Illinois Workers Compensation And Bedsores

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It doesn’t happen in a lot of workers’ compensation cases in Illinois, but in some where a worker has a very serious injury they can be sent temporarily to a nursing home or rehab facility to aid in their recovery.

You don’t picture a nursing home as being filled with people who months before were healthy laborers, but it happens.  Within nursing homes patients can have all sorts of injuries and physical issues.  One that you need to on the look out for if you are in a nursing home or rehab facility are bedsores.

Bedsores are also called pressure ulcers and decubitus ulcers.  They are skin injuries that come from pressure to the skin.  Stage one bedsores are relatively minor and can look like a cut that needs to be healed.  A stage 3 or 4 bedsore is much more serious and can literally cause your bone to be exposed and can potentially kill you.

These injuries happen a lot at these facilities because the patients there have conditions that limit their ability to change positions and spend a lot of time in a bed or chair.  They are most often found on your tailbone, back, hips, heels and shoulder blades.

Bedsores are caused by pressure and friction and can be made worse by medical conditions including poor blood flow and immobility.

Now you are at a work comp blog site, so the question is what do you need to know if you or a loved one gets a pressure sore at a rehab facility after having been injured on the job in Illinois?  Here are three important things to know.

  1. You may have a lawsuit against the facility where this occurred.  If the sore gets to stage three or worse, it’s a sign that the medical providers did not properly monitor you.  We know excellent bedsore attorneys in Illinois and would be happy to refer you to one in your area.
  2. If this happened after a work injury, it’s likely part of your work comp case.  That means all of the bills related to this problem should be covered.
  3. The sad reality is that bedsores are more common at poorly run facilities.  It happens often due to them not checking the skin of their patients.  The good news if you are injured on the job in IL is that you get to choose your own medical providers.  That means you don’t have to go to a crummy facility because the insurance company wants to send you there to save a few bucks. You can and should choose the best place possible for your treatment to prevent problems like this from happening.

These are unusual and probably happen in less than 20 work comp cases a year.  As a result it’s important to hire an attorney who understands how serious these issues are.  The attorneys in our network have handled these cases for many years and we’d be happy to talk to you any time.  All calls are free and confidential.

Work Comp Case Worker – 10 Things You Should Know

One of the advantages of having an attorney on an Illinois workers’ compensation case is that they will talk to the insurance adjuster case worker for you. That means someone who knows the law will be having conversations with them and you won’t get taken advantage of.

That said, most people will at some point talk to a case worker from the insurance company. In no particular order, here are ten tips for dealing with them that will help your case.

1. You don’t have to give them a recorded statement. This is a common request soon after you are injured as part of their “investigation.”  Anything you say can be used against you and often they will try to trick you in to saying things that hurt your case.

2. The case worker is not only not on your side, they are against you. They may seem nice or even be nice, but at the end of day, their job is to limit or deny your benefits.

3. Investigating a case doesn’t take months. So when they delay, that is to frustrate you, nothing else.  Honestly, most cases shouldn’t take even weeks.  They get your story and see what you told your doctor and that should be enough.

4. They can assign a nurse case manager to your case. That said, that person doesn’t have a right to talk to your doctor, schedule your appointments, be in your appointments, etc.  They can ask for copies of medical records and bills.

5. Don’t be surprised when you don’t get a returned phone call. Again, their goal is to frustrate you and one way they do it is by ignoring you.

6. They can’t give you legal advice. I’m stunned at the number of work comp case workers who tell injured workers what the law is. They are not allowed to do that and since they aren’t on your side, they shouldn’t.

7. They can send you to an IME, but can’t make you treat with their doctor. I’ve seen some insurance adjusters who say that they will pay your medical bills, but only if you go to a certain clinic.  That is not how Illinois work comp law works.  Whether they are seeking a discount or a doctor they know will be in their pocket, you shouldn’t go with the medical provider they want you to see

8. It’s not unusual for the person you deal with to change. They work in a high turnover industry with pay that isn’t great.

9. Usually when your TTD check is late, their reasons for it are a lie. If you are owed TTD benefits, all it takes is for someone to enter that information in a computer to get a check processed.  It’s not rocket science.  If you’ve provided the adjuster with an off work slip they should have no excuse for your check not arriving. It’s one more of the games they play to try and discourage you.

10. They don’t have a right to your whole medical history. One of the first things they will send you is a form asking for permission to get your medical records.  You should give them permission as relates to the body part you hurt on the job. However, if you hurt your back they don’t have a right to know about your pregnancy or psychological care or the time you removed your appendix, etc.

I hope this helps.  This list could be a lot longer. As always, if you have any questions please get in touch.

IL Work Comp – What Happens If You Get Hurt While On Probation?

A caller to our office from the Rockford area had a question about his recent work injury.

He strained his back two days after starting a job and the pain hasn’t gotten better.  He reported the accident, but hasn’t done anything with it.  The reason for that is he was on a trial period at this job so he didn’t really think he was an employee.

While an employer can say you are trial or probation or some other legal term, they can’t take away your rights under Illinois law.  This means that no matter what they call you, the first second you start working you are covered under the Illinois Workers’ Compensation Act.

You still have to prove that your injuries are work related.  You can bet that an insurance company will strongly look in to someone who says they were hurt soon after starting a job. But it doesn’t change the fact that if you can show you were hurt while in the course of your job duties, you are covered.

It really makes sense if you think about it. Let’s say you are a welder and working on a “trial period.”  Your first day on the job you are on a scaffold that collapses and you shatter your leg.

Should you not be able to get medical care for that injury because you were new?  That would be ridiculous.

Don’t doubt for one second that a first day worker has the same rights as someone who has been on the job for 30 years, at least when it comes to job injuries.  Now a long term worker will have a much easier time proving a repetitive trauma injury, but that doesn’t mean that you can’t bring a case at all.

My advice in these situations is the same I’d give in most other cases.  Don’t listen to non-lawyers.  Don’t listen to someone who might have a competing interest with you like your boss.  It’s free to call any work comp attorney (even the bad ones) to ask a question about whether or not you have a case.

In general, Illinois work comp laws follow common sense.  So if something doesn’t seem right, ask around before you give up.

Legionnaires Disease and Illinois Work Comp Laws

Injuries at work are unavoidable. Workers in Illinois and elsewhere get hurt on average every seven seconds.  You can do things to try and prevent yourself from getting hurt while lifting.  You can use special care while walking on a slippery floor. What workers can’t prepare for are airborne disease and bacteria that they can’t see and don’t know is there. Unfortunately, occupational related illnesses cause untold amounts of damage.

An occupational illness is any illness whose cause can be attributed to an employee’s workplace environment or conditions. There are quite a few different types of occupational diseases: however, some are far more common than others.

Let me introduce Legionnaires Disease: It is a type of pneumonia caused by a bacterium known as legionella pneumonphila. Although the disease primarily affects the lungs, it occasionally can cause infections in wounds and other body parts, including the heart. It is less common than other types of occupational illnesses, however, it can quickly spread among other workers. According to CDC close to 5,000 people contract this illness annually, and approx. one in ten people who suffer from this disease will die.

Legionnaires’ Disease is no stranger to Illinois. The state of IL reported 510 cases last year and confirmed 242 so far in 2019. The most commonly known case happened in 2015, when a state-run veteran’s home in Quincy, IL had an outbreak resulting in 66 residents and 8 employees/volunteers of the facility having tested positive for legionella in addition to 13 related deaths.  When it hits, it usually hits hard.

Workers can contract this disease when they inhale these bacteria in tiny droplets of water, such as vapor or mist, which can be present in the air. The disease does not spread from one person to another, but it can quickly infect many workers since the bacteria is in the air that all people in the same building are breathing.

When favorable conditions exist for the growth of the Legionella bacteria, man-made water systems seem to be the most likely source of the disease. Workers most risk is those who work in sealed buildings, particularly those who maintain air conditioning systems or water-cooling towers. If the germs become airborne, anyone within the building can become infected. Claims are typically made by individuals who develop flu like symptoms or pneumonia working in a hospital, nursing homes, grocery stores, or office buildings.  You might also get it as a traveling employee staying in a hotel.

A serious illness such as Legionnaires’ Disease can prevent you from returning to work, and without pay, you may struggle to support yourself and your family. If your illness has a direct link between the work environment and the disease it’s important to have an attorney in your corner that not only understands Illinois work comp laws, but also understands this illness. It can literally be the difference between winning and losing your case.

If you’d like a free consultation with an attorney, fill out our contact form or call us at 312-346-5578.  We help with work injury cases everywhere in Illinois.

A Contender For The Biggest Lie Of 2019

I’ve written a lot about Illinois work comp lies. I haven’t done it in a while because I haven’t heard a new one.  Most are the same ones over and over.  Stuff like: lying what the case is worth; saying that these cases always take years; telling you that you will get nothing at trial.

I hear those lies and others all the time.  The one that left my jaw on the floor was a new one, from a big Chicago workers’ compensation firm.

The client has a major back injury and needs pain management treatment that her doctor has ordered.  It’s been delayed for months and the client is dealing with a lot of pain that she shouldn’t be going through.

She went through weeks of not having her calls returned.  Finally the lawyer called back and told her a whopper. She said that the insurance company has spent all of the money they are required to by law on her case. If she wanted more medical treatment she’d have to get it on her own.

Wow!

There is no cap on benefits for medical care in Illinois.  In the most serious of cases, it could cost millions.  You are entitled to whatever is reasonable and necessary.

This caller was savvy enough to know that this is a lie. A ridiculous lie at that.  It’s really sad and pathetic though.  Your job as an attorney is to look out for your client.  Sometimes you don’t file a trial motion because you need more evidence. Other times it’s because you think you will lose or are waiting on a deposition.  But to blow off your client with a terrible lie, especially when they are in so much pain, is disgusting.

The caller believed that this attorney is just overwhelmed with cases and I believe that’s likely true. Some bigger firms limit their lawyers to save money and it ends up hurting the clients, especially when they take every case that walks through the door.  When that happens, the more difficult cases which will take some time or effort often get pushed to the side.

It’s a solvable problem by switching attorneys, but it never should have gone this far.  In the meantime she’s suffered for months without medical treatment that she needs.  Medical care that can really help her.

As with all lawyer lies, you can’t be expected to know that you hired a scum bag.  However, if you suspect something is off, we strongly recommend you ask around with a different law firm.  It could be that something is true and you just didn’t know that’s how Illinois work comp law works.  Or in this case, it could be that the attorney is making stuff up even though you are suffering as a result.

You are always welcome to reach out to us for free to discuss anything that concerns you.

Kelechi Osemele Wouldn’t Have This Problem If He Was On The Bears

Ok, I’ll be honest. I never heard of Kelechi Osemele  until the other day.  It was when I saw this article about how he plays for the New York Jets and needs shoulder surgery, but the team doesn’t want him to have it.

Apparently he had a shoulder injury before the season started.  He was able to play with the torn labrum when the season started, but being a human battering ram for 70 plays a game has caused the injury to get worse.  Osemele wants to have surgery based on his orthopedic doctor’s recommendation.  Per the article, his position is that he aggravated the pre-existing condition in August and then again in their third game.

The Jets say he can play through the pain.  Unfortunately for them, the second and third opinion doctor say different.

Now the NFL does have a collective bargaining agreement with their players, but it doesn’t trump state law.  So if Osemele played for the Bears, you’d likely only hear that he had shoulder surgery and was placed on injured reserve.

That’s because under Illinois workers’ compensation law, the employer can’t dictate your medical care.  If you can prove your job aggravated a pre-existing condition (pretty easy in this case) and that your doctor thinks you need surgery from that, if you want it, you get to have it.

A lot of this reeks of the NFL shadiness when they tried to get players to shake off concussions.  They don’t care about the health of their workers and will abuse them when they can.

For Bears players though, they have the same protections as any other Illinois worker.  You could be a very important plumber on a construction job. If you tear your labrum and need surgery, your employer can’t tell you to wait until the job is finished.  Illinois work comp laws look out for your health.

Because they are entertainers, it’s weird to think of athletes as employees. This is no different than if an actor on Hamilton tore his ACL and needed off the production to have surgery.  Even if the show wouldn’t go on without them, they can choose to take care of their bodies above all else.

Hopefully the nonsense with this player goes away, he gets better and is able to return to a productive career.  Bottom line though is that Illinois has great laws that protect you if you are hurt on the job. You are allowed to think about your long term health and get the treatment your doctor thinks you need.

Eight Ways To Make Sure You Get Illinois Work Comp Benefits

An open secret about Illinois workers’ compensation law is that insurance companies will deny any case they can.  Sometimes they have good reason, other times they just do it in bad faith. Nothing can guarantee that they won’t dispute your claim, but there are some things you can do to limit the possible defenses they may have.

1. Report the injury to the employer ASAP. That doesn’t mean that every time you are sore on the job that you have to tell your boss.  But if you feel a pop in your back while lifting, tell someone.  If you slip on a wet floor, let them know. While the law gives you up to 45 days to report an accident, the longer you wait, the more likely that some pencil pusher will flag your claim.

2. Get medical treatment right away. If you hurt yourself on January 1st, but don’t see a doctor for the problem for two weeks, it might make someone question if you really got hurt another way.  If you don’t see a doctor for three months, it will definitely raise some eyebrows.  If you are legitimately hurt, get medical attention sooner rather than later.

3. Make sure the doctor knows how you got hurt.  If you slipped on a wet floor at work and twisted your knee, but the doctor’s report says you don’t know how you were injured or were hurt at home, you may lose your case and the insurance company will for sure fight it. It’s your job to tell them how the accident happened and make sure it’s documented.

4. Don’t lie. Sounds simple enough, right? The reality is that some employers will encourage you to say you weren’t hurt at work. Other times injured workers will embellish their injuries. We represent honest people and those that lie put their cases at risk.  Just tell the truth, don’t try to create some perfect story.

5. Don’t give a recorded statement. The insurance adjuster will likely ask for one. It’s usually meant to try to trip you in to saying something that can hurt your case.  You aren’t required to do this and shouldn’t.

6. Listen to your doctor.  If you are given a 20 pound lifting restriction, don’t offer to help a neighbor move.  If physical therapy is ordered, make sure you go.

7. Don’t let a nurse case manager interfere with your treatment. This is a person assigned by the insurance company who will try to talk directly to your doctor.  That is against the law unless you give them permission. They aren’t doing it to help you.  They are doing it to try and limit or eliminate your benefits.  You should not consent to that happening.

8. Make sure to get copies off work slips. Your doctor shouldn’t verbally say you can’t work, they need to put it in writing.  If they don’t, you won’t receive TTD benefits.  And it is your job to provide the insurance company with a copy of that note (or if you have a lawyer, to give it to them).

These are simple tips that cost no money and will protect you.  They don’t guarantee anything, but will certainly increase your chances of success.  As always, if you have any questions, please don’t hesitate to reach out to us. You can always speak with a lawyer for free.

Do You Need To Go To A Second IME?

A reader of the blog had a very interesting situation.  He had been hurt at work and right after he was injured, the insurance company sent him for an IME.  That hired gun doctor said he was fine and could go back to work.

Fortunately this injured worker was smart enough to seek out his own doctor.  That physician had a MRI ordered which showed a major injury.  As a result, the work comp case was accepted and they paid for his medical care.

Fast forward 10 months later and the worker is still getting medical care.  Now the insurance company wants to send him for another IME.  The question he had is does he have to go?

While insurance companies can’t just doctor shop until they get the opinion they want, they are allowed to ask for IME updates.  In a case like this, we would advise him to go to the exam, but before that happens we’d reach out to the insurance company or their lawyer to set up parameters.

The new exam should be limited to treatment from when this guy was last seen for the IME up until now.  He can address the MRI, the current treatment plan and the workers’ physical condition.

On the flip side, we’ve seen in the past where insurance companies don’t like what their report says or they are trying to manipulate your medical care, so they send you to another IME within a couple of months of the first one.  This usually shouldn’t happen. The exception would be if it’s a follow up after something like an EMG. But usually they can just review the records and shouldn’t need to see you.

I do think the insurance company in this case is wasting their money.  Their IME doctor has lost his credibility by saying that the worker was fine.  The MRI proved that he was very wrong. Any determination now that the worker is fine will be met by an Arbitrator with skepticism.

So most likely this is nothing to worry about.  I do though like that this reader is looking out for himself. You should never just roll over and do what the insurance company wants without asking questions first.  They will push you around if you let them, so don’t let them.

What To Know Before You Settle Your Work Comp Case In Illinois

This is the third in a three part series of advice for injured workers.  The first post discussed what you need to know immediately after you are hurt on the job in Illinois.  The second post offered a bunch of warnings and tips for how to handle the middle of a case. This last post is advice on what to think about just before settling a case or going to trial. If you have any questions about Illinois workers’ compensation law and want to talk to an attorney for free, contact us at any time. We cover all of Illinois with our state wide network.

As you get toward the end of an Illinois workers’ compensation case, hopefully you are doing better physically and can start thinking about settlement.  If that’s the case, we highly recommend that you return to work without issue for at least two months.  You don’t want to settle and then find yourself needing more medical care.  You should also, once discharged from care, call EVERY medical provider you’ve had on the case to make sure that there are no unpaid bills.  It’s all about preparing for the best settlement possible.

If you aren’t 100% better, meaning that you have permanent restrictions or a need for future medical treatment there is other advice you need.

First, if at all possible, don’t quit your job.  If you do it could greatly reduce the value of your case. If you are thinking about quitting or have a job offer somewhere else, do not do anything without sitting down with a lawyer and making sure it won’t cost you tens or hundreds of thousands.

In some cases you will have permanent restrictions that your employer can not accommodate. Once your doctor says you are as good as you are going to get, it’s up to you to begin a job search to show what types of jobs you can get.  That doesn’t mean you have to take those jobs, but you must do a job search.  As part of that, you should keep a detailed job log of the jobs you applied for, how you contacted them, the pay and the response you got. On average you should be looking to apply to 15-20 jobs a week.

If you need or want help in your job search, you can get the insurance company to pay for a vocational rehabilitation counselor.  They can help you prepare a resume, conduct a job search, give you testing to determine what jobs you are capable of and in some cases make recommendations as to what re-training you can get to help your job prospects.  Just like with your doctor, you can and should choose this person.  Your lawyer should tell you who to go with.  You want someone who is working for your best interests, not that of the insurance company.  It’s possible that they will determine based on your age, injury and job experience that there is no stable job market for you. But if you don’t go through the process you will never get to that point.

It’s also very important to talk to your doctor about any future medical care that you may need.  For example, if you had a surgery where hardware was put in your body, it’s likely it will need to be replaced at some point.  You can get compensated for those anticipated costs at the time of a settlement through a Medicare Set Aside.  It’s very important that you do this.  This is money that should go in to your bank account and that the lawyer shouldn’t touch.

In some cases you need to think about not settling.  If you’re going to have a lot of future medical care or the offer isn’t fair or if they owe you a bunch of money, going to trial is possibly the better route.  If you win it keeps your medical rights open for life, you might keep weekly benefits and/or you will still get money that is equivalent or more to what you could have settled for.

If your injury is serious enough that you had a surgery or more than six months of treatment, you’d be foolish to not have a lawyer. While this may sound like a lawyer angling for clients, I promise it’s not. The honest truth is that even with a 20% lawyer fee, you’ll end up with more in your pocket with an attorney than without one.  And in really serious cases, the end result can be a difference of tens, if not hundreds, of thousands of dollars.

As always, if there’s anything you are unsure about, get in touch. We will always talk to you for free and give straight forward, honest advice.

Illinois Workers Comp Law, What To Know During A Case

The other day we offered tips on what you need to know right away if you are injured on the job in Illinois.  Today I’m writing about the most important things to know in the middle of a case.  In a few days, I’ll write about what you need to know as settlement gets closer.  As always, if you want to talk to an attorney for free, call us at 312-346-5578 or fill out the contact form and we’ll call you.  We help with work injuries everywhere in Illinois.

This post assumes you have had an injury that requires six months or more of medical care.  These are tips that I think everyone should know. They will give you the best chance of success on your case.

If your injury is serious, you can expect that the insurance company will send a private investigator to tail you at some point. Surveillance is legal under Illinois work comp law. They are looking for signs that you are faking or exaggerating your injury.  You can’t stop them from following you.  The good news is that it’s expensive and if they don’t catch anything in a few days, they will likely stop. If you are being honest with your doctors and in your daily acts of living, you have nothing to worry about.

You can also expect in a serious injury case that a nurse case manager will be assigned to you.  This is a insurance company representative and they are often the most sneaky people around. The worst ones will try to schedule your doctor appointments around their schedule or talk to your doctor directly to try and manipulate your medical care.  They don’t have a right to do any of this, but will unless you stop them.  Typically one of the first things an attorney will do is put them in their place. They can ask for copies of medical records and bills and that’s it.  If they go to far they will often badger physicians in to having you do things that risk your health just so the insurance company can save a few bucks.

It’s really important that you listen to your doctor. If he/she says no lifting over 25 pounds, you can’t go and use the bench press at the gym just because you are feeling good that day. The goal is for you to be better. If you are going to try increased activity, ask for permission first. Also make sure you are communicating with your doctor.  If you have problems, tell them.  If they say you can’t work, make sure you get an off work slip from them.

You can expect that you will be sent to an independent medical exam or IME at some point.  This is a hired gun doctor chosen by the insurance company.  They aren’t there to treat you.  Their job is to determine if you were hurt at work, what your condition, what future medical care you need and if your medical care is from the job injury.  They tend to make money by favoring the insurance company. You don’t want to go in to one of these exams without talking to a lawyer first.  In general though, be friendly, honest and don’t exaggerate. There is a good chance the exam will last less than five minutes and they will find against you.  That’s part of the work comp process in Illinois and if you have a lawyer you can go to Arbitration to make sure your benefits aren’t denied.

If at any point you are unhappy with your doctor, you do have a right to a second opinion.  That said, there are laws that limit you from just hopping from doctor to doctor. Our best advice is that even if you are going to see a new orthopedic doctor, get a referral. Assuming that your family physician referred you to the first orthopedic, you can ask them for a referral to a different facility.  Doing so increases the chances that the bills will be paid.

If you have a lawyer, it’s really important that you keep them in the loop.  It can be as simple as emailing them after an exam to tell them what the doctor said and to provide them a copy of your off work slip.  If we don’t hear from clients we assume they are fine. If your TTD check is late or you are getting bills in the mail, if you don’t tell us, we won’t know about it.

I will talk about settlement in the next post, but in the middle of a case know that the #1 thing is your health and getting treatment for your injury.  No attorney can tell you the real value of your case until they know what your ultimate recovery will be.

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