike Helfand on Posted in Injuries

Osteoporosis (OA), or degenerative joint disease, is the most common chronic condition of the joints, affecting more than 3 million Americans every year. It is a disease in which the bones become brittle and is likely to break. In normal joints, cartilage covers the end of each joint providing a smooth motion and acts as a cushion between the bones. Osteoarthritis occurs when this cartilage deteriorates causing pain, swelling and problems with joint movement. Any joint is at risk but most commonly, it happens in the knees, hips, lower back and neck.

Several factors can contribute to the development of Osteoarthritis. Unknown to many, osteoporosis cases can be by ones genetic make-up or being over-weight. However, the most common known contributing factor is by wear and tear: Repetitive movements, pre-existing injuries to joints, long periods of standing or remaining sedentary or by overuse.  So of course we see a lot of work related osteoarthritis cases in Illinois.

Plenty of jobs can lead to this injury. Typing, assembly line work, high impact activities, construction, manual labor, constant lifting, bending, twisting, turning or standing, or the use of heavy equipment and tools all can cause or worsen osteoarthritis overtime.

Repetitive motion work injuries can be a serious detriment to your health and you may be entitled to workers’ compensation benefits to help cover medical bills, lost wages or monetary compensation. A pre-existing condition does not disqualify an injury as a work injury.  Under Illinois law you simply have to show that your job contributed in some way to your problem.

It is a long-term disease and is incurable lasting for years or even a lifetime. There is several available treatment options that will help manage the pain, stiffness and swelling, and help with improving flexibility and joint mobility.

• Physical Activity – Light physical activity such as walking or strengthening exercises helps maintain and improve join flexibility and reduce stiffness.
• Weight Management – Excess weight adds stress to weight-bearing joints.
• Stretching – Slow and gentle stretching is great for improved flexibility and lessening stiffness.
• Pain and Anti-inflammatory medications
• Physical and Occupational Therapy
• Natural and Alternative Therapies – Nutritional supplements, acupuncture, massages, and relaxation can naturally address symptoms.
• Surgery – Severely damaged joints may need surgery to repair or replace joints.

It’s important that you report it to your employer as soon as you are aware of the problem.  Given the time limitations and the complexity of filing, it is important you speak to a knowledgeable attorney a file a workers’ compensation claim.  If you want our help and a free consultation fill out our contact form or call us at 312-346-5578.

Hurt At Work In Illinois, How Many Physical Therapy Visits Do You Get?

By Mike Helfand on Posted in Benefits

A very nice caller to my office hurt her shoulder while working in the northern suburbs of Chicago and was upset over what an insurance adjuster had told her.

Long story short, her doctor said she might need surgery, but wanted to try six weeks of physical therapy first.  This woman does not want to have surgery if possible to avoid it and was encouraged that after four weeks of therapy her arm was improving.  The orthopedic doctor thought this was great and said they’d do an additional four weeks, so eight weeks total, not six.

All of the sudden the insurance adjuster calls and says that they are only authorizing four weeks of physical therapy total and tell her that this is all you are allowed under Illinois workers’ compensation law.  So she wanted to know if this is true?

Short answer is hell no!!!

There is no law capping the amount of medical visits you may have for your injury.  The law in Illinois is that if you are hurt at work you are entitled to all reasonable and necessary medical care.  So who decides what is reasonable and necessary?

I can tell you who doesn’t decide.  It’s not some insurance adjuster making an arbitrary decision at their desk.  It’s decided by a doctor and in this case, the injured worker has a very credible orthopedic doctor who is monitoring her care and making recommendations.

What I think happened here is that there are some doctors who also own/operate the physical therapy clinics they recommend so some insurance adjusters won’t approve a long period of therapy because some shady doctors use their clinics as a way to make money when treatment isn’t needed.  In this case though the doctor does not have an affiliation with the physical therapy location and the therapy is actually working.

So the insurance company is breaking the law and has no leg to stand on for their terrible actions.  It’s a solvable problem, but it’s sad that these type of actions even take place at all.  Here is a legitimately injured worker who is trying to avoid an expensive surgery that would keep her out of work for a while and the therapy she’s tried seems to be working.  There is no legit reason at all for the insurance company to play these games.

 

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