One of my strengths as an attorney is that I know that even after 24 years I can always learn more. That’s one reason why I am always talking to other attorneys who I respect and picking their brains.
I had the opportunity to do that recently with a top Waukegan workers’ compensation attorney. When going over different scenarios of advice to give injured workers at the beginning of a case, he summed things up best when he said the following:
Bottom line, I don’t trust Illinois workers’ compensation insurance companies.
While it sounds so simple, these are great words of advice to remember. One of the most common scenarios I come across is hearing from injured workers that they aren’t sure if they should get a lawyer because “the insurance company is doing everything they should so far.” To an injured worker not familiar with how the system works, this means they are getting their medical treatment and compensation for time off of work.
But when I dig deeper, I usually find what I expect to find. The insurance company is playing a longer game in order to save money in the end. What will usually happen is I’ll ask if they gave a recorded statement and find out the answer is yes. That’s a trap they set to try and find a reason to deny you. Then I’ll ask if there is a nurse case manager on the case. That person is an insurance rep who contacts your doctors, often illegally and at times will try to be in the exam room. When I hear that they are involved, I let the worker know that is another trap. It’s possible that the doctor didn’t order medical care they think you need because they were talked out of it before they could even bring it up with you.
Most doctors care about their patients, but also want to be paid. So if a nurse case manager is implying bills won’t get paid if they don’t follow the more conservative (and cheaper) plan they want in place, it might be that you don’t get that MRI or surgery even though the doctor thinks it’s best.
Even without those things, it could be an “independent medical exam” or surveillance or a medical authorization form that gives them access to your entire history of medical care even though they don’t have a right to anything not related to the job injury.
You don’t know what you don’t know and can’t be expected to have an understanding of every trap or trick out there. And believe it or not, the insurance company seeming like they are nice or doing the right things is often a set up that will burn you later. The bottom line is insurance companies are in it to make money for themselves, not look out for you. They are not to be trusted. Ever.
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