“It’s under investigation”  Delay, delay.  “We are waiting on some records.”  More delay.  “It takes a while to process your information in our system.”  “We’ll let you know when we make a decision.”  “I’m sorry you haven’t gotten your check, I’ll look in to it.”  More delay.
Does any of this sound familiar to you.  I’ve noticed an incredible uptick in insurance companies messing with the lives of injured workers for no reason.  They aren’t approving surgeries even though every doctor says it’s needed.  They’ll pay for physical therapy, but not a MRI.  They’ll pay your medical bills, but not your lost time.  They won’t pay anything at all.  They won’t return your phone calls.
It seems to be a new and aggressive strategy to try and frustrate injured workers.  It’s not that there haven’t been unreasonable delays on prior cases, it’s that the amount of times that it’s happening has greatly increased.
And it doesn’t matter how strong your case is or how weak their case is.  They are just being ruthless.
The silver lining is that we’ve had some great success in getting these denials turned around once we’ve gotten involved, but on some cases we’ve had to go to trial when there doesn’t appear to be any valid reason for them disputing your care or benefits.
It’s not that you can’t win, it’s that they’ll put a hurting on you if you don’t have a savings or others to rely on.  In turn this can make your medical condition worse because the stress of it all can lead to further problems.
We are monitoring this closely.  The best thing we can do on our end is be very stern and file for penalties and fees if something unreasonable happens.  They are trying to send a message that they won’t make any case easy.  Work comp law firms in Illinois need to send a message back that if you mess with our clients and break the law, it will not be tolerated.
This certainly isn’t over and bears watching in the coming months.  We’ll report more as we see things develop.  But if you’ve had this happen to you, we’d love to hear your story.  And of course, if you need any help please let us know.

By Michael Helfand