How The IME Can Take Away Your Benefits

By Mike Helfand on Posted in Benefits

There is an infamous doctor in the Chicago area who does not believe that most job duties, including typing, can cause carpal tunnel syndrome. If a client calls me who is a secretary or in another job that types all day and I know that they are being sent to this doctor by an insurance company for an independent medical examination (“IME”) then I know the case will be denied and a trial will be necessary.  That’s OK, it’s one of the reasons you get an attorney.

The good news with this doctor is that almost every Illinois Workers’ Compensation Commission Arbitrator knows he says the same thing on every case and is essentially a professional witness.  As a result, he’s being used less and less these days because insurance companies know that in the end he really doesn’t help their case.  All that said, I don’t know if he really believes what he’s saying or if he knows that he can make a ton of money being a hired gun, but he does still create obstacles for legitimately injured workers.

The problem is that there are other doctors in other specialties who are just as biased in their opinions but not as well known.  I was talking to a defense attorney recently about a PTSD case from a man who was robbed at gun point.  His firm uses the same psychologist to defend those cases because allegedly he doesn’t believe that having a gun pointed at your head while working can actually cause post traumatic stress disorder.  The lawyer I know bragged about how cheap the doctor is and how well he testifies.

This is a common thing we hear in all areas of law.  Some doctors will testify that most back injuries are degenerative or that MRI’s can’t be trusted.  There are plenty of doctors who will gladly help insurance companies fight a repetitive trauma claim.  If you are pregnant, overweight or have diabetes and then get carpal tunnel, that will be used to state that your job couldn’t have had anything to do with your problem.

As lawyers, all we care about is the truth.  If a client really wasn’t hurt on the job, I don’t want to represent them.  But many of these doctors will say whatever needs to be said without thinking about how their actions have real life consequences for good, hard working people.

So if you have to go to an IME we have lots of advice for you and have blogged about it. You are welcome to call us with any questions and tips on what to do and not do at the exam. But do know that if the IME doctor finds that you aren’t really hurt or your job didn’t cause your problems, your work comp benefits can and will be taken away.  But they aren’t gone forever.  Your attorney just needs to gather your medical records, take a deposition of your doctor and the IME doctor (if needed) and go to trial.  Having a case on file already speeds up the process for you and gets you before a Judge sooner.

This post was a bit of a rant, but it drives me nuts how dishonest some medical practitioners can be.  If 99 doctors agree that carpal tunnel can be aggravated by typing, the one doctor willing to look the other way shouldn’t be able to blow up a case.

Illinois Work Comp Legal Advice – File Before You Get Fired

By Mike Helfand on Posted in Tips if Injured

When I started off my legal career over 20 years ago, I worked as an insurance defense attorney.  It’s the best training for learning how to handle cases for injured workers because you learn how insurance companies really think.  As I’m pro-worker, I hated the job, but I learned a lot that has helped me give good advice.

One thing you learn right away is that when a new accident gets reported, somebody at the insurance company is looking at it as if whoever is making the claim is a scammer and there must be a reason to fight the case.  The insurance company workers make money by taking this point of view even when it’s ridiculous.

So instead of looking at the black and white facts of an injury, e.g. Joe was lifting a box and felt a pop in his back, they look for a reason to turn you down.

One issue that comes up a lot is when an injured worker doesn’t file a case until after they lose their job.  This, for insurance companies, is a red flag and usually means they won’t accept the case right away.

The reason this happens is the insurance company thinks that if you don’t file a case until after you are fired, you are making it up in order to get back at the company. Now I’m not saying that couldn’t happen or has never happened, but in my experience most workers who don’t file a case before they get let go do it because they think doing so makes them a good employee or they are worried about losing their job if they file a case.

So if you are typing every day and have tremendous wrist pain, but don’t see a doctor or tell anyone about it until you are let go it’s going to raise some eyebrows.  If you claim that you hurt your back lifting a box a week before they let you go, the insurance company will believe you are making it up.

None of this means you can’t win your case, but it does mean that it will likely be more of a battle.

The best advice we can give, which ironically can protect your job in some cases, is to report and file a case ASAP and before you get let go. Under Illinois law you are required to report an injury to your employer within 45 days of when you knew or should have known it was work related.  Sometimes when you think you are going to get fired but file a case, they end up not firing you for two reasons.  First, the insurance company tells them not to because if they do it could make your case worth a lot more money.  Second, when you have an attorney, many employers worry that they’ll get sued if they let you go so they end up not doing it.

None of this guarantees anything of course, but these are trends we’ve noticed.  In general, if they are going to fire you they will do so and not filing the case just makes things worse for you.  The worst case scenario is losing your job and having a major injury that you can’t get medical treatment for and you aren’t getting TTD benefits for your time off work because they don’t believe you really got hurt on the job.

Bonus tip, if you are have any restrictions from your job injury and get let go, the insurance company has to pay you until you have a full duty release.

The bottom line is that while you still can pursue a work comp case after you leave a job, it’s better for you all around if you report it and file while you are still working.

How Long Should It Take For An Insurance Company To Approve A Claim?

By Mike Helfand on Posted in Tips if Injured

A reader asked us the following:

My husband was injured on the job about seven weeks ago.  We filed the claim right away, but still do not have an answer from the insurance company as to whether or not they are going to approve his case.  How long does this normally take?

We get questions like this all of the time and its a good one. The answer is that it takes as long as the insurance company wants to take and part of that is a strategy on their part to frustrate you and hope that you will just walk away or use your own insurance.

Under the law they are not supposed to ever unreasonably deny or delay your medical care or payments for time off work.  They try to get around that by saying that they are “doing an investigation” or looking in to the matter or collecting information, etc.  Its not to say that they don’t ever do that, but the truth is that it usually can be done in a day or however long it takes to talk to someone at your job and get a copy of your first medical report.

So what is an injured worker in Illinois supposed to do in this situation?  You have to be aggressive and formally file a case with the Illinois Workers’ Compensation Commission.  This is the only way to get the insurance company to stop playing games and respond.

It’s shocking how many legitimate claims get denied or delayed for no reason. What pisses me off and should make you upset is that they are messing with your health and livelihood by delaying everything.  I’ve seen minor back strains turn in to life altering injuries because proper medical care was delayed.  I’ve seen people lose their houses because they are behind on bills.  Its not right.

There are, of course, some cases where a work injury can be properly denied by the insurance company.  That’s fine. It’s the no doubt, slam dunk cases that get delayed that get my goat. And the only way to deal with that is to file a case, file a petition for immediate hearing and penalties and fees and pressure them to do the right, lawful thing.

As always, if you have questions about a case, start a chat, fill out the contact form or give us a call to connect with an attorney for free.

Can You Work While On Workers’ Compensation?

By Mike Helfand on Posted in Tips if Injured

When you get hurt at work in Illinois, sometimes you are so disabled that you can’t do anything.  Other times you are injured and maybe can’t do your normal job, but can do some work.  When you can’t work at all you receive workers’ compensation benefits. One caller to my office wanted to know if they could work while getting those benefits.

It’s a question I’ve heard a few times so I thought it was worth a post.

The most common scenario where you can work while getting work comp benefits would be when you had two jobs before your accident.  Let’s say you have a job in a factory that requires a lot of lifting and you hurt your shoulder.  To make extra money, you also work as a security guard.  You get a 20 pound lifting restriction that prevents you from doing the factory job, but the security job is mostly standing and watching.   You could do that job while still getting compensated for the time you are missing from your main job.

Another common scenario these days involves people who do ride share for Uber or Lyft.  As long as driving doesn’t put you at risk for making your injury worse or go against your restrictions, you are usually alright to keep doing that.

What you can’t do is receive TTD benefits for your time off of work and then go get a full time job or new work you weren’t doing before.  That would be double dipping. If you do this then you shouldn’t keep receiving TTD benefits to the full extent and potentially could be charged with fraud if you do.

You can also actually be permanently disabled and receive those benefits, but have the ability to do a small job here or there.  It seems odd, but if you are unable to hold a real, full time job that doesn’t mean you can’t on occasion do something.  It actually works the same way for social security benefits.

Bottom line is that for most people you have one job and you can either work it or you get hurt and can’t work it.  But if you want to work a different job or had two jobs before you got hurt or want to freelance, it’s worth talking to someone about it before you do so just to make sure you don’t put your benefits at risk.  If you have any questions call us at 312-346-5578 or fill out our contact form and we will call you.

Illinois Workers Compensation and Lyme Disease

By Mike Helfand on Posted in Injuries

Lyme disease is no joke.  It can take an otherwise healthy and active person and make them lethargic.  Most start with a simple rash, but some suffer from severe headaches, neck stiffness, muscle pain, facial palsy, heart palpitations, dizziness and shortness of breath. In the worst cases you can have a brain injury that could cause permanent memory loss.

Most people get bitten by a tick while camping or spending time in the woods or on a farm.  The question I got from a recent caller is, can Lyme disease ever be a workers’ compensation case?

For that caller, her husband climbs trees all day at work, clearing brush. In other words, his job requires him to be in a place where he’s more exposed to ticks than the general public.  He can’t prove the tick bite happened there, but he can prove it’s more likely than not that it did and that his employer benefited by him being exposed to ticks.  So unless he’s been spending a lot of time in the woods or around ticks outside of work, I think under Illinois work comp law he has a strong case.  If so they’d have to pay all of his medical bills, all his time off work and give him a settlement based on his recovery.

While this doesn’t happen a lot in Illinois, infected deer ticks, which carry Lyme disease, can be found in Illinois.

So in general I’d say if you work for the Cook County Forest Preserve or other similar organization that has you near a wooded area, tall grass or brush, and you get Lyme disease, looking in to a case is worthwhile.  On the other hand, if you sit at a desk in an office building and get bit by a tick, it would be harder to prove you have a case.

The key element is showing increased exposure as compared to the general public while on your job.  It’s similar to how if you get stung by a bee at work you probably don’t have a case, unless you are a bee keeper or in some other job that puts you around a lot of bees.

I hope this makes sense.  Lyme disease is brutal and if you can’t work or have bills coming in it becomes even harder.  If you have any questions or want to see if you have a case, please contact us at any time.

When You Don’t Want Them To Access All Of Your Medical Records

By Mike Helfand on Posted in Tips if Injured

We are experienced Illinois work injury attorneys who give direct, honest advice.  If you have any questions please call us at 312-346-5578 or fill out our contact form.

Under Illinois workers’ compensation law, your employer or their insurance company has a right to medical records related to your injury.  As a result, it’s very common after you get hurt for you to get a letter that asks you to sign a “medical release form” that authorizes them to have access to your medical records.

These release forms are written by insurance companies in a way that favors insurance companies. If they could, they’d see every medical record of your life since you were a baby.  It’s a fishing expedition for them to look for something that might possibly give them a reason to deny your case.

The good news is that while they are entitled to medical records that relate to your injury, they have no right to look at any and all medical records from your life. So if you don’t want them to know you had cancer or are bi-polar or see what happened when you were pregnant or anything that doesn’t relate to the body part hurt on the job, you can restrict them from seeing that.

So how do you do it?

When we get these requests, we strike out any language that says “any and all medical records” and replace it with language that limits their request to the accident and treatment that relates to the same body part.  They have a right to see records from a car accident that hurt your back five years ago if you are claiming back pain now.  They don’t have a right to records from a car accident that hurt your back if you are now claiming carpal tunnel.

People assume that they have no right to push back against these forms or make amendments.  They are wrong and we don’t let anyone we represent get pushed around.

Illinois workers’ compensation law is mostly common sense and protects the rights of workers.  If you don’t want someone to access your medical history, you should not stress.  You need not be embarrassed about the treatment you’ve had because it’s supposed to be kept confidential.

Bonus tip.  Lawyers can subpoena medical records in these cases.  Medical providers are supposed to limit what they disclose, but aren’t always careful.  Nothing stops you from contacting those providers, letting them know you were hurt at work and instructing them that they do not have your permission to release any records that aren’t related to your accident claim.

4th Of July Work Comp Injuries

By Mike Helfand on Posted in Injuries

Happy 4th!  Hopefully you don’t have to work today.  We are open via our answering service or contact form if you want to talk to an attorney.  In the meantime, here are the top 10 4th of July injuries I’ve seen in my 20+ years as a work comp lawyer.

  1. Fireworks accidents. You’d expect this.  Sadly, someone, somewhere is going to blow off their fingers or burn themselves. It’s usually a result of a job where you didn’t get enough training.
  2. Car accidents. The craziest one I heard was from someone who was walking in a parade and got hit by another car.
  3. Slip and falls. Tons of restaurants and bars are open and the crowds can be massive.  That leads to a lot spilled drinks and wet floors.
  4. Fights. Another big one for restaurant workers.  It can be amateur hour at some bars, especially with all of the college kids home for summer.  This leads to people flexing their beer muscles and punches being thrown.  We’ve seen plenty of workers get caught in the middle.
  5. Back injuries from lifting. There are a lot of quick setups for stages and other areas that are being put in to place temporarily.  Hurried work often means you are being overworked which is a time bomb for your back.
  6. DUI victims. Not many people have to drive for their job on the 4th, but if you do, you are at huge risk of drunk party hoppers.  Be careful out there and if you don’t have to drive we recommend avoiding it.
  7. Gun shot wounds. This is an odd one, but for whatever reason, people like to shoot off guns on the 4th.  If a stray bullet catches you while you are working, you may have a case.
  8. Police officer injuries. A cop can have any injury on this list at any time, but they sure do seem to go up on the 4th, probably to all of the crowds.
  9. Torn rotator cuffs. Grocery stores are open and workers are doing lots of lifting of beer and water cases.  That will lead to torn rotator cuffs and other arm injuries.
  10. Nurse injuries. Nursing homes in Illinois are already woefully understaffed and some hospitals are too. It’s at its worst on major holidays because they don’t want to pay OT. You can bet some CNA or nurse will have to lift a patient by themselves tonight, absorb all of that weight and hurt their back.  All because their employer tried to save a few bucks.

Please don’t hesitate to contact us today or any other day if you have questions or need help. It’s always free and a pleasure.

Does Your Lawyer Tell You What You Want To Hear?

By Mike Helfand on Posted in Tips if Injured

I was recently talking to top car accident attorney at another law firm about a case I sent him. It was a driver of a Lyft who had been broadsided and injured.  He hurt his leg and went to the hospital.

He had told the attorney I recommended that he wanted to sign up, but didn’t pull the trigger.  That lawyer followed up and the client said he was stressed because “all of these law firms have been calling me out of the blue” and he didn’t know what to think.  For the record, he called me and any attorney who calls you unsolicited is a scumbag and probably breaking the law.

One of the things confusing him is that he was hearing different things from different law firms.  He has no money coming in and wanted to know if he could file for work comp.  I told him know because he’s with Lyft and so did the attorney I suggested.  But an ambulance chaser said sure you can file for work comp even though they must know it’s not true.  It’s either that or it’s a “runner” for the firm who isn’t a lawyer, but gets paid to act like one and chase down these clients.

This happens a lot where a lawyer tells you what you want to hear.  We’ll never do that.  We always tell the truth.  And it has cost us business.  That’s OK.

Some attorneys though figure that the best thing to do is get you signed and then deal with their lies later.  Instead of saying, “We lied, we knew you can’t get work comp if you drive for Lyft or Uber” they will say some b.s. like “After we signed you up the law changed.”

The biggest tell them what they want to hear lie we encounter is when someone gets hurt on the job and immediately wants to know how much the attorney can get them.  One Chicago work comp law firm is infamous for telling people their case is worth at least 100 grand no matter what the injury is or if they know that there’s no way to tell yet what it’s worth.  They end up with pissed off clients down the road, but that moral dilemma doesn’t seem to bother them at all because I keep hearing about them doing it over and over.

The bottom line is that you don’t want an attorney who tells you what you want to hear.  These firms will sell you out in the end and aren’t the types that fight for you. If you talk to five lawyers and four say your case is worth at most 40k and another says 100k, you can bet the 100k firm is full of it.

Illinois Workers Comp And Degenerative Condition

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

Imagine this scenario:

You’ve worked the same heavy duty job for 20 years, but have never missed a day of work.  You’ve had aches and pains, but don’t complain and take Tylenol when you are feeling especially sore.  You get promotions and raises and the owner of the company says he loves you.  One day you pull on a jammed machine and you feel a pop in your shoulder and instant pain. You’ve never gone to the doctor in your life for shoulder pain.

You get treatment, the doctor says your shoulder popped out of place and puts it back in. After that your arm strength is bad and you have trouble doing your normal job.  Work comp paid all of your medical bills and lost time, but then they sent you to an IME doctor.

That hired gun tells the insurance company and the injured worker that he doubts that the shoulder was really popped out of the socket and says any problems are probably “degenerative arthritis.”  Next thing you know is you are told that you don’t need any more treatment even though your doctor is discussing surgery and you aren’t working, but don’t get paid.

How does this happen?

Insurance companies in Illinois work comp claims try to fight cases any way they can. One way is to say that even if you are hurt, the job had nothing to do with it. If you are older they will find a doctor to state that any problems you have are “degenerative” and will throw out terms like degenerative arthritis to make it sound as if this is something that has happened over time because you are older.

The problem with this defense is it ignores the fact that you were fine before the job issues.  In this case, a really loyal worker didn’t ever have shoulder trouble until he did something to hurt it while working.  This is a slam dunk, definite case.

So the good news is that if something like this happens to you, I think you will win and often a good Illinois work comp attorney can get benefits going with a trial motion or a phone call.  The bad news is that they are fighting it at all and delaying your recovery.

Everyone has degenerative conditions, but if your job aggravates or accelerates those problems it’s a valid work comp case.  It’s a pretty settled Illinois law.  So don’t panic, don’t get frustrated, just get someone in your corner who knows how to push back and deal with this nonsense.

And as always, if you want to talk with one of our lawyers for free, contact us any time. We help all over IL.

Detroit Lions Tight End Should File An Illinois Work Comp Claim

By Mike Helfand on Posted in Injuries

I’m a fairly casual NFL fan.  I know most of the Bears players and many of the “star” players on other teams, but certainly don’t know of most of the role players.

I’d never heard of Michael Roberts before the other day.  Last year he was a tight end with the Detroit Lions. I became aware of him after reading a blurb on ESPN.com that he’s failed two physicals this off season due to a shoulder injury.  It sounds to me like his career is likely over.  He should file an Illinois workers’ compensation claim.

Why would a Detroit player file a case in Illinois?  As far as I can tell, Roberts hurt his shoulder in a November game at the Bears.  He played a little bit after that, but never fully recovered.

If he can prove he was hurt in Illinois, which it seems like he can, Illinois has jurisdiction over the case.  In plain English that means he has a right to file the case here.  I’m sure he could also file the case in Michigan, but from everything I know about the law in both states, the benefits in IL would be much greater.

In a case like this in Illinois, Roberts would be entitled to have all of his medical care related to his shoulder problems paid for, likely for his life and he most certainly, assuming he can’t play in the NFL anymore, would be entitled to wage differential benefits of over $1,100.00 per week until he turns 65.  Essentially he could count on around $58,000 tax free for the next 40 or so years unless he somehow found a job that made close to what he makes as a player.

So why should any of this matter to you?

The reason it matters is Illinois has some of the strongest laws on the books for protecting workers who suffer career altering injuries.  If you work out of another state, but are hurt while on the job in Illinois, you can bring  a case here.  That’s true whether you are a football player, salesperson, traveling nurse or anyone else.

Over the last 22 years of being an attorney I’ve seen far too many people not file Illinois claims simply because they didn’t know they had a right to.  I assume Roberts’ agent or union is making him wise to his rights, but my goal is for everyone to know and exercise their rights.  You know the Lions would use every legal right against him.  He should do the same.

 

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