Who Are The Worst Illinois Workers’ Compensation Insurance Companies?

By Mike Helfand on Posted in Tips if Injured

A FedEx injured worker in Chicago called our office recently and was telling me about their work injury claim and seeking our free legal guidance. We were of course happy to help.

During our call he was telling me about things the adjuster had done and what appears to be an unreasonable delay in him getting benefits that he is entitled to. I blurted out under my breath, “Sedgwick is the worst” which is something I believe, but that really means that they do a lot of bad things, in my opinion, in how they handle their cases. The injured worker said he agreed.

Days later I was talking to an injured Menard’s worker who was clearly hurt on the job, but could not get approval for a surgery that their orthopedic doctor said they needed. I again muttered, but this time said, “Gallagher Bassett is the worst.” The injured worker laughed and said that they agreed.

So Who Is The Worst Illinois Work Comp Insurance Company?

To answer this question, you have to first understand that there are two types of insurance companies. The first is known as a third party administrator or TPA. That happens with large companies/employers like FedEx, Walmart, Amazon, The City of Chicago, Walgreens, Southwest Airlines, etc.

These bigger companies know that it will cost them more in insurance premiums than it’s worth to have work comp insurance. So they are “self insured” which means for the most part, work comp payments come out of their pocket. They hire these TPA’s to process the work comp claims. That is because companies like Sedgwick, Gallagher Bassett, ESIS and others specialize in this type of work. Southwest is in the plane flying business. So they hire a work comp specialist that is outside of their company.

Smaller companies like law firms, restaurants, many trucking companies, many warehouses, etc. have work comp insurance. These are handled by companies like Travelers, Zurich, The Hartford, Chubb, Liberty Mutual and others.

The biggest difference is that a TPA really needs to hold onto a client because it is a huge source of money. In other words, there is motivation to fight extra hard on claims, even if they are in the wrong, because that business is worth many millions of dollars a year. On the other hand, if a company like Travelers loses a small restaurant as an account, it will not affect their bottom line in any meaningful way.

Does This Mean That TPA’s Like Sedgwick Are Worse Than Companies Like The Hartford?

The answer is no. Insurance companies in general are built around a model of the less you pay out on a claim, the more money you make. It is how they profit at billions of dollars per year.

So every insurance company I have ever come across has done things that I view as slimy, completely wrong and at times illegal.

This does not mean that they do this on every case. Some injuries are so obvious (think of an explosion at a factory) that they can not be denied initially. So initially medical care might be approved and payments for TTD benefits will be made. But that does not mean that they will not drug test you or try to find some other reasons to stop or limit what they pay on your case.

And every insurance company does this without exception. So really, they all are the worst. It is the nature of their business model.

What Are Some Insurance Company Tactics To Look Out For?

While every case is different, some of the things insurance companies do, which often are not allowed include:

  • Taking a recorded statement of you
  • Trying to access all of your medical records, even for injuries not related to your claim
  • Implying that you have a pre-existing condition so you do not get benefits even when you have not treated for that injury for years
  • They will conduct surveillance on you
  • A nurse case manager will be assigned to your case and potentially illegally talk to your doctor
  • You will get a letter stating that your claim is under investigation when it really is not
  • They will tell you that they need more information when that is not true
  • Medical tests will not get approved or they will say you can only have two days of physical therapy a week
  • TTD benefits will arrive late. This is to try to make your life hard financially in hopes you will go back to work against the advice of your doctor
  • They will send you to an independent medical examination
  • They will lie about your right to choose your own doctor or seek a second opinion

All of these tactics are designed to limit what they pay out to you. Again, this is how they make money. It is why most people who are injured in Illinois need a workers’ compensation attorney. It is really the only way to push back.

Who Do Other Lawyers Say Are The Worst Work Comp Insurance Companies?

When I was writing this, I asked some other attorneys who are the best and worst work comp insurance companies to deal with?

One of them said that Liberty Mutual was the worst and talked about a certain adjuster who ignores their files and always makes excuses and seems to pay late. He said he just files trial motions against them because they can not be trusted.

But another attorney I know and like said he enjoys Liberty Mutual the most. He has a lot of UPS cases and deals with the same adjuster a lot. Because they can make each other’s life miserable, they actually treat each other with respect. They are not friends, but have a good, professional relationship. That makes the cases go smoother.

These are common sentiments across all insurance companies. The more cases your attorney has against them, the more likely it is that they will treat the attorney and thus you well. It is another reason why you should never hire a work comp attorney who just dabbles in these cases. Knowing the adjuster well can be a really big deal.

So, Is There An Answer?

The reality is that the only insurance company that matters is the one that is handling your case. If you were playing the odds, it is likely that no matter who you are dealing with, they are looking out for themselves. They do not care about your health, your finances, your bills or anything else. Adjusters get bonuses by limiting what their employer pays out. So they have an incentive to deny your medical treatment or pay the wrong amount to you.

So in my opinion, while there are good adjusters with every insurance company, all of these places in general are the worst. Sedgwick will fight your claim in the same way Travelers, The Hartford, ESIS, Chubb or any other will. So prepare yourself and give yourself the best chance of getting a good case result by getting a strong work injury attorney in your corner.

If you would like a free consultation with an attorney, we have a state wide network of top lawyers. Having a tough attorney in your corner is the only way to fight back against an insurance company who is not following the law. Please reach out any time.

Illinois Work Comp When Your Employer Won’t Let You Fill Out An Incident Report

By Mike Helfand on Posted in Tips if Injured

An injured worker came to us recently and shared two awful things that happened to her when she got hurt at work. By way of background, she is a receptionist at a company that does heavy labor. So while her job is relatively light duty, it is a company that sees work injuries all of the time.

The company mailbox is outside and part of her job requires her to go get the mail. On the day she did this, it had snowed a lot, as it does in Chicago, and she unfortunately slipped on ice that had formed on the walkway.

This is a clearly compensable work related injury as she was doing her job duties when she got hurt. What happened next is gross.

The first thing that happened when she told her manager that she fell is they responded by stating that office workers are not eligible for Illinois work comp benefits. That is a flat out lie. EVERY employee is covered by the Illinois Workers’ Compensation Act. It was especially gross because when she reported it, she believed (correctly) that she had broken a bone in her wrist when she fell.

The second thing that happened is that her manager refused to fill out an incident report. This is something that happens all of the time at all sorts of companies. I have no idea why they do this. Maybe they think that if they do not fill out a report that no claim will happen and you will lose your rights under Illinois law. Whatever their motivation is, it’s a waste of time.

While an incident report does create a paper trail and can be helpful, you do not need one to have a work comp case. Here is what you need to do instead:

  • Document the injury by reporting it via email to your employer. It can go to HR, your boss or anyone in authority. Keep it simple, e.g. Just confirming that when I went to get the mail two days ago, I slipped on ice and hurt my wrist.
  • Go to the doctor. It can be a family doctor, the ER, urgent care, etc. Get there as soon as you can and tell them how you got hurt. You do not need health insurance for this. If it is a work related injury, work comp should pay for everything.
  • Hire an attorney so they can file an application for adjustment of claim for you. This is the official paperwork that puts your employer on notice that you are pursuing your rights and works similar to an incident report. It will also make them turn the claim in to their insurance company. From there, things usually go smoothly.

It is only the worst employers who do not care about their workers who do stuff like this. The good news is that they can not lie or delay their way out of giving you a right that every Illinois worker has.

If your employer will not fill out an incident report or you need help with any part of a case, please contact us any time. We would be thrilled to offer you a free consultation.

Illinois PPD and TTD Rates For 2026

By Mike Helfand on Posted in Benefits

We are experienced Illinois work injury attorneys who will talk to you for free. If you would like a case review or just have questions, start a live chat, call us at 312-346-5578 or fill out our contact form. It’s all confidential and a lawyer is usually available right away.

Every year, the Illinois Workers’ Compensation Commission publishes updates to the benefit rates for work comp cases. The rates are tied to the state average weekly wage, so they increase every year. That means that work injuries in 2026 are much more valuable than the same injury that happened ten years ago. This is another reason why you never determine what your case is worth based off what happened to someone else.

TTD Rates For 2026 In Illinois

For 2026, the state average weekly wage is $1,506.49. To determine the temporary total disability rate you get (TTD) for when you can not work, the state sets a maximum amount you can receive. That amount is 133 1/3% of the state average weekly wage.

So for injuries from January 15, 2026 until July 14, 2026, the maximum TTD rate is $2,008.60. The rate will go up for injuries after July 15th. The TTD payments are 2/3 of your individual average weekly wage for the 52 weeks prior to the accident.

In essence, what this mean is that if you make approximately $154,000 a year and get injured at work, you will basically receive the equivalent in take home pay that you would have gotten normally. It’s important to note that this money is tax free. If you make more than that and get hurt at work, you will not be taking home as much as you are used to, but hopefully can make it up with a settlement down the road.

This rate is up almost $75 from January of 2025.

The minimum rate is now $400 per week. It goes up if you have children or a spouse, starting at $460. That means if you make $500 a week, even though 2/3 is $333, you’d get at least $400 and more if you have a spouse or child.

PPD Rates For 2026 In Illinois

Permanent partial disability or PPD is the rate used to calculate your settle. It is 60% of your average weekly wage and also subject to minimums and maximums.

These rates only change once a year in July. It covers accidents from July 1, 2025 through June 30, 2026. That means that any injuries in the first six months are subject to the rates below. Note that these rates do not come in to play until the case is ready to settle.

For the first half of this year, the maximum rate is $1,084.66. The total amount of compensation you will receive for a settlement is based on how high your rate is along with many other factors including the severity of your injury or any defenses the insurance company might have. Higher wage earners will have bigger settlements for similar injuries suffered by lower wage earners. But each can get significant settlements depending on what happened.

Note that if you had an amputation or lost an eye, the PPD rate for those injuries are actually subject to the TTD maximums. The same is true in cases of a death on the job or when a worker is permanently totally disabled. Lawyers who do not know what they are doing will cause their clients to get less than what they deserve. Death benefits are paid for 25 years or $500,000, whichever is greater. There are also cost of living increases in cases of death or permanent disability.

If your injury is after July 1, 2026, check back with us as to what the new rate will be to calculate your settlement. It takes some time for the State to publish it. The rate for 2026 is up around $39 from 2025 and we expect that it will be higher after July 1 for those injuries.

And as always, we are happy to talk to any injured worker, any time, for free.

ACL Tears and Illinois Workers’ Compensation

By Mike Helfand on Posted in Injuries

A torn ACL is not just a sports injury—it is something that happens on the job in Illinois quite frequently. So while you might think of Patrick Mahomes or Micah Parsons when you hear about an ACL tear, the truth is that it is a common injury that happens to Illinois workers every day. If it happened to you and you would like a free case review with an experienced lawyer, please contact us any time.

Workplaces that involve physical activity, uneven surfaces, climbing, or quick movements put employees at risk for knee injuries. A slip on a wet floor, a fall down stairs, a misstep while carrying heavy materials, or an awkward twist while lifting can all result in a torn ACL. An ACL injury is not just painful, it will impact your ability to do your job. Recovery time for these injuries can be 6-12 months depending on type of work you do.

What is the ACL?

The ACL, or anterior cruciate ligament, is one of the main stabilizing ligaments in the knee. It connects the thigh bone to the shin bone and helps control rotation and forward movement of the leg. When the ACL tears, people often feel a pop, followed by swelling, instability, and significant pain. In many cases, the knee feels like it may “give out,” making walking, standing, or climbing extremely difficult. Because the ACL plays such a critical role in knee stability, a tear is a serious injury.

How do you know if you tore your ACL?

Diagnosis usually starts with a physical examination, but imaging often confirms the injury. An MRI is the best tool for diagnosing a torn ACL and determining whether there is additional damage, such as meniscus tears or cartilage injuries. Treatment depends on how severe the tear is, how old the worker is, and what the physical demands of their job are. Some people may start with physical therapy to strengthen the knee, but most torn ACLs—especially in active workers—require surgical reconstruction followed by months of rehabilitation. Recovery is not quick, and returning to full duty can take a significant amount of time.

Workers we have represented for torn ACL’s

Workers in physically demanding jobs are at higher risk for ACL injuries. People who work on construction sites, in warehouses, and in health care settings are vulnerable. Jobs that require climbing steps or ladders, navigating uneven surfaces, frequent bending, or quick directional changes put constant stress on the knees. Delivery drivers and many tradespeople fit that description. That said, an ACL injury can happen to almost anyone. Office workers, teachers, and other non-physical employees can suffer a torn ACL from something simple like falling down some stairs or slipping on a wet floor at work.

We have helped injured workers in all of these industries and more. I have helped indoor football league players, many people from Amazon, FedEx, UPS, CTA conductors and drivers, nurses, phlebotomists, teachers, all sorts of laborer and construction workers, plumbers, stage hands, electricians and more. We have been helping injured workers since 1997. There is probably not any type of job that has not seen an ACL tear.

Next steps

Because a torn ACL often keeps someone out of work for weeks or months, it is critical to understand your rights under Illinois workers’ compensation law. You are entitled to wage loss benefits while you recover, as well as coverage for all reasonable medical treatment. Even after returning to work, you may have restrictions that prevent you from performing the same duties you had before—or you may not be able to return to that type of work at all. If that happens, you are entitled to vocational rehabilitation to help you find a job within your restrictions.

If you would like to discuss your knee injury with an experienced attorney, we would love to help. We have a state wide network of top lawyers and have handled hundreds of ACL tear cases. Call us at 312-346-5578 any time.

Illinois Workers’ Compensation When Your Injury Is Self Inflicted

By Mike Helfand on Posted in Injuries

Illinois work comp law protects workers who get injured on the job. Not every injury is covered by the Illinois Workers’ Compensation Act, but most are.

The majority of work injuries are nobodies fault. If you do a lot of lifting and hurt your back or tear a muscle in your shoulder, that’s simply a risk of doing those activities. Same if you type all day and get carpal tunnel.

In other cases workers get hurt when they slip on a wet floor or a co-worker bumps into them with a forklift. Illinois is a no fault law, so you do not need to prove someone else caused your injury, but it is also something that happens a lot.

But what if you are the reason that you got injured?

Does Workers’ Compensation Cover Self-Inflicted Injuries?  

The answer is it depends. Most self inflicted injuries are covered. That is because they are usually not something you did to yourself on purpose. For example, if you are using a box saw and cut your wrist when the saw slips, that would still be a good work comp case. On the other hand if you decide to purposely cut yourself, that would not be covered.

Every day there are hundreds of work related injuries that an insurance company could say are the fault of the worker. That in no way prevents you from getting work comp benefits. It is a no fault law.

In fact, a lot of jobs are high risk for these types of injuries happening. These include:

  • Construction workers – Just the other day a laborer who dropped a heavy beam on his foot and fractured it called us.
  • Warehouse workers – Under pressure to get work done, sometimes workers take shortcuts or don’t lift the way they’ve been trained. They still get work comp.
  • Nurses – There is a lot of under-staffing at hospitals, nursing homes and other places. I wouldn’t blame a caring nurse for trying to lift a patient without the help of someone else. Technically it would be their “fault” if they hurt themselves doing this, but it doesn’t impact the case at all.
  • Truck drivers – The other day we were contacted by someone who hit his head getting into the cab and caused a bad neck injury. I guess it’s his fault, but that is part of the risk of doing those jobs.

All of those “self inflicted” injuries would be covered under the Illinois Work Comp Act. None are intentional or a result of goofing off, being inebriated, or something that happened outside of work. Those would be the types of scenarios where a self harm injury would not be a good case.

My best advice is to not stress about this issue. The insurance company might try to lie and tell you that you do not have a case. That is what they did to the truck driver. Once you get with an attorney who knows what they are doing, you will be protected and can focus on your health and getting better. If you would like our help, please reach out to us at 312-346-5578.

User Error and Illinois Work Comp Law

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

I recently was contacted by an injured worker who was badly hurt when a machine he was using collapsed. It crushed his leg among other problems.

When I get this type of call, one of the first things I ask (and what any Illinois workers comp lawyer should do) is what was wrong with the machine? If some outside company was responsible for the accident happening, the worker might have not just a work comp claim, but also a personal injury lawsuit.

He told me that he did not think anyone else was at fault and then asked me the following:

Can someone still get work comp in Illinois if they were hurt due to user error?

That was not something I had been asked before in that way. Usually someone says something like, “Do I still have a case if I was at fault?”

The questions are the same as is the answer. Illinois is a no fault law when it comes to receiving workers’ compensation benefits. That means two things. First, you do not have to prove negligence in order to win a claim. The second thing it means is that if it was your own fault that you got hurt, you are still entitled to benefits. Think of someone tripping over a box because they were not paying attention or running a red light while driving for work. They get the same rights and benefits as anyone else.

The only exception to this is you do not get work comp benefits if one of two things happen:

  1. You were drunk, high, etc and that is why you got hurt. If you fail a drug test, they can deny your claim, but you can still get benefits by proving (usually through your own testimony) that you were not impaired at the time.
  2. If you get injured due to horseplay. The classic example is that of a security guard who patrolled a large factory on a golf cart. He and another security guard decided to race each other and he lost control of the vehicle, causing a crash. That injury was denied and he did not win his case.

Beyond that, your injuries should be covered as long as you are doing some activity for the benefit of your employer. This includes you doing something that is not a part of your job duties. For example, if you are a secretary at a construction company, but hurt your back moving equipment that you saw was in the way, that would be a case. This is true even if nobody told you to do it.

So while it is understandable that this issue would concern you, it is almost never something to actually worry about.

By the way, I have heard stories of many employers telling workers “You can not get work comp because you were the reason you got hurt.” That is complete BS and they are only doing this because they are looking out for themselves and not you. If you end up putting your medical care through your group insurance instead of work comp, that could create a whole bunch of problems for you.

Ten Lies Illinois Workers’ Compensation Lawyers Tell

By Mike Helfand on Posted in Tips if Injured

One reason people contact us is because we will provide a free, confidential case review, even if you have an attorney. We are experienced Illinois work comp lawyers and will give honest, blunt opinions about what you should do.

In talking to thousands of injured Illinois workers, I am shocked at how casually some lawyers will lie to their clients. Some are one offs and some seem to happen all of the time. Here are ten lies that we have heard that Illinois work comp lawyers told to their clients/callers:

  1. It will take two years or more before we can get your case before an Arbitrator. That is pure nonsense. If your benefits are wrongly denied, your attorney can file a 19(b) petition for immediate hearing that can be presented any month. While it is true that things need to be done before you can go to trial such as taking your doctor’s deposition, the only other major hurdle is the schedule of the Arbitrator. In the worst case scenario, your lawyer should be able to get an informal hearing (pre-trial) within 30 days to fight for your benefits. This is sadly the most common lie out there that lazy attorneys love.
  2. Your case is worth $X even though you just got hurt two days ago. There is one notorious Chicago work comp firm that will tell potential new clients that they can get them over $100,000 when the accident just happened. There is no honest way to know that. You can not assess what a case is worth until we have an idea what your recovery is going to be and what defenses the insurance company might have. They say this because it makes potential clients excited. Don’t fall for this BS. We will never tell you what you want to hear, but will always tell the truth. This same firm (and others who do this) over promise and under deliver. They then have to lie to cover the first lie to explain away why the great result did not happen.
  3. I’ve won 98% of my cases! There is no won/loss record when it comes to Illinois workers’ compensation claims unless your case goes to trial. Most cases settle. If your case is worth up to $50,000, but your attorney only gets you $30,000, is that a win? It is not to me, but they will call that a win. They will count a case where they settled for $1,000 a win too. That is not the same as your lawyer busting their butt to fight for you and getting your case settled for over $400,000. Talking about a won/loss record is phony marketing that does not reflect reality.
  4. These cases take years. This is different than the first lie. When you are done with your medical care and back to work, that is when you can begin to talk about a settlement. That does take some work. For some shocking reason, there are some attorneys who at this point will tell their clients that it will still be a couple of years until they can get paid. Again it comes down to laziness. I have seen countless cases where the defense attorney essentially begs the lawyer for the worker to settle since that lawyer is not doing their job.IT makes no sense as the attorney will only get paid once the case is over, but they still won’t order medical records and write a thorough settlement demand letter. By far the strangest lie around.
  5. I do not know any employment attorneys. When you hire an Illinois workers’ compensation attorney, you are hiring them for that case only. That said, you should feel as is you can approach them about things that come up in your life. If you can not, then you have hired the wrong lawyer. At times people are on work comp and get fired or retaliated against. That may require the services of a labor lawyer. Your work comp attorney does not have to handle that case, but should refer you to someone who can. These issues come up enough that if your attorney is really experienced, they should know multiple law firms who can help. If they tell you they do not know any then they are blowing you off or lying to you. We often take cases over in this situation. We would not do one without the other, but are happy to help when we can.
  6. You have a great case, I am just too busy to take it. For some reason, some attorneys in Illinois have convinced themselves that they could get sued if they tell a potential client that they do not have a case. I am not sure where that came from but it is ridiculous. So if you go to a work comp attorney and tell them you were hurt at work four years ago and never reported the accident or saw a doctor, they should simply tell you that under Illinois law they can not help you because you did not report the accident in time and waited too long to file. Instead they will say something like, “You probably have a great case, but we are just too busy to take in on right now. You should call someone else.” That does not help anyone. I have had workers call me and tell me that five different law firms told them this. I was the first/only to explain why they do not have a case. If this happens to you, call them back in a day and tell them your brother was rear-ended by a semi truck on the highway and is having back surgery. I guarantee they will not be “too busy” to help with that much more complicated case.
  7. You have to see this doctor. This is something scummy work comp lawyers do. They get client referrals from certain doctors and pay that back by making some clients get treatment with that doctor. It is gross and not in your best interests. You do not have to see any specific doctor and if your lawyer insists you do then it is a huge red flag. This would be a perfect time to get a new/better law firm.
  8. Workers comp is all I do. This applies to some downstate lawyers. I have seen attorneys in small towns tell injured workers that all they do is work comp. I usually get these calls from clients who are dissatisfied with the lack of fight by the attorney. When I don’t know a lawyer, the first thing I do is Google their firm. Usually I see that their website mentions a whole bunch of other practice areas aside from work comp. They might dabble in work injury cases, but don’t make it their sole focus. That does not give you the best chance of success. One attorney who told this lie appears to mostly write wills and handle bankruptcies. That is not the type of law firm you want in your corner.
  9. I am entitled to more than a 20% fee. Illinois law caps attorney fees in these cases at 20% of what is recovered. Usually this is only from a settlement. Even then, there is a limit to how much that 20 percent can be. There is a law that allows a lawyer to petition for more when they put in extraordinary effort on a case. I have seen some lawyers imply to their clients that they do not have a right to contest this. You do and you should.
  10. I am going to handle your case. If you call us, usually an attorney will answer the phone. The lawyers in our state wide network handle their own cases and they are all experienced. There are some firms who tell you a certain attorney is going to handle your case and that person is very experienced and sounds great. The problem is that they do not actually work that way. Instead you can never get them on the phone and all of your communication is with their secretary or paralegal. With other firms, they pull a bait and switch and let you talk to an attorney, but it is someone with less than two years of experience. They are essentially training on your case. Either way, this is bad. If you do not have access to a top lawyer when you need them, then you are not getting the best representation possible.

All of these lies do not pass the smell test. If you are experiencing something like this and want to discuss your case, give us a call any time at 312-346-5578. We help everywhere in Illinois.

How One Terrible Illinois Work Comp Lawyer Hurt His Client

By Mike Helfand on Posted in Tips if Injured

Some people have a perception that all lawyers, like politicians, suck. I’m not going to lie and say that there are not any good lawyers (or politicians). There are. And the reality is that the bad ones help form the opinions most people have way more than the good ones.

The truth is that most Illinois workers’ compensation lawyers are good at their job. They might not be great on every case and definitely some are better than others. But the majority want to do well and will do what needs to be done for their clients.

Unfortunately, Not All Illinois Workers Comp Lawyers Are Good

Of course there are bad ones. Some are disorganized. Some are part of firms that just take on too many clients and employ too many inexperienced lawyers. Some go through personal events that mess them up like a divorce, illness, death of a loved one or even getting arrested. And some just start to care less as they get older.

I was contacted by an injured worker who got royally screwed by hiring a bad lawyer. I had not heard of this attorney and do not know what they were going through or if they were just incompetent.

A couple of years ago, this worker injured their back. They reported the accident and went to a doctor. They work for a large employer who is known to have an insurance company that treats injured workers poorly. That is not a problem if you have an attorney in your corner who knows what they are doing. Most experienced Illinois work comp lawyers have taken on this employer dozens or more times. They have a lot of workers and a lot of injuries.

It of course is a problem if they do not advocate for you in any way.

How Could This Happen?

This worker reached out to me more than two years after they were hurt. They had received some medical care, but not a lot because the case was denied. Of great note, they injured their back when a forklift ran into them. They had never seen a doctor for their back before. There is absolutely no reason why this case should be denied, but it was.

Normally in these situations, two things would happen. The first is you would see your orthopedic doctor and they would state that your injuries are work related. Somehow this lawyer never told the worker to see an orthopedic doctor. That is stunning. Almost every injured worker with a back injury needs to see one, especially if their case drags on. The worker didn’t know any better and only saw the company doctor and occasionally his own doctor.

The second thing that should have happened is the attorney should have filed what is called a 19(b) petition for immediate hearing. This would have gotten the case before an Arbitrator AND forced the insurance company to give an explanation as to why they are denying/delaying benefits. They have never given one.

In fact this attorney did not file any motions of any kind in over two years. The only motions that were filed were done by the defense attorney who told me that they could not get a call back from the lawyer. That is NUTS!!!

Of course this poor worker had no idea on any of this and why would they. It is not their job. It is why workers go to a lawyer in the first place. They just unfortunately picked a terrible one that does not care.

Now the worker has finally gotten a MRI (should have been done a long time ago) which shows a major disc herniation. The problem is that they no longer work for the company and the MRI does not prove the problem is related to the work injury.

All we could do was suggest they see an orthopedic doctor and let us know if they think the current problem is due to the work accident.

We discuss taking over work comp cases from other attorneys all of the time. Sometimes it is because they are bad communicators or do not return calls. Sometimes it is because a lawyer left the firm and you do not like their replacement. But it is the times like these when the lawyer is either clueless, lazy or just does not give a shit that really piss me off. Everyone deserves better.

Insurance Bad Faith And Illinois Workers’ Compensation Law

By Mike Helfand on Posted in Tips if Injured

A lot of people have heard of the term “bad faith” when it comes to insurance claims. Most people do not know what it means. It applies when an insurance company acts dishonestly or fraudulently in how they handle a case.

A caller to our office actually had a great understanding of how bad faith law works as she used to be an insurance adjuster. She had been injured on the job in Chicago and can not go back to the work she was doing (not insurance anymore). Her doctor has given her permanent restrictions that her employer can not accommodate. She has had neck and shoulder surgeries. The insurance company has cut off her medical care and payments. She called me wanting to sue them for bad faith. Surprisingly, she did not yet have a lawyer even though her injuries were severe and three years old.

Bad Faith And Illinois Workers’ Compensation Law

Although bad faith is an insurance term, it does not apply to Illinois workers’ compensation cases. That is because work comp claims are not lawsuits, but instead administrative claims for benefits.

I told this to my caller and she said, “So does this mean the insurance company can do whatever they want and get away with it even if it is fraud?!?!” She was not happy with my answer, but fortunately gave me a chance to explain.

There is a process for going against the insurance company when they act inappropriately. It is not called a bad faith lawsuit, but you should not worry about terms. Worry about rights and results.

Under Illinois work comp law, we can file a petition for penalties (which go in your pocket) and fees (which cover our attorney fees so that is also more money in your pocket). The penalties can be severe, up to 50% of the amount they owe you, plus they have to actually pay what they owe. They can also have a $30 a day penalty up to $10,000 for unreasonable lateness with TTD benefits.

To get this, we have to show that their behavior was “unreasonable or vexatious” or there was an intentional underpayment. In plain English, this means that they did not pay benefits and did not have a good reason for their failure to pay. There is no real controversy and any denial is frivolous.

How To Get Penalties And Fees

To get these benefits, we file a motion for penalties and fees at the Illinois workers’ compensation commission. The employer (through their insurance company) then has 14 days to respond in writing to explain their reasons for the denial.

In other words, this can put pressure on them to do the right thing because they have a lot of risk and can not just blow you off anymore.

So while this is not a “bad faith” lawsuit, it is a way to hold them accountable for acting in bad faith. And that is really all that matters. You getting your benefits and them not getting away with a bunch of bs.

If you have a scenario you want to discuss, please reach out for a free consultation any time.

When Is The Repetitive Trauma Accident Date?

By Mike Helfand on Posted in Tips if Injured

Under Illinois workers’ compensation law, an injured worker has to notify their employer within 45 days of when they got hurt that they had an accident. The clock starts when you “knew or should have known” that an accident occurred.

When your foot gets run over by a forklift or you slip and fall on a wet floor, it is pretty easy to know when an accident occurred. And while you have up to 45 days to report it, you should do so ASAP as well as get medical care right away.

Not all work injuries happen at a specific moment in time. Some are from doing the same job activities over and over to the point that your body breaks down. This is known as a repetitive trauma claim. Common examples of this include getting carpal tunnel from typing all day, a back injury from lifting all of the time or shoulder injuries from too much overhead work. We also see this a lot when an employee suddenly gets a heavier workload.

So if it is a repetitive trauma injury, when is the accident date?

There are three different way to show an accident date from a repetitive activity. What applies to you will depend on your case facts. It is very important to understand all of this because insurance companies love to try to win these claims on a technicality that you did not report the accident in time.

The first one can not be used against you generally. There have been many cases where the date you told your employer that you were injured or hurting is the accident date. That makes sense in that you know there is a problem and if you mention work, you are aware that it is due to your job activities.

The second and most common date of accident is the date that you get a diagnosis. In other words, you go to the doctor, tell them about your pain and they tell you what is wrong with you. They might not state that the problem is work related, but it can often be inferred from their notes. This is where “should have known” comes into the equation.

The final way is the date you first missed work due to the condition. This is typically the doctor taking you off work, but if you call in and say something like, “My back is really sore from all of that extra work we did the last few days” then it is clear you know your problem is work related.

It would not surprise me if you read all of this and felt confused. It definitely can be. This is why we strongly recommend that you get medical care when you are in pain and alert your employer about the problem. There is nothing wrong with vaguely saying, “I’m seeing my doctor, I have had a lot of pain at the end of the work day lately.” That is essentially letting them know you have a work related accident.

When your lawyer files the case, we will choose an accident date based on one of these factors and do whatever we can to make sure you do not lose because you did not provide notice in time. The good news is that Arbitrators at the Illinois Workers’ Compensation Commission are not overly strict on this issue. But you should still be careful and always report as soon as you can.

Hopefully we did not confuse you too badly. If you would like a confidential free case review, please contact us any time at 312-346-5578 for help anywhere in Illinois.

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