Here’s something we hear a lot from people calling us with Illinois workers’ compensation questions.
My case is closed, but I’m still in pain. Is there anything I can do?
The answer depends on what you mean by closed.
The only real closure of a case is if you wait too long to file the case with the Illinois Workers’ Compensation Commission or if you have an approved settlement contract. If you have waited too long to file with the State (more than three years from the accident or two years from the last payment of compensation), you are out of luck unless you can get the insurance company to pay a medical bill. If that happens, the statute of limitations to file will be extended.
If you took a settlement, unless that settlement provided you with open medical benefits (this almost never happens) then you are out of luck. Settlement contracts close cases related to that specific work injury. So your only chance at getting more medical care or compensation through workers comp is to show that you had a new accident or an aggravation of the old injury due to job activities. This can be hard to do but not impossible, especially in heavy-duty jobs.
For most callers, when they say that their case is closed, what they really mean is the insurance company told them it was closed. This is a common insurance company tactic wherein they feel if they tell you it’s over then you will accept that it’s over. It’s sneaky and usually a lie. To paraphrase “Animal House,” nothing is over until we say it is. Let me give you an example of how this usually plays out.
Let’s take the case of a mechanic I recently talked to. He hurt his knee and had surgery. After surgery, he had some physical therapy and made it back to work. He was having some problems so the doctor gave him an injection in his knee. He was told that hopefully no more treatment would be needed, but to come back if he had more pain. He worked for about four weeks when his knee began to stiffen. He really didn’t want to go back to the doctor so he toughed it out for another six weeks. Finally, it was becoming too big of a problem so he called his doctor for an appointment.
The appointment was set, but then the doctor’s office called to say the work comp insurance wouldn’t approve it. He called the adjuster who told him, “Oh, your case was closed after the injection.”
Basically, the insurance company is trying to get away with not paying for more medical care or offering a settlement. That’s not how Illinois work comp law works. By filing an application for adjustment of claim his case will “magically” be open and he can file motions for approval of more medical care and force a settlement as well when that is appropriate.
The other common scenario is when someone has a case, gets treatment, gets better, and then asks for a settlement. They will tell you the case is closed, but it’s the same type of lie as with the mechanic. They just want to avoid paying you the benefits that you are entitled to. The hope is that you will go away which saves them money.
The solution in these cases is to always file with the Illinois Workers Compensation Commission. It will give you an avenue to address any problems and stop this gameplay from the insurance company. And if you haven’t done that yet, please don’t take their word for it that the case is closed. Ask an experienced lawyer for an opinion. You can call us for free at any time at 312-346-5320. We help all over Illinois.