Overview Of Pain Management And Illinois Work Comp Law

We are fortunate to be able to help people who have been injured on the job in Illinois. These workers have sustained many different types of injuries. Some people recover quickly and are back to 100% in a matter of weeks. Others, however, end up suffering from chronic or long-term pain.

Most people understand that their company’s workers compensation insurance will cover  100% of the treatment required (e.g., surgery, physical therapy, rehabilitation) to address the injury. But many are unaware that after that treatment, if pain persists, pain management care should be covered by workers’ compensation as well.

Pain serves a purpose. It alerts a person to damage to the body. But after a person receives and interprets this message, further pain can be counter-productive. Pain can have a huge negative impact on one’s quality of life, not just from the physical side of things but also on the mental and social sides. Anxiety, depression, difficulty sleeping, and difficulty maintaining relationships can result from chronic pain.

In most situations, the doctor who treated your injury will refer you to a pain management specialist. For example, if an orthopedic surgeon performed surgery on a person’s back, and the patient is experiencing significant pain post-surgery, the surgeon may refer him/her to a pain management doctor.

What does the pain management doctor do? In this medical specialty, doctors try to find an effective treatment to help relieve and manage your pain. That sounds simple enough, but in reality, finding the right treatment can be very complex, and it might take some time. What works for one person with back pain may not work with a person with arthritis.

That treatment often involves the doctor prescribing pain medication and/or performing injections or other procedures. Painkillers will likely play a role in your treatment. Common options include:

  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Acetaminophen
  • COX-2 inhibitors
  • Antidepressants and anti-seizure medications
  • Opioids

Your doctor should discuss the benefits and risks of pain medications so you can make safe choices.

As we mentioned, injections and other procedures may be a part of a patient’s pain management plan. Nerve blocks, facet joint blocks, ablation, and trigger point injections are common examples. A pain management pump is one that many of our callers with back injuries have had success with as well. This is a device that is surgically planted under your skin by your abdomen and slowly releases medication directly to your spinal cord. It allows you to control symptoms with a smaller dose of medication since it’s delivered directly to the area causing you pain.  This is great because it can help reduce the harmful side effects of some medications.

People who benefit from pain management treatment are those who have tried everything else, aren’t a candidate for surgery, don’t have medication addiction issues, and don’t have other unrelated but severe medical conditions. We’ve seen it help a lot of people who have RSD, failed back surgeries, severe arthritis, and strokes.

There aren’t a lot of great pain management doctors out there as it’s a bit of a niche specialty. If you are struggling with pain related to a work injury, feel free to contact us to learn more about your options and our opinions as to which doctors would be best for your care. We are of course also happy to discuss any aspect of your case for free and in confidence. Please call us any time at 312-346-5578.

Don’t Settle Your Illinois Workers’ Compensation Case Just Because It’s Denied

A truck driver called my office about an ankle injury. He rolled it while stepping out of his truck and immediately sought medical care and reported it to his boss. X-rays were negative, but he had a lot of swelling. As an aside, in my experience, sometimes an ankle can be so swollen that an x-ray will miss a fracture.

The doctor told him to rest and ice the ankle. He did that and while it got better to the point that he could walk on it and eventually return to work, it continued to bother him. Eventually, it started to hurt too much and he asked to go to the company clinic.  He had a few visits and it was suggested that he get an MRI of his ankle. That’s when the insurance company decided that his need for treatment was no longer related to the job accident. They told him to use his own insurance.

He’s gone ahead and done that and is waiting for the MRI. The whole experience has him frustrated. He called me and asked if I could help him get a settlement since the case was denied.

I told him that I could, but I wouldn’t because if he settled now he’d be potentially leaving a lot of money on the table. He needs to get the MRI to find out what’s really wrong. If the answer is nothing, then it’s possible he could settle.  And waiting until the MRI wouldn’t change the value much if any.  On the other hand, if the MRI shows a big injury and he needs surgery, we’d want to talk to his doctor to learn if they feel that his current problem traces back to his work accident.  If that doctor does, suddenly a case that’s probably worth a couple of thousand dollars is now worth somewhere in the five figures and possibly more if he can’t return to work.

There’s also the issue of paying for his future medical care. If he can’t work he might lose his medical insurance or at least would have to pay out of pocket a lot. But if it’s a work-related injury that would all be covered by the work comp insurance.  Also if he misses time from work, a work comp case in Illinois would pay for his time off.

We see people considering settling for too little and too early when an insurance company says the case is closed. That is usually not up to them to decide and often is a strategy they deploy to try and keep money out of your pocket.  I get how they can frustrate injured workers, but highly recommend that you at least get an opinion before making a final decision. If you’d like to speak with an experienced attorney for free, you can contact us any time at 312-346-5578.

Calculating Average Weekly Wage, Look Out For This

When you are injured in Illinois and taken off work by your doctor, you get paid benefits called temporary total disability (TTD). Your TTD rate is 2/3 of your average weekly wage (AWW) and is tax-free although there is a weekly maximum on how much you can be paid based on when you were hurt. Currently, that amount is over $1700 a week. Even if you aren’t missing time from work, your average weekly wage is used to help calculate your settlement at the end of the case.

The average weekly wage is calculated based on Section 10 of the Illinois Workers Compensation Act. In determining your AWW, the basic explanation is we look at your earnings from the prior 52 weeks from your injury. So if you’ve worked at a company for years and are salaried at $52,000 a year, it doesn’t take a genius to determine that your average weekly wage is $1,000.00 a week.  If you are paid by the hour and consistently work 40 hours a week, a wage sheet would help in the calculation.

Some people of course get hurt before they’ve been on the job for 52 weeks. In those cases, you divide by the actual weeks worked. So if you were hired 30 weeks ago, we’d divide by 30, not 52.

In a recent case I worked on with a lawyer friend from out of town, the injured worker is permanently disabled and is going to receive weekly payments for the rest of his life. He was hired about 10 weeks before his accident.  His first workday was on a Thursday and he got hurt on a Tuesday.  The insurance company took the first Thursday and Friday as one week and the Monday and Tuesday of the week he got hurt as another week. So they calculated his wages and divided by 10 weeks when in reality they should have done it by less than nine.

The difference amounts to over $70 a week, so over the last two years, he’s been underpaid by about $7,000.00.  That’s item number one to look out for.

The second issue is that this job brought him along slowly. He didn’t work more than 35 hours during the first four weeks as there was some training involved. By week six he was doing the work that he was expected to which involved around 45 hours a week. Under Illinois law, when you’ve only been at the job a short while, your wages can be calculated by looking at a “similarly situated employee” and what they earn. There is no litmus test as to how many weeks’ time that is, but I’d argue that he was really only on the job for 4-5 weeks. So if they look at what a full-time employee working 45 hours a week makes, his actual AWW could be increased by over $200 a week. So he might be owed around $20,000.00. That’s a lot of money.

What you can’t do, unless you are salaried, is take the insurance company at their word that you are being paid the right amount. You might be or they might be ripping you off. I promise you that they aren’t doing whatever they can to make sure you are getting the most you are entitled to under the law.

If you have any questions about your pay rate and want to talk to a lawyer for free about it, contact us any time at 312-346-5578.  We cover all of Illinois.

Illinois Workers Comp, Getting A Referral To A Doctor

I’m not personally on any social media sites, meaning that I never post, but I have a Facebook account so I can access a community happenings page where I live. It’s usually stuff about the local schools, restaurants, police activity, etc.  But the other day there was a post about workers’ compensation law in Illinois so of course, I had to turn that into a blog post.

The poster said that they were looking for a pain management doctor who would take a work comp case.  Someone replied and said that the work comp insurance should provide a list of doctors and that getting the referral through them would make getting the bills paid easier. The original poster replied that she asked the insurance company about that and was told that they don’t do that.

There are so many lessons about Illinois workers compensation law in this one small post. The first is don’t take legal advice from non-lawyers.  The well-meaning person who told her to get a referral from the work comp insurance carrier almost sabotaged the case. If they recommended a doctor, it would likely be someone who would be friendly to them and not look out for the best needs of the patient. It’s kind of shocking that the insurance company didn’t agree to recommend a doctor. My guess is that there’s a younger adjuster on the case who doesn’t know what they are doing.

The second lesson is that if you want a referral to a doctor, there are two ways to go about it. The first is to ask your doctor for a referral. In a case like this, I assume the injured worker is treating with an orthopedic doctor. That doctor would have recommended that she receive pain management treatment.  Every orthopedic doctor I know has relationships with pain doctors because it’s important that they can communicate about your care. If for some reason you don’t like the referral or can’t get one, ask your attorney who they recommend. There aren’t thousands of pain doctors around so in a case like this, any experienced lawyer should be able to tell you who is reputable and who isn’t. Even with that, you still want to ask your doctor to give you a referral because if you don’t you might lose your right to make the insurance company pay for it.

A final lesson is don’t post about your case on social media, ever. A car accident attorney I refer cases to had a client lose a $100,000 settlement because they posted about it on Instagram.  This poster didn’t ruin her case by posting, but she certainly opened herself up to people asking questions about the case and her responding in a way that could create evidence against her. I get that people love their social media, but I promise you that on every case, insurance companies and their lawyers are looking for your profiles and will be monitoring you. Even if you don’t post about your case, if you have a back injury and show yourself on a speed boat or dancing at a bar or swinging your grandchild, you are potentially creating evidence against yourself.

And of course, if you have any questions about anything related to your case or Illinois work comp law, you can contact us for free at any time.

Can You File For Workers Compensation After Giving Your Two Week Notice?

We are Illinois workers compensation lawyers with over 25 years of experience. Contact us for a free consultation at any time. We cover all of Illinois.

Giving two-week notice to your job is a professional courtesy that you don’t have to do. People do it because they don’t want to leave their company and co-workers hanging, to not create any bad will and because they have pride in the work they’ve done and want to make sure everything is in order.  Other people do it because they think they have to.

Whatever your reason, giving notice doesn’t stop you from being an employee or having rights including those under the Illinois Workers’ Compensation Act.  So to answer the question of this post which was that of a caller to my office, yes you can still file for workers’ compensation benefits even after you’ve given your two-week notice.

What’s crazy, is the woman who called me actually gave her employer four weeks’ notice because she was in the middle of a project and didn’t want to have it get messed up for her employer or their customer. How did the employer repay her loyalty? They lied and said that once you give notice, you are no longer eligible for work comp. That is just ridiculous.

In this case, her arm got broken when she fell on a wet floor and she’s going to need surgery.  100% of her medical bills will be paid for by the workers compensation insurance. While she’s fully authorized off of work by her doctor, she will also continue to get paid.  When her doctor releases her with restrictions, if the employer can show they would have accommodated her had she not quit, her entitlement to off-work benefits will end.  When she’s all better she will be entitled to a settlement.

I hear stories of these kinds of employer lies told all the time. Sometimes they say you can’t get work comp if you are on probation or a part-time worker. Those are lies too. Every employee is covered from the first minute they start working until they leave for the very last time and for every day in between. You still have to prove that your injuries come from the job, but assuming you can, you are entitled to the full benefits under the law no matter when the accident happened.

On top of all of this, you don’t have to formally file for workers’ compensation while you are still employed to be eligible for it. As long as the employer had notice within 45 days of your accident, you have up to three years from the injury date to file your case. So in the case of my caller, had she called me a few months after her last day because bills weren’t getting paid or she wasn’t healing well, we’d still be able to help her since her fall was witnessed by her boss so clearly, they have notice.

In general, this comes down to the fact that some employers and most insurance companies play games. Don’t take legal advice from them and don’t make decisions based on what they tell you the law is. If you want to know what it really is, you can contact us any time for a free consultation. This will allow you to make an informed decision.

RSI And Illinois Workers’ Compensation Law

When you get into workers’ compensation cases there are so many abbreviations that become second nature for attorneys, but can at first be confusing for injured workers if they haven’t heard of them before. MMI, IME, FCE, TTD.  Those are just four of the terms that come up a lot in Illinois work comp cases that the average person on the street doesn’t know about and shouldn’t be expected to.

Another one of those terms is RSI which is short for repetitive stress injury. There are two main causes of injuries at work. One is a one-time event. That would be something like slipping on a wet floor and breaking your leg or lifting something heavy and feeling a pop in your back.  There is a specific time and place you can point to as to when you were injured.

RSI cases are due to doing the same or similar activities at work for an extended period of time. The repetitive nature of the activity and the frequency can eventually cause your body to break down. There are so many examples, but the most common ones include:

  • Typing for most of the workday and getting carpal tunnel.
  • Continuous heavy lifting that leads to a back injury.
  • A lot of overhead work that causes a problem with your shoulder.
  • Working on an assembly line and using your arms/hands a lot.  This can lead to injuries from the fingers all the way up to the neck, but the most common problem occurs in the elbows.

There are of course other repetitive activities that can cause a body to break down. Sometimes these problems get better with rest or modifications such as an ergonomically correct workstation or wearing wrist guards. More often than not though either there is no modification that can be made (if you lift all day, a back brace isn’t going to solve a problem) or your body is beyond the point of being fixed without medical treatment.

Many of the people we have helped with an RSI in the past try taking Advil until the pain gets too much to bear.  At that point, they usually go to the doctor.

When it comes to Illinois workers’ compensation cases, it doesn’t take a rocket scientist to conclude that a carpenter who works overhead all day and has a shoulder injury was hurt at work. But despite that, insurance companies for work comp are ruthless and will often deny RSI claims from the get-go.  And if they don’t they will use another abbreviation (IME) to fight you. IME stands for independent medical examination and that’s when they send you to a doctor of their choice for an opinion that your condition isn’t work-related.

Other sketchy tactics they use include saying that you had a pre-existing condition (often that shouldn’t matter or is irrelevant), that you’re heavy or diabetic (a popular one for fighting carpal tunnel cases) or that your job couldn’t cause your injury.  They also might try to make you give a recorded statement or send a nurse case manager to your appointments. Those things shouldn’t happen.

To win these cases, there are some important things for you to know:

1. The moment you suspect your injuries are work-related, let your supervisor know.  Another defense insurance companies use is that you didn’t notify your employer in time. We can usually get around that by saying you didn’t know for sure until you saw a doctor, but it’s still important to tell your employer ASAP.

2. See a doctor. Advil isn’t medical care.  These injuries get worse if untreated.  If you need rest, have a doctor take you off work. If they feel it’s work-related you’ll get TTD which stands for temporary total disability.  In plain English, it means you’ll be paid for your time off of work.

3. When talking to your doctor, make sure they understand the true nature of your job duties. Don’t assume they know what you do. They probably don’t. Don’t say, “I’m a secretary.”  Do say, “I’m a secretary. I type seven hours in an eight-hour day, five days a week. I’ve been doing that for 11 years.  It’s a really fast-paced job and it’s not uncommon for me to type 80-100 pages a day, and I’m making a lot of corrections for my boss on those pages. The workload lately has been heavier and for the last month, I’ve been working about 15 hours a week of overtime. I notice pain in my wrists at the end of the day. It’s worse toward the end of the week. I have numbness and tingling in my fingers at the end of the day and at random times throughout the day too.”  Hopefully, you can see that this extensive detail paints a clearer picture. You should do that no matter what your job is.

4. There’s no test for how long you have to have been doing the activity to win an RSI case. That said, the longer you’ve been doing it, the better. In other words, it would be hard, but not impossible, to make an RSI case if it happens a week into the job. You should also know that while you can bring a case after you leave the job, the longer you go without working before you file or see a doctor, the harder it will b to win.

5. Talk to an attorney. This isn’t some bogus sales pitch for you to hire my firm or someone I recommend. Most RSI cases get denied at some point by an insurance company. You have to be prepared for this and that means having an attorney. There is so much we can do for you right away including making sure the job duties description you give to your doctor makes sense and getting the nurse case manager off your case.

6. Don’t freak out. Easier said than done I’m sure. As I was writing this, I got a call from a guy with an RSI that is being wrongly denied by Walmart. His doctor has him off work and they are telling him he needs to come back. So of course he’s worried. These cases do get fought, but as long as you follow our advice and don’t have something odd (e.g. getting in a non-work-related car accident the day before you first went to the doctor) you usually will prevail. And while we can’t guarantee a result, after 25 plus years of doing this, we can usually tell you over the phone or soon thereafter your chances of winning the case.

If you’d like to speak with an attorney for free, please call us any time at 312-346-5578. We cover all of Illinois and will give you direct, honest, and compassionate advice.

The “But For” Test When Hurt At Home, Illinois Work Comp Law

If you’ve ever been hurt, whether on the job in Illinois or not, you know that a serious injury can lead to other issues. For example, if you break your leg and are using crutches, you might develop an elbow injury. If you have trouble lifting with your right arm and overuse the left, it’s possible that you will then develop a left arm injury.

When the first injury happens due to a work accident in Illinois, the second injury can get covered under the Illinois Workers’ Compensation Act.  And it can be covered even if you get hurt at home. The test we use to determine if it should is called the “but for” test.

In plain English, this means we need to be able to say that if it wasn’t for the work-related injury, you wouldn’t have had the second injury.  A recent case shows how this gets applied in real life.

In that one, a worker at a cement contracting company had an undisputed work-related accident that resulted in two ankle surgeries.  While recovering at home from the second surgery he was walking up the stairs when he felt a sharp pain in his left ankle. Per his testimony at trial, this caused him to fall forward and injure his low back. At the time of the fall, he was wearing a CAM boot due to the second surgery.

He received treatment for his back, but the insurance company disputed the case. The Illinois Workers Compensation Commission found in his favor noting “but for” the original injury which led to ankle surgery, he wouldn’t have been wearing the boot, wouldn’t have had ankle pain, and wouldn’t have fallen.  So they ordered that the employer through their insurance company pay for the back surgery that he now needed.

These types of second injuries happen all of the time, but sadly many of them don’t get handled by workers comp. Sometimes that is because the injured workers don’t know they have that right. Other times attorneys aren’t experienced enough to know that it can be a part of the case. And worst of all, some lawyers know it should be part of the case, but don’t want to make an otherwise clean case messy.

In this case, the injured worker is going to end up with tens of thousands more in their pocket and a fixed back because their lawyer fought for them.  It’s a really big deal.

Bottom line is that even if you are hurt at home, if it wouldn’t have happened “but for” the original work accident, you can add that to your case. And you should.

And of course, if you have any questions about this, you can call us for free at any time at 312-346-5320 to speak with a lawyer.

Home Care Aides And Illinois Workers Compensation Law

In Illinois, there are more than 81,000 people working as home care aides.  This is double the amount of workers we had a decade ago, and it’s expected that number will grow as people are living longer and the elderly population in Illinois is increasing.

These workers are saints. The job duties vary, but are pretty much hard everywhere. And it’s not just elderly people who are being cared for. Many home health aides help the disabled with acts of daily living. Here are some of the job duties per the Illinois Department of Human Services:

  • Personal Assistant (PA): Provides assistance with household tasks, personal care and, with permission of a doctor, certain health care procedures. PAs are selected, employed, and supervised by individual customers.
  • Homemaker Services: Personal care provided by trained and professionally supervised personnel for customers who are unable to direct the services of a PA. Instruction and assistance in household management and self-care are also available.
  • Maintenance Home Health: Services provided through a treatment plan prescribed by a physician or other health care professional. Other services include nursing care and physical, occupational, and speech therapy.
  • Electronic Home Response: Emergency response system offered by hospitals and community service organizations. This rented signaling device provides 24-hour emergency coverage, permitting the individual to alert trained professionals at hospitals, fire departments, or police departments.
  • Home Delivered Meals: Provided to individuals who can feed themselves but are unable to prepare food.
  • Adult Day Care: The direct care and supervision of customers in a community-based setting to promote their social, physical, and emotional well-being.
  • Assistive Equipment: Devices or equipment either purchased or rented to increase an individual’s independence and capability to perform household and personal care tasks at home.
  • Environmental Modification: Modifications in the home that help compensate for loss of ability, strength, mobility or sensation; increase safety in the home, and decrease dependence on direct assistance from others.
  • Respite Services: Temporary care for adults and children with disabilities aimed at relieving stress to families. Respite services may be provided for vacation, rest, errands, family crisis or emergency. Services may include personal assistant, homemaker or home health.

Basically every one of these tasks puts workers at risk of injury. The top one we see is a back injury from lifting a patient who loses their balance or isn’t cooperative. But literally in the last 25 years, I’ve seen just about any injury possible. This includes slip and falls on floors wet from bodily fluids, injuries from being attacked by a patient, burns from kitchen accidents and car accidents while running errands. All of these events (and more) are covered under the Illinois Workers’ Compensation Act.

Unlike workers in a factory or office setting, most home health care aides have accidents with no witnesses.  As a result, two things are really important:

  1. You need to notify your employer/agency ASAP about what happened. We highly recommend that you do so in writing so you can prove that you gave notice. Some of these organizations are sketchy and don’t treat their employees like people. They will certainly lie if they think it will save them some money.
  2. Get medical treatment right away and be very clear in telling the doctor how you were injured.

Because these are work injuries, it doesn’t matter if you have health insurance or not. All of your treatment should be covered by the work comp insurance of your employer. This means no co-pays and no out of pocket expenses.  In addition, if the doctor takes you off of work, you will be compensated for your time off until you are better. Many home care workers have two jobs.  As long as your employer knew about both jobs and approved of it, you should be paid based on your wage loss from both jobs.

Risk wise, the biggest issue we commonly see is aides who return to work before they are ready. If you have a torn muscle in your shoulder or a herniated disc in your back, doing this work will likely just make it worse.  And of course as mentioned, some of the employers are shady and will fight cases when they shouldn’t.

This showed up in a recent Illinois Workers Compensation Commission trial.  The worker was assigned to a client and was given specific duties which included bathing, dressing, preparing meals, housework and undefined “outside of the home” tasks.  One day she drove the client and her son to get food and there was a car accident.  Somehow the insurance company fought the case even though outside of the home tasks were part of the job. This client had mobility problems and going with her on this trip was providing help.  There was no company policy against it and it was of course reasonable for her to do so.

So in the end she won her case, but had to deal with a bogus denial before it happened. Fortunately, she had an experienced attorney in her corner who knew how to properly represent home health care aides.

We have helped hundreds of injured home workers throughout the years and would be happy to help you. If you would like to speak with a lawyer for free, you can contact us any time at 312-346-5578. We help workers everywhere in Illinois.

30 Things You Wish You Knew About Illinois Workers’ Compensation Law

I started my law firm over 21 years ago and have been a licensed Illinois attorney since 1997.  One thing I’ve heard a lot from people about Illinois work comp cases is, “I really wish I knew that earlier.”  In fact, I’ve heard it so much that I thought I would make a list with the hopes that some future injured workers will see it and it will make their case go smoother or help them to avoid any mistakes.

1. You don’t have to give a recorded statement to the adjuster and shouldn’t.

2. Illinois work comp law is a no-fault law. That means you don’t have to prove negligence.

3. Failing a drug test doesn’t mean that your case is over.

4. Insurance companies will often say your case is closed. That can only happen in reality if you settle the case or wait too long to file it.

5. Almost every case has some settlement value.

6. It costs nothing to switch attorneys.

7. The insurance company can conduct surveillance on you which includes filming you in public places.

8. Unless your company has set up a preferred provider program (PPP, Jewel is one company that has done it), you get to choose your own doctor.

9. Payment for time missed from work is based on calendar days missed, not work days missed.

10. Once you have a lawyer, the insurance company isn’t allowed to talk to you.

11. The nurse case manager has no right to talk directly to your doctor, nor can they attend your appointments.

12. There is a maximum amount for weekly off-work checks depending on your accident date.

13. While AMA ratings are a consideration in settlements, they are not binding or even a main factor in my opinion.

14. Most work comp trials take less than a day.

15. Doctors typically testify via deposition before you testify.

16. While you can’t sue the insurance company, you can file for penalties and fees against them.

17. You have to notify your employer of an accident within 45 days of getting hurt.  The sooner the better.

18. While it’s advisable to formally file a case with the Illinois Workers’ Compensation Commission as soon as possible, you have three years from the accident date or two years from the last payment of compensation to do so.

19. It’s not unusual for multiple insurance adjusters to be on your case if it lasts a while. Those are high turnover jobs.

20. If you are on social security or soon will be, there is language your attorney can add to a settlement contract which will limit the amount your SS benefits get reduced by you receiving a big, lump-sum payment.

21. It doesn’t take years to get to trial. Some Illinois work comp attorneys lie to their clients about that.

22. If you were hired in Illinois, you can file your case in Illinois even if you mainly work out of state.

23. You are eligible for work comp benefits the minute that you start working. There is no probation period.

24. If your boss says they will pay for your bills and time off work out of pocket they are likely lying and it’s a terrible idea for you to lie to your doctors thinking that your boss will be honorable.

25. Work comp settlements are tax-free.

26. While any attorney licensed in IL can take your case, you are best served by working with someone who primarily does nothing but work comp cases all day, every day.

27. While the thought of going to trial sounds intimidating, everyone I’ve worked with has told me after that it wasn’t nearly as bad as they thought it would be and most feel like they can’t believe they were worried about it.

28. There are certain times of the year when an insurance company is more interested in settling because insurance adjusters get bonuses based on how many cases they close. So usually toward the end of the year, you’ll get their best offer.

29. There are some attorneys who advertise a lot in the Chicago area who aren’t themselves licensed to practice law in Illinois.

30. Just because the insurance company pays your benefits or medical bills doesn’t mean they can’t fight your case later on.

 

Hopefully, none of these items are making you more confused. If you have any questions please call us at 312-346-5578 to talk with an attorney for free. We cover all of Illinois.

How Does Workers’ Compensation Work In Illinois?

We have been helping injured Illinois workers since 1997.  Call 312-346-5578 to speak with an attorney for free.

A rather flustered and recently injured Illinois worker called me with a very direct question. “How does workers’ compensation work in Illinois?” they asked.

They were flustered because they had been recently hurt on the job, and nobody is giving them answers. It’s a straightforward situation (they were hit by a forklift), but in the one call with the insurance company, they were told that the case was under investigation. That’s insurance company speak for, “We are going to jerk you around.”

So how does workers’ compensation work? It’s a very good question if you’ve never experienced the system before.

The first thing that happens is that a worker gets hurt while working or realizes that an injury they have is due to the repetitive nature of their job.

Step two is to get medical treatment. In almost every case you can choose your own doctor and you certainly can go to any ER you want.  That treatment should be 100% paid for by the work comp insurance for your company. Be honest. Tell them what happened. And get a diagnosis.

Step three is to make sure your employer is notified of your accident/injury. If your boss sees you get hit by a forklift, that’s them having notice. If you are alleging carpal tunnel from typing all day or they didn’t see you get hurt, you have to report the claim to them, in writing or verbally. We recommend that you do both and document it.

After that, it really comes down to what your doctor says. If they say you need to be completely authorized off work due to your injury, you are entitled to 2/3 of your pay, tax-free. The same is true if your doctor gives you restrictions that your employer can’t accommodate such as no typing or no lifting more than 10 pounds.  This payment for being off work can last as long as it takes for you to get better.

You can continue to treat, at no expense to yourself, for any medical condition that is related to your claim as long as the care is reasonable. For us, we highly recommend that our clients get referred to reputable specialists such as orthopedic doctors and trust their guidance. If you want a second medical opinion, you are usually entitled to that too.

When you are all better or as good as you are going to get, you may be entitled to a settlement. The value of that depends on your injury, treatment, recovery, wages, age, job history, any potential defenses to your case, and other things.

In between getting hurt and the case getting settled, you must be on the lookout for insurance company games. Our caller had experienced one already when they were told the case was under investigation.  Here are some other things to look out for:

  1. Drug tests. They have a right to make you take one and if you refuse it could end your case. But just because you fail a test doesn’t mean that you lose your case. It means you have to prove that you weren’t inebriated when you got hurt which can be done by your testimony.
  2. Recorded statements. It’s not uncommon for the “investigation” to mean that the adjuster wants to ask you questions in a way that could cause you to lose your benefits. You don’t have to take part in telling them anything, certainly not in a recording. We highly recommend that you refuse to participate if asked and once you have a lawyer the insurance company can’t talk to you directly.
  3. Independent Medical Examination (IME). This is a one-time medical exam at the request of the work comp insurance company. They pay for it. The doctor is usually working for them, not looking out for you.  It can be used to get an opinion, even if it’s absurd, that can be used to deny your case.  Often these exams last less than five minutes.
  4. Surveillance.  If your injury lingers, the insurance company at any time can pay a private investigator to follow you around and film you. Their goal is to catch you doing something that your doctor says you shouldn’t do. If you are honest and follow your doctor’s restrictions you’d think nothing could go wrong. But stuff happens like you are feeling good one day and decide to pick up your kid and carry them. Next thing you know your benefits are cut off because you lifted more than you should.

When benefits are wrongfully denied, that gets resolved by either having your lawyer convince the insurance company they are wrong or by filing for arbitration. And if a settlement offer isn’t made or isn’t fair, arbitration is the process too to make that happen.

While you may think I’m biased, it’s a really good idea to get an attorney. A good one will protect you along the way and in the end, not only make sure you get a settlement, but also get the most possible for your case. It costs nothing upfront to hire an attorney or file a case. Typically attorney fees are 20% of any settlement they get for you or any award at arbitration if your case goes to trial. If you’d like to speak with an attorney for free, please contact us any time.

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