As I get older, my weekends are certainly way less about going to bars than they were when I was in my twenties.  My wife and I like to go to dinner with friends.  We also do game nights with our friends.  It’s a good excuse to get together and laugh at ourselves and our inability to draw or give good clues.  It’s also a good excuse for a drink.

Insurance adjusters in Illinois workers’ compensation claims like to play games too.  They aren’t playing Cards Against Humanity or Pictionary.  They are playing games with your health and livelihood.  What are some of the games they play you ask?  Here are some of their favorites:

Ignore the injured worker.  Your check is late?  You want approval to see a doctor? You call the insurance adjuster and they never call you back.  They are hoping you will get frustrated and not go to the doctor or just drop your claim.

Deny for no reason.  This is a popular one.  A worker gets legitimately injured on the job, reports the accident and goes to the doctor.  A couple weeks later the insurance adjuster sends a letter saying that after an investigation they’ve determined that your injuries aren’t work related and your case is denied.  Is there a good reason for that? Of course not.  But if you believe them then they will save a lot of money.

Fake investigation. A cousin to the bogus denial, you get the adjuster on the phone and are trying to get approval for a MRI or other medical procedure.  They let you know they can’t approve it yet.  They tell you that your case isn’t denied, but under investigation. What do they need to do to finish the investigation?  Usually nothing.  They’ll tell you that they are trying to gather medical records, talk to possible witnesses, etc, but it’s usually b.s.  Those things do need to happen, but it doesn’t take weeks.  They’ll blow you off as long as they can.

Case closed. This is a favorite. You’ll get medical care and lost time paid for.  Then one day you’ll call your adjuster to try and get a settlement and they’ll tell you that they closed your case.  How’d they do that?  They didn’t! It’s again a ploy to try and make you go away and save them money.  As long as you file your case with the State before the statute of limitations expires, your case can be magically re-opened.

I’m not a doctor, but let’s pretend I am.  Illinois workers’ compensation insurance adjusters love to pretend they know what’s best for your body.  If your doctor recommends physical therapy for three days a week, they’ll tell you that you can only get it two days a week.  Why?  Because on some case that was all that was needed so they are going to act like they know what’s best for you.  Why should you listen to an orthopedic surgeon when you have their very biased judgment instead?

I need to see it all.  Illinois work comp adjusters are entitled to see your medical records if you are hurt on the job.  The records they can get are the ones related to your injury.  So if you hurt your back at work, they can see those records as well as those for any prior back problems. They don’t have a right to see records related to your pregnancy or colonoscopy or cancer treatment or mental health treatment or anything else you aren’t claiming is work related.  But they will try to.

All of these games are designed to help the insurance company save money and potentially screw you over.  We of course know how to play these games and win which is one big reason to get an attorney. If you have questions or would like to discuss a case, please call us for free any time at 312-346-5578.  We help all over Illinois.