A reader came to us for help and raised many interesting issues:
I have been working for the same company in the Chicago area for 20 years, I injured my left shoulder doing work in January 2011. I notified my manager on monday in 2011 that I hurt my shoulder Saturday while working it wasn’t until January 2013 that he filed a claim with his insurance, Gallagher Bassett service inc., I was unaware of how workers comp is handled and didn’t seek treatment until late march 2013, my manager told me I would be contacted by an adjuster with instructions for treatment which is why I hadn’t sought any till march, after calling Gallagher and them telling to go to any doctor for treatment. Gallagher Bassett called me today to inform me they are denying my claim and they closed my case in early march and that I have exceeded the 2 year limitation for seeking treatment. Money is an issue as I have 3 children and a wife who live on my income alone.
There are so many issues to address from this e-mail. First and foremost is that there is no two year limitation for seeking treatment. That’s just a blatant lie by the insurance company.
That said, waiting over two years to go to the doctor makes it almost impossible to prove that the need for treatment in 2013 is related to something that happened in 2011. It would be a very hard case to win. The best chance would be if an orthopedic surgeon would state that the repetitive nature of his job activities contributed to his problem. But to pin it on a specific date more than two years ago would be very hard to do as the defense would be that if you were really hurt, you would have gone to the doctor much sooner.
Beyond that, money should never be a consideration when thinking about a workers’ compensation claim in Illinois. 100% of your medical care is paid for if it’s a work related injury, even if you don’t have health insurance. Also, it doesn’t cost anything up front to hire a lawyer as attorney fees are based on a paid if you win (contingency) basis.
The reality is that this worker probably blew it by not going to the doctor soon after he knew he was hurt. It’s one thing if he was just being a tough guy. It’s another if he never went because he didn’t think he could afford it.
We are workers’ compensation attorneys who help people with Illinois work injuries anywhere in IL via our statewide network of attorneys. Contact us and we will answer your questions or find the right lawyer for your situation.