One of the awful strategies by the people who wish to destroy the Illinois workers’ compensation system are from those who want your settlement to be tied to something called AMA ratings. Those are medical impairment ratings that have nothing to do with actual disability or how your injury will affect your body and ability to work in the future.
When the Illinois workers’ compensation laws were amended, one of the compromises is that AMA ratings were one of the items an Arbitrator was to consider when determining what a case is worth. The goal by the people who put this change in to place has been to make it the sole way that case value is determined. That would be terrible for injured workers as the value of most cases would be nothing. It’s essentially a play to try to eliminate the work comp system in Illinois.
This is what has happened in Indiana where it’s pretty much impossible to find a lawyer to help an injured worker as a result. To be honest, lawyers are in this for the money, even the ones like me that genuinely like to help people. We have staffs to pay and families to support so if your case has no value then we’d have to help everyone for free. Of course that isn’t going to happen which is what the insurance companies want. If they get their way, they’ll be able to deny you medical treatment for no reason and tell you that if you don’t like it, get a lawyer. Right now that’s not a problem, but if we end up like Indiana or some other states it would be. Workers would get screwed.
As it stands now, insurance companies will tell injured workers who don’t have lawyers that their settlement offer will be based on AMA ratings. To see how that works you can look at a recently decided case for a firefighter with a completely torn biceps muscle that required surgery. A doctor who does a ton of ratings and IME exams for insurance companies (e.g. a hired gun) said that the injured worker had a 0% impairment rating.
Without a lawyer this person would have been told their impairment rating is 0%, but they’ll “generously” give him a couple thousand of dollars. At trial what happened is the Arbitrator looked at the whole picture (which they are supposed to do) and noted that he had permanent work restrictions and continuing pain and tenderness.
It’s absurd to suggest that there is no impairment here, but that’s what these hired guns do. The Arbitrator saw right through that and actually applied the law in awarding a 25% loss of use of the arm. The insurance company appealed and the decision was upheld.
So justice prevailed in this case, but that’s not the goal of an insurance company. Much like us lawyers, they are in this to make money. They make money by limiting what they pay to you. The good guys won this round, but you can bet the insurance companies will do whatever they can to avoid making a proper payment in the next case.
If you have any questions about this post or simply want to talk to an Illinois workers’ compensation attorney, please call us at (312) 346-5578 or fill out our contact form online. We are based in Chicago, but help with cases throughout Illinois via our state wide network of aggressive, experienced and like minded attorneys who fight for their clients.