A reader of our Illinois work injury blog asked us about what happens if he settles and then re-injures the same body part or otherwise feels pain and wants to go to the doctor.
Under Illinois law these are two very different scenarios even though they revolve around the general same idea.
Under scenario #1, you get hurt at work, get better (or at least as good as you are going to get), get back to work and your case settles. This is a way over generalization of how things go down, but you hopefully get the gist.
If this happens and then you get another work related injury to the same body part, that’s a whole new case. The process would start all over with an accident report, a visit to the doctor, etc. You can bet the insurance company will argue that your injury isn’t new, but instead related to the now settled case. If they are correct then you can’t get treatment because once you settle you close out your medical rights to your old case. But if it’s a new injury/accident then it’s a new case then your treatment should start anew and they should pay for it.
Bottom line is that if you are better and then get hurt again it should be a new case.
Under scenario #2, our reader wanted to know what would happen if they got hurt, got back to work, settled, but still noticed pain while working. If they wanted more treatment, but didn’t have an accident, they’d have to show that the repetitive nature of the job caused the problem which was better to get worse.
In general you aren’t expected to be pain free if you get hurt and go back to work. It really comes down to how bad the pain is, what’s causing it and what treatment you need. Again you can expect the insurance company to argue that since there was no accident it’s not a case, but that doesn’t mean they are right.
Bottom line for this situation is it really comes down to the specific facts of why you need to go back to the doctor and what type of job activities you are doing. If you had shoulder surgery and now that you are back to work you are doing a lot of overhead lifting, that would seem to be a good case. On the other hand if you had back surgery and just sit at a desk all day, it would be harder to prove your job was the problem.
I hope this makes sense. If it doesn’t you can contact us any time for a free consultation at 312-346-5578. We cover all of Illinois.