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In every Illinois workers’ compensation case, the goal is to get better, get back to work and get a great settlement. That is what happens in most cases and leads to a happy client.
Quite often the insurance company won’t voluntarily make a settlement offer, or if they do, it’s a low ball one. It’s important to know that insurance companies make money by not paying out money on claims and limiting the amount they do pay out.
In some cases, the insurance company is eager to settle and if you get a settlement offer and accept it, it could be a bad thing. And it all goes back to my earlier point that insurance companies want to limit what they pay you for your Illinois work comp claim.
Under Illinois workers compensation law, the insurance company has to pay for 100% of medical expenses related to your claim as long as the care is reasonable. So often we see settlement offers made because the insurance company wants to cut off the possibility of having to pay for future medical care.
Take for example a construction worker we talked to who had a shoulder injury that resulted in surgery for a torn labrum. During the surgery there was an anesthesia error that caused a brand new problem. The surgeon wasn’t at fault, but also is a really arrogant guy. He said that he wasn’t going to treat the new problem and after about six months of physical therapy, he released the worker to return to work even though they have numbness in their fingertips from the anesthesia error.
So the insurance company is eager to settle and take advantage of the bad surgeon who won’t address an injury that isn’t part of the shoulder. But under Illinois law, because the surgery was for a work injury, the medical treatment for the surgery error is part of the work comp case.
If the worker takes a settlement now, they will lose their right to future medical care at the expense of the insurance company. In other words, if in a year they need a surgery that costs $250,000 to fix the new problem, they’d have to find some way to pay for it.
So the insurance company is eager to give a high five figure settlement today because they will potentially save four times that much in the future. They actually have risk management people whose job is to figure out the odds of those things happening. It’s how insurance companies make billions every year.
The good news is that this worker got to us before an offer was made and before he agreed to anything that would take away his rights. It was our advice that he not consider a settlement now, but instead try to work with his issues and see where he’s at in six months. It’s typical that nerve damage gets as good as it’s going to get a year after surgery or so.
That doesn’t put money in his pocket or ours right now, but it’s the best, safest and smartest thing for this worker. And that’s what a good attorney does; they protect their client.
