One myth that I hear when it comes to Illinois workers’ compensation law is the belief that if you get injured at work you automatically are entitled to work comp benefits. Usually you do, but it depends on the facts. Your injury has to arise out your job duties and be in the course of your job duties. This is shown especially when you have a fall at work.
Most falls at work are covered. If you slip on a wet floor, it’s a case. If a step is broken and fall, it’s a case. If you are running to a meeting or carrying a bunch of work documents then you’ll win too. The reason all of those injuries are winners is because you can explain why the fall happened. You should probably even win if your shoe laces are untied and you stumble over them.
All that said, under Illinois law, unexplained falls are not covered if they happen at work. In other words, if you are walking and the next second you are on the ground and have no idea why, you will not win benefits. This is known as an idiopathic fall. Fancy legal term, right?
The people who get screwed over in these situations are the honest ones. A woman called me after a fall. She was walking in between buildings at her office and fell down, badly hurting her knee. It was raining, the pavement was wet, she was in high heels and she was carrying a bunch of documents. The accident happened so fast that she didn’t think at first why she fell because she was in so much pain.
The mistake she made was that while still in the hospital she gave a recorded statement. The insurance adjusters are trained to ask questions in a tricky way and in this case they took advantage of her. The lead her in to stating that she didn’t know why she fell. And that is likely going to doom her case.
Key point: You do not have to give a recorded statement and should not do that. Let them talk to your lawyer. Anything you say can be used against you. Anything we say is just talk.
Bonus point: We want you to always tell the truth. If you don’t know why you fell that’s fine if it’s true. In this case what the woman meant to say was she didn’t know if it was the heels, the wet pavement or the stuff she was carrying, but assumed it was a combination of the three. So if you do make a mistake and give a statement, make sure you are detailed.
Her mistake could be explained away, but it’s an up hill battle and will have to happen at trial. It’s a shame because she’s been in the job for many decades, has never had a case and her employer supports her on this. It’s not their call though, it’s up to the insurance company and they will always fight a case if they can.