IL Work Comp, Getting Approval For A Spinal Cord Stimulator

By Mike Helfand on Posted in Benefits

This is a post that thankfully won’t be relevant to most people who read my blog. That’s because it’s going to discuss a major back injury and treatment for people who can’t get better through physical therapy, epidural injections or surgery. I’m talking about a spinal cord stimulator.

A spinal cord stimulator is like a pacemaker for your back. It gets surgically implanted in to your body and sends low levels of electricity to your spinal cord in order to decrease pain. It’s an often last resort pain management measure for very seriously injured people. The doctors who place these devices in your body typically have very high level training in interventional pain management. The procedure typically takes around two hours.

It’s a pretty effective procedure, but it does come with a lot of risks including infections, a punctured spinal cord, the device migrating and bleeding. It also is common for it to need maintenance or need to be replaced.

As you can imagine, this procedure is not cheap, so many Illinois workers’ compensation insurance companies try to avoid paying for it.  There is a recent case brought by a Walmart employee that shows how to win approval.

In that case, the worker actually injured her foot when a pallet fell on it and developed complex regional pain syndrome (CRPS). She wasn’t getting any better so she began treatment with a pain management doctor and a physiatrist who specialized in interventional pain management. The key point here is that she tried normal treatment, it didn’t work and she then sought out higher level specialists.

Both of those doctors recommended a spinal cord stimulator due to her chronic pain. One of the doctors noted how young she was which made that option better than narcotics. Despite two very experienced and specialized doctors having the same opinion, Walmart denied her approval for this treatment.

The good news is that the Illinois Workers’ Compensation saw through this denial that made no sense and awarded placement of the spinal cord stimulator which will hopefully greatly improve her life. It’s of course ridiculous that they didn’t do what they could in order to make her life better sooner instead of later.

In sum, you have to start with conservative care in most cases (physical therapy) and then gradually increase the type of care that you’re getting when you don’t get better. And you need to get with experienced, reputable physicians. In almost any case when that happens we will be able to win benefits at trial if not sooner.

DWP, Medical Only Claims, And Other Illinois Work Comp Questions

By Mike Helfand on Posted in Tips if Injured

We are experienced Illinois work comp attorneys who will talk to you for free. Please call us any time at 312-346-5578. We help with accidents and injuries everywhere in Illinois.

We get so many great questions that every couple of months I like to do a blog post about them. Here are some of the best ones we got this fall.

What does DWP mean in Illinois workers’ compensation?

It means dismissed for want of prosecution. That’s a fancy way of saying that your case was up on the status call at the Illinois Workers’ Compensation Commission and your lawyer didn’t show up. If the case was filed more than three years ago it will be “DWP’d” and you’ll have 60 days from notice of the dismissal to have it reinstated. Twice this year we’ve had calls from injured workers whose lawyers didn’t show up and also didn’t get the case reinstated. When that happens your only option is to sue your attorney.

My lawyer said the IME doctor is a classic Dr. No. What does that mean? My attorney doesn’t like to answer questions so I don’t want to bother him as he always makes me feel stupid.

First off, it’s a huge problem if your lawyer doesn’t like to answer questions and makes you feel stupid. That’s a sign you have a terrible lawyer and should fire them. That said, a “Dr. No” means that the doctor the insurance company is sending you to is essentially a hired gun and will say whatever they want him/her to say. It’s also a bad sign, but one that an attorney who will fight for you can deal with.

I’m a teacher and was told that we have to use 14 sick days before we get paid wc. Is that true?

Not only is it not true, it’s a terrible lie that someone told this teacher. The Illinois work comp laws apply the same to everyone. There is no waiting period at all.

What is a medical only claim?

We see that a lot when insurance companies say the case is closed when it’s really not. Basically it’s their way of saying they will pay your medical bills and nothing else. Of course nothing in the law says they can do this. They are just trying to get away without paying you a settlement or in some cases without paying you your time off of work. It’s blatant breaking of the law, but just a common trick they use to try and save money. The bad news is that it sometimes works because unsuspecting workers don’t find out what the law actually is. The good news is that we can turn this around usually as soon as we formally file the case.

I was injured on the job while working as a semi driver. I broke my neck and it pressed on spinal cord causing right side weakness. I have Bad PTSD flashbacks anytime I’m on the interstate just as a passenger. Can my employer force me to go back to driving even with the PTSD diagnosis?

Nobody can make you return to a job. As far as being able to refuse work and still get paid, this driver could if he has a doctor in his corner that takes him off of work or gives him restrictions of no driving. If so they’d either have to pay him while off work or find work for him within his restrictions. This is true in any case. As long as you have a credible doctor in your corner and a legitimate injury, you should be able to receive work comp benefits.

If you on workers com for almost 2 years, should they raise your weekly benefit every 6 months?

Unfortunately that doesn’t happen. Your pay rate is based on your wages at the date of accident. If you are found to be permanently disabled, you will be entitled to a cost of living increase.

 

As always, if you have any questions about anything related to Illinois work comp law, please contact us any time.

Work Comp When You Die From A Drug Overdose

By Mike Helfand on Posted in Do I Have a Case?

A very nice guy called me the other day with a sad situation. His cousin had been injured on the job and was receiving workers’ compensation benefits for a back and neck injury. As you might expect, part of his treatment not only included physical therapy, but also pain medication. Prior to the work injury his cousin never took prescription drugs, but did drink regularly and smoke marijuana occasionally.

Long story short is that he died of an opioid related drug overdose. They were told by a lawyer that they didn’t have a case because the death was drug related.  As a famous football commentator says, “Not so fast my friends.”

If he had overdosed on heroin or fentanyl that he had bought on the street, it would be hard (although not impossible) to argue that his death was work related. That type of death would indicate he likely died from simple recreational drug use.

In this case it seems he died due to taking drugs that were legally prescribed for him due to a work related back and neck injury. He had severe shooting pains down his arms and legs which are big signs of a herniated disc. The insurance company was balking at paying for a MRI so the caller believes his cousin increased his drug usage and that led to the fatal overdose.

Since he was taking the medication for the work injury, it’s part of the work comp case. It’s no different than if you were to have back surgery and die on the operating table. If your medical treatment leads to a further injury then that becomes part of your case. He leaves behind a wife and child who are entitled to compensation for burial expenses and up to $500,000.00 for the death.

I believe that would be the right result even if he didn’t take the medication as prescribed. He did so because his treatment was getting delayed and he was in severe pain. It’s reasonable and foreseeable that something like that would happen. Quite honestly I think a good argument could be made that even if he was taking heroin for his pain and died it would be a part of the work comp case.

This is where having a trial attorney really makes a difference. The lawyers we work with on cases regularly try cases and aren’t afraid of a challenge. This case isn’t a slam dunk, but it’s one that should result in benefits being paid to his survivors. It’s not much different than the cases where an insurance company has been ordered to pay for drug counseling due to addiction caused by drugs from the work accident.

Illinois Work Injuries When You Fall Entering The Building

By Mike Helfand on Posted in Do I Have a Case?

A common myth about Illinois workers’ compensation law is that you have to be “on the clock” or otherwise punched in to bring a case for an injury. That’s simply not true. If you are doing a reasonable activity that you’d be expected to do and have an accident, that can be a compensable workers’ compensation case. This reality is shown when workers have falls entering a building either before a shift or after a break. Two recent Illinois Workers’ Compensation Commission decisions show what I’m talking about.

In the first case, a nurse at a state mental health facility worked an overnight shift. She was told to start at 9:00 p.m. The main door locked at 8:00 p.m. so she had to use a side entrance.  It had snowed that evening. While walking in, she slipped on a tile floor because her shoes were wet from the snow. This caused injuries to her wrist, ankle and knee. Of note was the fact that the parking lot had not been plowed. All of these factors increased her risk of having an injury. She entered through a door not accessible to the general public. She wasn’t on the clock, but once she got to their building she was doing things to benefit the employer. That’s what you need to win a case.

In the second case, a Joliet custodian was taking one of his two allotted 15 minute breaks when he fell on ice while walking on a ramp back in to the building.  He injured his hip, back and had some teeth knocked out. The insurance company fought the case saying that the custodian shouldn’t have taken the ramp back in to the building. That sounds ridiculous and it is, but they did force the case to arbitration. Fortunately common sense prevailed and the Arbitrator awarded benefits. That was because it was common for employees to use the ramp and it wasn’t dangerous or reckless to use it. And because it was common for workers to access the ramp, it was found that the employer was ok with it. In other words, if this was a rule violation he might have been in trouble. The fact that he was coming off a break was a non factor because he was still on their property.

The bottom line is that while we see fights on cases for falls while entering a work building, more often than not the defenses to these cases are bogus and fail at trial. Don’t be discouraged or bothered if an insurance company is making your case more difficult than it should be. These are solvable problems and we are happy to help you solve them. Contact us any time to speak with a lawyer for free.

Social Media And Illinois Workers’ Compensation

By Mike Helfand on Posted in Tips if Injured

When you are a teenager, you think, “When I’m older, I’ll understand teens and get what they are doing.” Sadly that is not the case, and I’ve been told by my own kids that I don’t understand. That’s OK, it’s part of being older and a parent.

One thing I certainly don’t get is the obsession with social media. I have a Twitter account to check news and follow some comedians and soccer commentators, but I never post. I don’t use Instagram, Facebook, TikTok, etc. I don’t begrudge those who do, but don’t get the obsession of always posting or when I see kids staging so many photos of their “happy” lives. I’ve never told my kids not to post, just to be smart about what they are posting.

Clients aren’t my kids, but I’m tougher on them than I would be my own children. My strongest advice is that if you have an active Illinois workers compensation claim, you should never post and also make sure that all of your accounts are private.

One of the first things an insurance company or defense attorney will do is check and monitor your social media. If you are discussing your case in any way, you are potentially creating evidence that can be used against you. You might want to take a picture of yourself at the hospital and post it on Facebook for all your friends to see, but that would be a terrible idea. Even if you put something simple like “Ankle surgery after getting hit by a forklift on the job” that could come back to bite you. I say that because you never know if a friend will write something in the comments like, “Didn’t you hurt your ankle a month ago too?” They might not mean anything bad, but that simple comment would cause your benefits to get denied.

Even when you think that you aren’t posting something about your case, posting is a bad idea. If you have carpal tunnel or a neck or arm injury, you should be limiting your use of your hands in many cases.  Posting a lot opens you up to questions on cross examination at trial and could also be used against you in a deposition of a doctor about your injury.

The other thing to beware of is friends who tag you in photos. Ask them to remove those if it happens. We’ve seen cases where insurance companies have cut off benefits because they felt that with a significant injury the worker shouldn’t be engaged in social activities. That might not be a winning argument at trial, but if it causes them to delay your care or pay then it will hurt you.

A final reason not to post is you never know if you have an enemy or jealous person in your life. There have been cases where people don’t understand the law and think if you are claiming an injury that you are pulling some sort of scam. Don’t give these losers ammunition to try and torpedo your life. You don’t need some “friend” from high school to know that 30 years later you have a back injury.

The bottom line is that you don’t want to ever mention your work comp case to anyone and certainly not online where it will remain forever. I’m sure that can be tough if you are used to posting all the time, but I promise you that there is no other smart lawyer who would tell you something different. It’s truly in your best interests to keep a low profile.

Proving A Repetitive Trauma Shoulder Injury In Illinois

By Mike Helfand on Posted in Injuries

Do you have a shoulder injury that you think is work related? We are experienced Illinois work comp attorneys who will talk to you for free and in plain English. If you’d like a no commitment, confidential and free consultation, please call us any time at 888-705-1766.  We help with cases everywhere in Illinois.

There are two major ways injuries happen on the job in Illinois. The first is a one time accident. Those cases can be hard to dispute because if you are walking down a hallway and get hit by a forklift and break your tibia, making a defense to that case can be a challenge. That’s not to say the insurance company won’t try. They’ll drug test you. They’ll try to get old medical records. They’ll question if you really should have been there.

The second major way workers get hurt is through repetitive activities. There’s no one time event that causes an injury, but instead the continuous use of a body part and common activities cause your body to break down. Maybe you type a lot and get carpal tunnel. Maybe you lift a lot and hurt your back. Whatever the reason, it’s very common for insurance companies to fight these cases or make you jump through hoops to get benefits. That’s because there are often other reasons your problem could have developed such as age, other activities, illness, etc.

One common repetitive trauma injury is to the shoulder.  The shoulder is susceptible to over use problems, especially when you are doing a lot of lifting or overhead activity.  To prove your case is work related you need facts. That would mean providing clear, detailed information about what you do, how you move your arms, how frequent you do the activity and what pain you notice while doing this.  A recent case highlights how to win a claim for a repetitive injury to the shoulder.

In that case, the worker was a forklift driver.  She did the same job for five years and at trial and to her doctor gave very detailed testimony of what she did. She said the truck she used required her to make 300 to 500 rotations of the steering wheel daily. She described a quick turn knob she used and at the hearing demonstrated how she did the job. She was clear to show how she used her right arm and how she placed her left arm.  She talked about the great effort involved in turning the steering wheel with her left arm.  She talked about how the job got busier right before she got diagnosed.  Eventually she was diagnosed with shoulder impingement, degenerative arthritis and a biceps injury.

Do you see any possible defenses to her case? Neither do I. While the opinion of a credible medical doctor is still required to win a case like this, she made crystal clear how the job contributed to her problem. To top it off, she mentioned at trial how she made an effort to work through the pain with hopes it would go away, but then sought medical care when it didn’t.

Given all of this she thankfully won her case. There was no defense, but like I said, you have to jump through hoops if your case is repetitive.

The bottom line is that you need an attorney who can make sure your testimony is detailed and your doctor is truly informed about your job duties. Almost every repetitive injury case needs at least the threat of a trial to prevail. If you’d like to discuss a case, please contact us any time.

Age Is A Big Factor In Illinois Workers Compensation Settlements

By Mike Helfand on Posted in Benefits

By far the most common question we get about Illinois work comp law is, “What is my case worth?” Quite often that’s from people who are at the beginning of their case which means there’s no way to reasonably answer that. If they are close to getting done with their medical care, we can often provide a settlement range.

Some people will say something like, “I hurt my back and had two epidural injections. What is my case worth?” That’s not enough information to answer them. We need to know what other care they’ve had, what their wages were, are there any defenses to the case, is future medical care needed, did they have prior similar health problems, are they back to work and last, but not least, what is their age?

Age can be a really big factor in determining the value of a case.  The younger you are, the more likely you will feel the effects of your injury for a very long time. This is especially true for back and neck injuries or cases where you have surgery. Whether it’s arthritis, on going pain or the frustration of most of your life having to deal with this problem, the younger you are, the more likely it is that the case will be worth more money.

Age is also very important when a young worker can no longer do the job that they are used to doing. Years ago I represented a man in his 20’s who had a heavy duty construction job and hurt his foot.  He had permanent restrictions that prevented him from working on uneven surfaces.  Because of that, his case ended up settling for over $300,000.00 due to his wage loss.  Wage differential benefits are only paid until age 65, but if you’ve got 40 years of work life left then your case could have huge value even though you can still work other jobs.

And age is also important when it comes to workers who are permanently disabled from working again. All things being equal, someone who is permanently disabled at age 35 will have a much more valuable case than someone that happens to at age 55.  That’s because these are lifetime benefits. Any settlement is based on your life expectancy.

Finally, age is really relevant when it comes to future medical care.  A 70 year old may not recover as well so they might be more likely to need additional treatment. But given their lower life expectancy, the payment for that could still be limited. A younger person will usually bounce back quicker. But if they have a fusion or hardware in their body that needs to be replaced every ten years, that will make their case worth much more than the 70 year old.

The bottom line is that you want to consider all factors in making a settlement, including the age of the worker. If you have any questions about this or want to talk with an experienced lawyer for free, please contact us at any time.

Proving Your Knee Replacement Surgery Is An Illinois Work Comp Case

By Mike Helfand on Posted in Uncategorized

We are experienced Illinois work injury lawyers who will talk to you for free about your case. You can fill out our contact form or call us at 312-346-5578 to speak to an attorney right away. We cover all of Illinois.

I remember the first time a friend of mine had a knee replacement. He was in his early 50’s, a pretty fit and active guy and loved to play basketball. But years of activity and wear and tear caused him knee pain and he went under the knife. He’s doing great now although his basketball days are over.  What his experience shows is that it’s not uncommon for bodies to break down as we get older.

Because knees, backs, shoulders, etc. can have problems as you age, it’s not uncommon for a work comp insurance company to fight a surgery claim in older workers. They can usually find some hack doctor to write a report that states your problems are due to age and not your job.  Usually though these doctors don’t address what your job has been and how it affected you.

In other words, if you are a carpenter, plumber, laborer, etc and for years have been doing heavy duty work with a lot of lifting, squatting, bending, etc. it would make sense that those job activities would cause a lot of wear and tear on your knees. So if your end up needing a knee replacement surgery, it would make sense that it would be part of a workers compensation case.

And that’s what you need to do to prove under Illinois law that your need for a knee replacement is a work comp case. You have to show your job caused, aggravated or accelerated your problems. If so then your surgery and all other medical care should be paid for, you should be paid for your time off work and you should get a pretty significant settlement.

You can also prove it’s work related if you had a prior knee surgery that was work related and you didn’t make a recovery. In a recent case at the Illinois Workers’ Compensation Commission, a therapy aide hurt his knee breaking up a fight and had a knee scope. He didn’t get better and ended up with a total knee replacement. There was a clear chain of events from a work injury to the first surgery and then the need for the second surgery. This was a guy who had no physical problems before his work accident. The patella surgery he had caused severe inflammation.

The bottom line is that insurance companies will do whatever they can to deny benefits you are rightfully entitled to. This is very common with major injuries and procedures because if they win, they save hundreds of thousands of dollars. Don’t get discouraged or think you don’t have a case just because they deny your case. That’s not the end of the road of your case and if the facts show that your job contributed to your problem, you likely will still win benefits.

 

Sexual Assault On The Job In Illinois

By Mike Helfand on Posted in Injuries

Have you been sexually assaulted while working? We can help and will treat you with dignity and respect. Call us at 312-346-5578 to speak with an experienced lawyer for free and in confidence.

A recent caller had a horrific experience while working. Her boss came up and cupped her breasts from behind and started kissing her neck. They had no prior relationship other than that of co-workers and she said this was “out of the blue” and unexpected. She pushed him off, but of course does not feel comfortable working there anymore. She asked HR about seeing a doctor for this and they told her that this wasn’t a work comp case. To their credit, they did fire the scumbag who did this to her.

My first piece of advice was to recommend that she call the police. Second we discussed how she’s feeling. Even though this jerk is gone, she feels anxiety being at work because it happened out of the blue. She saw a community therapist once, but nobody since then as she doesn’t have health insurance.

It becomes kind of a catch 22 because she needs to get medical care to prove an injury, but it’s hard to get that care without the case being approved. Usually if we can get just one visit to provide a diagnosis and an off work slip (if needed which it was in this case) that is enough to prevail.

There was a recent case similar to this one when a juvenile facility guard was sexually assaulted on the job by a co-worker. She was able to win her case for two reasons:

1. The attack occurred during work hours in a place where the guard would be expected to be.

2. The attack was related to her job as it was an interaction with her supervisor.

I find that most sexual assaults while working happen in a similar fashion to these two cases.  That said, every case is different.  Sometimes they happen at or after work functions. Sometimes they happen when traveling for work. Quite often we can tie what happened to your job, but speaking with you allows us to make that determination.

We can’t promise a result, but do guarantee a few things:

1. The call will be confidential. We won’t discuss this with your employer or anyone else without your permission.

2. We will be respectful.

3. We will be honest in our advice and do whatever we can to help you.

4. There will never be a fee to talk to us.

We have been involved in hundreds of these cases over the years and have been able to point most people in the right direction in helping secure benefits through an attorney. If you want to discuss your case, please reach out to us any time.

IL Work Comp – Mental Injuries After You Are Attacked While Working

By Mike Helfand on Posted in Injuries

Do you have PTSD that is related to your job? We are experienced Illinois workers’ compensation attorneys. Since 2001 we’ve helped tens of thousands of injured workers who are looking for representation or just need questions answered. If you’d like to speak with a lawyer for free, fill out our contact form or call us at 312-346-5578. We help everywhere in Illinois.

While Illinois work injury laws are mostly common sense and usually employee favorable, that’s not always the case. You’d think if you were just minding your own business on the job and got physically attacked and injured that would be enough to make a successful claim. It’s close, but you still have one hurdle to clear.

Under Illinois law, when you are attacked on the job, you have to show one of two things. First you can prove that the attack was related to your employment in some way. So if you and a co-worker were arguing about a job assignment and they punched you, that would be related to your job. If a customer tried to rob your store, that would be related to your job. But if you get punched in the face for hitting on someone’s girlfriend, that wouldn’t be related to your job.

The second way you can prove a case is if the environment of your job increases your risk of attack. In a recent case, a CTA bus driver had to clean a bus on the overnight shift.  He was attacked by an unknown man who entered the garage through an open door. The Arbitrator ruled that the overnight shift and public access to the garage increased the risk of the environment causing an injury.

As a result he was awarded compensation for acute stress disorder, post traumatic stress disorder (PTSD) and depression.  It’s not easy to win a mental injury under Illinois Workers’ Compensation Act, but when it’s the result of a one time, physical attack while working, we find that the workers who contact us usually prevail.

The key point is to know what the two standards are to win and remembering that you don’t have to prove both of them, just one of them. Whether or not your environment increases the risk of an attack is subjective, so getting as many details about where you work, what time the attack was, who had access to your work area, etc. is very important. It’s also important that you get medical care. You can’t just say you are stressed, you have to prove an actual injury through a diagnosis by a psychologist or psychiatrist.

Bonus tip. Getting mental health care in the U.S. can be expensive. But if it’s from a work injury, 100% of your care should be covered by work comp.

If you have any questions or want to speak with a lawyer, please contact us any time. All calls are free and confidential.

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