One of the advantages of having an attorney on an Illinois workers’ compensation case is that they will talk to the insurance adjuster case worker for you. That means someone who knows the law will be having conversations with them and you won’t get taken advantage of.
That said, most people will at some point talk to a case worker from the insurance company. In no particular order, here are ten tips for dealing with them that will help your case.
1. You don’t have to give them a recorded statement. This is a common request soon after you are injured as part of their “investigation.” Anything you say can be used against you and often they will try to trick you in to saying things that hurt your case.
2. The case worker is not only not on your side, they are against you. They may seem nice or even be nice, but at the end of day, their job is to limit or deny your benefits.
3. Investigating a case doesn’t take months. So when they delay, that is to frustrate you, nothing else. Honestly, most cases shouldn’t take even weeks. They get your story and see what you told your doctor and that should be enough.
4. They can assign a nurse case manager to your case. That said, that person doesn’t have a right to talk to your doctor, schedule your appointments, be in your appointments, etc. They can ask for copies of medical records and bills.
5. Don’t be surprised when you don’t get a returned phone call. Again, their goal is to frustrate you and one way they do it is by ignoring you.
6. They can’t give you legal advice. I’m stunned at the number of work comp case workers who tell injured workers what the law is. They are not allowed to do that and since they aren’t on your side, they shouldn’t.
7. They can send you to an IME, but can’t make you treat with their doctor. I’ve seen some insurance adjusters who say that they will pay your medical bills, but only if you go to a certain clinic. That is not how Illinois work comp law works. Whether they are seeking a discount or a doctor they know will be in their pocket, you shouldn’t go with the medical provider they want you to see
8. It’s not unusual for the person you deal with to change. They work in a high turnover industry with pay that isn’t great.
9. Usually when your TTD check is late, their reasons for it are a lie. If you are owed TTD benefits, all it takes is for someone to enter that information in a computer to get a check processed. It’s not rocket science. If you’ve provided the adjuster with an off work slip they should have no excuse for your check not arriving. It’s one more of the games they play to try and discourage you.
10. They don’t have a right to your whole medical history. One of the first things they will send you is a form asking for permission to get your medical records. You should give them permission as relates to the body part you hurt on the job. However, if you hurt your back they don’t have a right to know about your pregnancy or psychological care or the time you removed your appendix, etc.
I hope this helps. This list could be a lot longer. As always, if you have any questions please get in touch.