Medical Marijuana And Illinois Workers’ Compensation Law

By Mike Helfand on Posted in Benefits

Since 2013, it’s been legal for doctors in Illinois to prescribe “medical marijuana” to their patients. For whatever reason, it hasn’t been an issue that comes up a ton in workers’ compensation cases. The more common concern is having a case denied because you test positive for marijuana after an accident.

The reality though is that marijuana has many medicinal benefits including helping people who are coping with chronic pain, nerve damage, PTSD, and other health issues.  And while insurance companies may not like it, if your treating doctor prescribes it for you, they have to pay for it and can’t cut off your benefits for using it.

The biggest potential concern in these cases is that you will be impaired due to your marijuana usage and potentially injure someone else or yourself if you return to work or get behind the wheel of a car.  To me though, these worries are not legitimate as many of the over-the-counter medications can make users impaired and put themselves and others at risk potentially. Just because it’s marijuana which used to be illegal doesn’t make it any more dangerous. In reality, it’s probably less dangerous.

Part of the problem is that too many people have been conditioned to think of drugs that can be recreational as all bad.  Some certainly are and I wouldn’t anticipate medical cocaine or heroin any time soon. But marijuana has scientifically proven benefits that have helped millions of people.

The other issue is that some insurance adjusters in Illinois work comp cases like to think they are doctors. To some of them, there is no reason that you should get this benefit so they want to fight you on it without good cause. Never mind that marijuana is less addictive than opioids and often cheaper. In other words, it’s in their best interests for you to have access to medical marijuana.

This is just one of many atypical medical benefits that are available to workers under the Illinois Workers’ Compensation Act. Your doctor can prescribe many things if they think they will help you that some might find odd. This list includes gym memberships, therapeutic pillows, cars, house modifications, and many other things. If it’s reasonable and medically necessary then the insurance company should have to pay for it.

So if this is something that you think could benefit you, talk to your doctor about it. While most people could get recreational marijuana on their own, getting a prescription from your doctor will make it so you don’t have to pay for this medicine out of your pocket.  And as always, if you have questions or concerns, you can contact us to speak with a lawyer for free about it.

Not The Time To Settle Your Illinois Workers’ Compensation Case

By Mike Helfand on Posted in Benefits, Tips if Injured

We were contacted by a tradesman who badly injured his back about a year ago. He had a microdiscectomy, which is a back surgery, and while it is serious, it’s the most common back surgery that orthopedic doctors perform.  The surgery involves removing part of a herniated disc that is pressing down on the nerves in your spine.  It’s usually successful, but of course not 100% of the time.

Unfortunately for this injured worker, who works a very heavy-duty job, the surgery didn’t solve his problem.  So now his surgeon is recommending lumbar fusion surgery which is a much more serious surgery that not only has a longer recovery period (usually six months or more), but it’s expensive and often requires an additional surgery down the line.  We’ve seen it help a lot of clients, but it’s definitely a long process.

When you are in this situation you should be focused on nothing but your health. If your injury is work-related, 100% of the bills for this surgery and the extensive follow-up care you’ll need (often patients have to go to a rehab facility for a couple of weeks) will be covered by work comp.  Also, you should be paid for all of your time off work.

He will be entitled to a settlement at some point as well. In this case, the insurance company is being sneaky. The adjuster called and said something to the effect of, “I know this injury is frustrating for you. Do you want to put it all behind you and just settle your case?”

In other words, they are asking to be let off the hook for the expensive surgery he needs and the other things he will be owed.  They want to give him the money he will get someday anyway, but add the burden of his pain and care all on him.

I can’t emphasize enough how scummy this is by the insurance company and how bad of an idea it is to consider settling your case while you are still under a doctor’s care.  If he were to do that and get the surgery later on, he’d likely have nobody to pay for it as it wouldn’t be covered by personal insurance or Medicare once they realize the need for the surgery is due to a work injury.

And while I get that everyone wants a settlement in their work comp case, you don’t do it before it’s the right time. Once you settle, your case is closed forever and can’t be re-opened.

Sadly, I’ve seen some inexperienced or unethical work comp attorneys in Illinois push their clients to settle before it was the right time. Some attorneys just want that quick buck and others just are too lazy to do the work needed on the case.

It’s not a complicated formula to know if it’s too soon to settle or not. If you are still treating with a doctor or need more treatment soon, don’t settle.  If you just got released back to work by your doctor, don’t settle until you know you can handle the rigors of the job.  If you are off work and getting weekly checks, don’t settle unless it’s a huge number they are offering. That’s really it.

We make money by getting you a settlement, but would never tell you to do that before it’s appropriate. If you have concerns about this or anything else related to Illinois work comp law, please call us for free at any time.

Can You Work Another Job While On TTD Benefits?

By Mike Helfand on Posted in Benefits

One thing I really like about most of the people that contact us is that they really want to work. There’s a BS stereotype that some people just want to be off on work comp. I’m not saying that never happens, but almost everyone I talk to just wants to be healthy and back at work. Sitting at home in pain isn’t fun and can be boring.

A nurse who appears to be a really hard worker contacted me after an ankle injury.  She can’t walk for about three months following a significant surgery. Being a nurse she has to be on her feet all day of course, so she can’t work.  She asked if she could do her job with a knee scooter and her hospital said no. So she’s sitting at home with nothing to do.  She reached out to a friend of hers and was offered a job doing medical billing work from home. It’s not exciting or her preference, but it gives her something to do all day.

Her question to me is can she do this?  The answer is yes she can, but she has to be really careful about it. You can’t “double dip” and get paid for a job and also get your weekly workers’ compensation benefits (known as TTD benefits).  So unless she is doing casual work here and there, which this isn’t, her pay would either go to the insurance company or would lower her TTD payments.

I say to be careful for a couple of reasons. First off, you don’t want to get accused of insurance fraud. So it’s important that you have a lawyer craft a carefully worded letter and get approval from work comp to do this. They will likely be happy for it to happen as it saves money for them. The second reason to be careful is you need to make sure this new job won’t in any way risk you making your work injury worse. If it could, you could lose your right to benefits. Third, she really wants to go back as a nurse so she has to be careful that taking on this other temporary work isn’t seen as a resignation. This again is where your lawyer can add value and protect you by making sure everything is done in a way that makes clear no resignation is taking place.

Bottom line is that it’s something you can do but only should do after talking to an attorney. I’ve seen many people over the years screw their case up by having another job that nobody knows about.

Speaking of having another job, if at the time of your accident you were working two jobs, if you can’t work the job you got hurt on, but can work the other one, you can continue to do that, but still should talk to your lawyer about it.  If your hours greatly increase because you have more free time, that could be an issue. And if you are unable to work both jobs, you should likely get paid for being off of both jobs.

This is a really important issue and one that truly requires you to be thoughtful and careful. If you’d like to speak with a lawyer for free to go over your options, you can call us any time.

Video Evidence At Illinois Workers’ Compensation Trials

By Mike Helfand on Posted in Tips if Injured

If your work injury case is going to trial at the Illinois Workers’ Compensation Commission, winning or losing comes down to the evidence presented.  Mostly that will be from your testimony and the medical records that get submitted that show what you told your doctors and what treatment you received.  There also could be a deposition of your doctor and the company IME doctor as well as any witnesses for or against you.

In some cases, the insurance company will hire a company to do surveillance on you. Their hope is to get video evidence of you not following your doctor’s orders or showing that you are lying or exaggerating about your symptoms. If you have a back injury, but they show you working out with heavy weights, that will look bad for you.

In other cases, there could be video of you injuring yourself. Many buildings have cameras set up and can prove (or disprove) that you were injured while working. This is beneficial when you suffer a slip and fall or if you notice immediate pain when lifting something while working.  There was a case recently where a worker won their trial because the video evidence showed that they moved out of the way of falling boxes, just as they testified. It made them more credible.

There’s other video evidence that isn’t used as much, but should be more often, especially with how easy it is to film something these days.  I’m talking about film that shows what you do at work and how you do it.

This is really useful in cases where you are alleging that the repetitive nature of your job has caused or contributed to your injury.  It’s one thing to say you do a certain type of task a lot, it’s completely another to show a doctor who is going to testify on your behalf or against you what the work is, how you do it, how forceful it is, the way your arms move and bend, etc.  It also can be very impactful to an Arbitrator in deciding for or against you.

You may not have permission from your company to make such a video, but certainly should try to get in after consulting with your attorney first. It can be a real powerful trial strategy. In the alternative, if filming is not allowed on-site, your lawyer might have you prepare a video that simulates the work you do or had to do when you got hurt. And if you can’t do it physically, they can someone else perform the tasks.

It’s one thing to say, “I used a large hammer a lot,” and completely another thing to show the force used in swinging one and then make clear that you did this 50 times a day.  Some Arbitrators just can’t picture how big some work tools are, but get impacted when they see it. The same goes for doctors.

In the end, this is why having an experienced work comp trial attorney really makes a huge difference. It can be the difference between winning and losing your case.  Insurance companies will use video to their advantage when they can. You should too.

 

The Biggest Mistake Illinois Workers’ Compensation Lawyers Make

By Mike Helfand on Posted in Benefits

I’ve been a lawyer for 25 years now.  My primary focus that whole time has been Illinois workers’ compensation cases.  I know enough about other areas of law to talk intelligently, but not so much that I could or would represent anyone in an outside area. In fact, if I had to file for divorce or defend a DUI, I’d really have no idea what to do and would be mostly winging it.

Sadly, I see a lot of attorneys try to dabble in work comp and it times it seems like they are winging it too.  They know just enough to be able to handle to most straight forward of cases, but not enough to help most clients get the best result.  And one mistake they seem to make over and over ends up costing their clients a lot of money.

When you are off work due to a job injury, you get 2/3 of your “average weekly wage” for your time off. So if you make $1,500 a week, you should get $1,000 a week tax free.

Average weekly wage or AWW is calculated by looking at your income for the 52 weeks prior to the injury or “parts there of.”  That means if you are hired on January 1st and get hurt July 1st, they are going to look at your earnings over 26 weeks, not 52.  That makes sense and most lawyers won’t screw that up and most insurance companies won’t try to get away with cutting your wages in half.

The people who tend to get screwed are the ones that work something like 47 out of 52 weeks or 50 out of 52 weeks and don’t get paid for the days they missed.  If you made $75,000 in the year before you got hurt and worked all 52 weeks, your AWW would be $1,442.  But if you made that same money by working 46 weeks, your AWW would be $1,630.  That would result in an increase in your weekly benefits of about $125.00.

What typically happens is a worker will have most weeks that they work five days, but some weeks where they work 1-4 because work isn’t available.  But if you look at a wage statement, it will show wages earned each of the 52 weeks prior to the accident so the insurance company tries to divide by 52 weeks. And inexperienced attorneys will let them get away with it because they don’t know any better.

The reality is that the law is really fair, but nobody but an experienced attorney will make sure that it’s applied correctly and in your favor. And of course if they screw up your AWW it will also mean your settlement will be too low and who knows what else they will screw up on.

I actually have a lot of lawyers who dabble in work comp call me for advice. I try to guide them as best I can because I want the best for every injured worker. But it does make me shake my head as to why they even took the case at all.

The good news is that even if you were underpaid, it can be fixed all the way up to the time when your case is settled or tried.  So if you learn that your lawyer made this simple mistake, give them the boot and get someone in your corner who knows what they are doing.

Can I Sue The Insurance Company For Not Paying My Work Comp Benefits?

By Mike Helfand on Posted in Benefits

In Illinois workers’ compensation claims, sometimes you have a good-faith disagreement as to whether or not a case is compensable or benefits are owed.  Maybe you were treating with a doctor for a similar problem before you got hurt. Perhaps they sent you to a credible IME doctor who doesn’t think your condition is work-related.  Maybe a witness told a different story than you about what happened. None of these disputes are issues that can’t be overcome. You take your case to trial, present your evidence and let an Arbitrator decide. That is what they are there for after all.

Other times benefits get denied for no reason at all. Maybe you get a letter in the mail that said they did an investigation and determined your case isn’t compensable when that’s just not true. Maybe they just ghost you and don’t return calls. Maybe your case is accepted but it’s taking months to get medical procedures approved or your TTD checks are late all of the time and you are about to lose your house.

I’ve talked to many injured workers to whom this has happened, and they are understandably beyond frustrated.  It’s one thing if a check is late once or you can’t get into your first physical therapy session. It’s a completely different story when it happens all the time over many months or years or when you are in terrible pain because they won’t call back your doctor to approve payment for a simple procedure.

So the question we hear a lot from these justifiably angry injured workers is, “Can I sue the insurance company or the adjuster?”

The answer unfortunately is that you can’t. It’s simply not allowed under Illinois law and the Illinois Workers’ Compensation Act. You can’t sue the employer either for these delays and it’s not considered negligence.  I wish the answer was different.

So does that just mean they can get away with it?

Absolutely not. Under the Work Comp Act, when the insurance company acts unreasonably, we can file a petition for penalties and attorney fees. While this isn’t a lawsuit, it’s a request that the Arbitrator acknowledge the bad faith and unreasonable actions of the insurance company and punish them for it.  Depending on how bad their behavior is, this could put tens of thousands or more extra dollars into your pocket.

To make this happen though, you need a fighter as your lawyer and that means someone who will prepare the case for trial and take it to trial. Without a trial, there isn’t a hearing on any petition for fees and/or penalties.

I will say that it’s often weak attorneys who won’t push back whose clients get hurt most by this bad behavior. Often a stern phone call is enough to get them to stop playing games. Other times, an experienced attorney has a good relationship with the adjuster or opposing attorney and can get things straight so you don’t get a raw deal.

Big picture, you can’t sue, but you can punish them if they are out of line which is presumably what you wanted to do with a lawsuit anyways. So it’s not called suing, but in the end, the effect can be the same.

Speak To A Chicago Workers’ Compensation Lawyer For Free

By Mike Helfand on Posted in Tips if Injured

Although we are attorneys and want to make sure you get the best representation for your case, we also pride ourselves on being a great resource for free information about Illinois workers’ compensation law.  As part of that process, we will talk to anyone about their case for free and answer questions. Some of the questions lead to a whole blog post. Others don’t need that long of an explanation.  Here are some great questions we’ve received in the last few months.  And if you’d like to talk with a Chicago work injury attorney for free, call us any time at 312-346-5578.

I worked a job for two weeks and haven’t gotten my paycheck.  Can you help me? This is a common mistake. Workers’ compensation means work-related injury. It has nothing to do with missing wages or benefits.  Calling it “workers compensation” was not a common-sense decision by whoever decided to call it that.  But if you are looking for a lawyer for vacation pay or a missing paycheck or something like that, do you need a labor lawyer?
Do I have to use PTO if hurt at work? Is it true they only have to reimburse me if I miss 10 days? No, you don’t have to use vacation pay, sick days, or anything else if it’s a work injury and your doctor takes you off work. Starting on the 4th calendar day you miss, you are entitled to benefits.
Are there any options for me if my employer doesn’t have work comp insurance or am I screwed? Yes. The State of Illinois has a fund that will pay almost all of the benefits that you’d get if there was insurance.  It can take longer at times, but you aren’t out of luck. FYI, it’s a felony in Illinois to not carry work comp insurance and the State will go after the employer for reimbursement.
Can the insurance company cut you off your benefits for hiring a lawyer? I heard this one from a potential client a couple of months back. Insurance companies will say anything to try and gain the upper hand. No, they can’t stop your benefits just because you have an attorney.
My car was damaged when I had to be at Amazon during the tornado. Do they have to pay for it? We get a version of this question a lot.  Unfortunately, the Illinois Workers’ Compensation Act doesn’t provide compensation for damage to personal property like your car. It’s really a better question for a labor lawyer though if they made you work in dangerous conditions like that.
Whose job is it to report the claim to insurance so I can get paid, me or HR? Technically it’s their job, but I always advise people to be their own best advocate. So if there are any delays that are preventing you from being paid or getting treatment, I’d either call the insurance company myself or hire an attorney to do it for me.
If you have any questions about anything, fill out our contact form or give us a call and we’ll do whatever we can to help you.

Truck Drivers And Hip Injuries

By Mike Helfand on Posted in Injuries

Over the last 25 years, I’ve helped thousands of truck drivers who have had work-related injuries. The most common one we see is when a driver falls off their truck. It’s not unusual as drivers are regularly elevated and have to step or jump down.  Those falls can lead to all sorts of injuries including ACL tears, back injuries, shoulder injuries, etc.

But truck drivers get hurt in all different ways and have unique risks as compared to the general public. We see a lot of hip injuries with truck drivers and not all from falls off the truck.  There is a risk of injury when entering and exiting the truck as well as when checking on loads. They also work in a lot of slippery, icy, and wet conditions.  There’s also a unique risk they face.  The following question from a reader is a situation we see a lot.

I have been a truck driver at my company for 25 years.. have been experiencing hip pain on my clutching leg for 4 years.. finally went to a hip specialist.. xray revealed missing cartilage in the hip joint..I need a replacement…could this go under workmans comp?

The answer is that yes it could be a workers’ compensation case in Illinois and it could be a good one although it’s not an easy one.  If you’ve never been in a semi-truck or other large commercial vehicle, you might not have an idea of the force needed to use the clutch. It’s way different than a regular car and we see this type of injury a lot due to the repetitive nature of the job.  Over 25 years this driver may have made the same movement over a million times.

So I don’t think there is any doubt that the driving caused or contributed to his hip pain which is what we need to show in order to win him benefits. The insurance company will argue that it’s due to something else like getting older or that he waited too long to file the case, but I don’t think those are winning arguments.  It wasn’t until he saw a doctor that the clock to file notice of a case should likely start under IL law, and if he continues to do the job, essentially every day is a new injury.

As a result, there’s work to be done, but ultimately I think he’ll win his case.  To win a work comp case in Illinois, you have to show some unique risk factor which in this case is using the clutch. The general public doesn’t do that.  And then you have to show that the job contributed to your injury.  So unless he fell on ice in his driveway at home or had some other non-work-related accident, I don’t see him losing this claim.

There’s actually a study that was done that showed over 60% of truck drivers have some sort of musculoskeletal pain and are 350% more likely to have an injury than the general public. A lot of these injuries are to the back, but plenty of others are to the hip. Sometimes it’s just hip pain and other time the cartilage wears down and a hip replacement is needed.

Aside from falls and the clutch, truck drivers also hurt their hips due to prolonged sitting as well as the types of seats they are in. It can lead to impingement of the nerves and scar tissue.  While everyone sits during the day, not everyone sits for ten hours straight in a vibrating seat that is cramped.

Finally, if sleeping stations aren’t constructed correctly and you get thrown around a bit while your partner is driving, doing that day after day can really cause hip irritation among other injuries.

The bottom line is that if you are a truck driver with a hip injury, we’d be shocked if you didn’t have a workers’ compensation case, especially if you have been doing it for a while. If you’d like to talk to an attorney for free about your situation, please call us any time at 312-346-5578.  We help everywhere in Illinois and all calls are confidential.

One Worker Won Their Trial, One Worker Lost. Here’s Why

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

One thing I hear a lot from people call me with Illinois workers’ compensation questions goes something like this:

I hurt myself at work and my case has been denied. I have no idea why. My cousin had the exact same type of injury and they got all their benefits and a $60,000.00 settlement. Why aren’t I getting paid?

In most cases, the answer is that your injuries sound similar, but the facts around the case are way different when you take a closer look.  In other words, you can’t compare what happened to you to someone else. Even if it’s a co-worker, you come in to the case with a different history, especially medically.

This thought popped in to my head the other day when a read the Illinois Workers’ Compensation Law Bulletin case summaries. It’s a monthly report of newly reported cases from the Illinois Workers’ Compensation Commission. It’s a great guide as to why Arbitrators rule the way they do and to learn about new laws. If your attorney isn’t reading those updates they aren’t prepared to properly represent you in my opinion.

In one of the recent ones, there were two cases about Illinois workers that experienced severe mental trauma at work.  The first person was a witness to a major electrical explosion. The second person had guns pointed at them.  The first person testified it was the worst moment of their 26 year career and that loud noises startle him. The second person also alleged post traumatic stress.

There was one big difference in these cases beyond the facts. While both cases established a work related accident, the worker who experienced the explosion never sought medical treatment. The second sought treatment with a psychologist who treated him for anxiety and depression related to the mental trauma at work.

You can’t win an Illinois workers’ compensation case without medical evidence.  You aren’t a doctor and you are biased in the eyes of the Court so you can’t offer medical evidence. You can talk about your experiences or pain you’ve had, but you can’t offer a diagnosis as to what’s wrong with you even if you 100% know it.

This is especially true for mental health injuries as they can’t be seen. You can’t self diagnose a broken leg, but if you had one you’d also have to see a doctor because you can’t walk. Some people can experience severe mental trauma, but for whatever reason choose not to seek help.

The medical evidence you get is usually the most important part of any case.  If you don’t treat, it will be hard to win.  If there is a delay in treatment, it will be hard to win.  If there is a gap in your treatment, it will be hard to win. If you lie to your doctor it’s going to be really hard to be victorious.

Interestingly enough, while it’s probably worse mentally to be robbed at gun point than to see an explosion, if the person robbed didn’t go to a psychologist, they would have lost.  And had the person who saw the explosion gone to a mental health doctor, they would have won.

Degenerative Disc Disease And Workers’ Compensation

By Mike Helfand on Posted in Injuries

We are experienced Illinois workers’ compensation attorneys who fight for their clients. If you would like to speak with an attorney for free, please call us at 888-705-1766.

Getting older has its pros and cons. One downside is that as the body ages, its joints begin to wear down. Most people think of gradual wear and tear on the hips and knees, but it is also common on the joints of the spine.  You can wake up with back pain for seemingly no reason.

In a healthy back, rubbery discs between the vertebra provide a cushion, contribute to our height, and facilitate bending and twisting. The discs act as shock absorbers. As we age, the discs begin to wear down.  Some days you might feel great, others you can be hurting.

In some people, the discs wear away completely and the bones rub against one another causing stiffness and pain. There is little blood supply to the discs (unlike with other body tissues), so they can’t repair themselves. Most people aged 40 and older experience some disc degeneration, but not always with pain.

Degenerative disc disease is not actually a disease, but a condition in which worn-down discs cause pain. Factors that lead to degenerative disc disease (DDD) include:

  • Drying out of the disc with age
  • Tears in the outer part of the disc due to a lot of lifting or activity
  • An injury to the spine

So how does degenerative disc disease relate to workers’ compensation? If most adults over 40 experience some disc degeneration, what changes an underlying condition to a workers’ compensation claim? Those are good questions.

Many people have DDD, but it’s asymptomatic. That means an MRI of your back might show a problem, but for the most part, you are able to live your day-to-day life with little to no problems with your back.  If you have a work-related incident that brings out the problem then you likely have a claim.  Under Illinois law, if a work injury accelerates or aggravates your degenerative disc disease, then it is covered under the Illinois Workers’ Compensation Act.

What is crazy is that many workers don’t even realize that they have an underlying back problem because they previously had no back pain. We have seen several instances of employees with DDD getting hurt at work and then developing a bulging disc or a herniation.  Others only show as having DDD on an MRI, but now have tremendous pain and need medical care that they didn’t before. Those are cases too.

These cases result from both one-time lifting accidents and continuous lifting over time.  It’s not unusual to just wake up and feel pain after a long day of work. Sometimes it goes away and other times the work you’ve been doing has just been gradually wearing away at you and finally, your body breaks down.

The bottom line is, whether or not you were experiencing back pain before a work injury, you may be entitled to workers’ compensation if you were hurt on the job. We are happy to speak with you about your specific situation and help determine if you have a case.

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