Funeral Expenses And Illinois Workers’ Compensation

By Mike Helfand on Posted in Benefits

I had a caller recently who called me about a work related injury, but didn’t know it.

Their relative had died of Covid and had a life insurance policy that paid out a benefit to her two minor children.  The family wanted to use that money to pay for the funeral, but that wasn’t allowed because it was left to the benefit of the children.

It turned out that the relative who passed was a nurse.  Under Illinois law it’s presumed that health care (and many other) workers who get Covid, got it from their job.  So in those cases, victims, or in case of a death, their families, can bring a work comp case.

This death is of course tragic and the fact that she left behind two young kids makes it worse.  That said, a lawyer’s job is take the emotion out of a case and prevent the facts. So while I don’t want to make it seem like we are making light of this situation, it’s important for people to know what their rights are.

In this or any other Illinois workers’ compensation death case, one of the benefits your estate receives is $8,000.00 toward funeral expenses. So while they can’t use the life insurance check in this case, there is a simple way to make sure a proper burial takes place.

On top of that, the kids would receive a minimum payout of $500,000.00, likely much more to help take care of them and partially compensate them for the loss of their mother.

We are going through some crazy times as a society.  I highly recommend that if anyone you know passes from Covid or even has it, that you contact us for a free consultation to see if that illness can be in any way connected to the job. Please call us at 312-346-5578 for a free consultation.  We help with cases everywhere in Illinois.

Have You Avoided The Doctor Because Of Covid?

By Mike Helfand on Posted in Tips if Injured

One interesting fact about Illinois Workers’ Compensation law is that it changes all of the time.  The basic principles remain the same, but either new laws get passed or new cases interpret existing law to change how we’ve always viewed things or establish for the first time how a certain aspect of a case should be handled.

Covid has had a similar affect.  It used to be that if you got injured on the job, but didn’t get medical care for many months it would essentially kill your case.  The longer you wait, the harder it is to prove your need for treatment is related to the original accident.  A delay of a couple weeks doesn’t usually hurt injured workers, but a delay of many months can.

With Covid though, many people are understandably afraid of going to the doctor or hospital.  Instead they treat themselves with pain killers, ice, rest, etc.  For some that’s enough, for others it is only a temporary fix and eventually the pain becomes too much.

Take for example a very nice man who called me recently regarding a fall at work in March.  It happened right as the pandemic was hitting.  While he reported it to his employer right away, he read warnings to avoid exposure if you have any underlying conditions which he does.  He works in a managerial role so he’s able to continue working, even it’s remotely. He has a shoulder injury that is getting worse and finally has decided that it’s too much pain to not see a doctor.

His case is no slam dunk, but where before I would have told a potential client with a five month delay in getting medical care that I can’t help them, in this case I might be able to.  I told him he should get with an orthopedic doctor right away, tell the doctor how they hurt themselves, what they’ve been doing to treat it and ask two questions.  The first question is what is the diagnosis? The second is does the doctor believe the problem is at least partly related to the work accident.

This gives us something to work with.  Arbitrator at the Illinois Workers’ Compensation Commission are not dumb and certainly apply common sense to most of their rulings.  If this person has a credible doctor in their corner and comes across as authentic in person as they did on the phone, the Arbitrator will believe that they were hurt at work and avoided the doctor because of Covid.  That’s of course the truth, but the truth doesn’t always prevail.

The bottom line is that if you can get to a doctor, please do so, for your health. I’ve personally been to a doctor five times since March and in my opinion it’s very safe due to masking and cleaning. Some doctors will also examine you by Zoom or outdoors.  Nothing is 100% safe, but it does seem that there are realistic work arounds with this.

You can’t bring a work comp case without medical care, but the good news is that a delay in care, at least for now, doesn’t end your case.

As always, if you have any questions, please do not hesitate to contact us.

What To Do If You Waited Too Long To File For Workers’ Compensation

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

There are a lot of unique things about Illinois workers’ compensation law as compared to other injury cases.  Our claims are resolved via Arbitration whereas regular personal injury cases usually go to a jury trial.  In a car accident case you have to prove fault, but you don’t have to do that if you are hurt at work.  And in personal injury and malpractice cases if you miss the time limit to file you are out of luck.  In work comp cases you can sometimes miss the time limit to file and then get more time.

How does that work?  It’s not common but it happens.

Generally speaking, you have three years from the date of your accident or two years from the last payment of compensation (typically TTD benefits or payment of medical bills), whichever is later, to file a case.

So if you were hurt on April 10, 2017, you would have had to file your case with the Illinois Workers’ Compensation Commission by April 10, 2020.  In the alternative, if a medical bill or TTD payment was made at any time in the last two years, the time limit could be extended. So if you were hurt in April of 2017, but the last payment made to your case was done on October 1, 2018, you’d have until October 1, 2020 to file your case.

So what’s the exception to this rule? A recent caller to my office illustrates it pretty well.

He was hurt in June of 2017 and broke his arm.  He didn’t call me until July of 2020 which is unfortunately past the three year timeline.  I had him look to see when the last medical bill was paid on his injury and it was also in 2017 so the two year rule doesn’t help him either.

So he’s likely out of luck, but there are two pieces of strategy he can take to revive his claim:

1. I told him to call every medical provider on his case.  Often there’s a $50 medical bill out there that never got paid and they never bothered to collect on. If it exists and he can get the insurance company to pay it, he’d start his two year clock all over again.  That’s because the last payment of compensation related to his case would be in 2020.

2. He originally contacted me because he was having pain in his arm again.  I told him he could contact the insurance company and see if they will authorize a one time medical visit to look at his arm.  If they do and pay for it, that too will re-start the two year time window.

Now work comp insurance companies don’t care about your health, they care about making/saving money.  So if the adjuster he calls knows what they are doing, they will not pay an old bill and won’t authorize more care.  That said, I’ve seen it happen plenty of times because they, like anyone else, make mistakes.

In this case his settlement would likely be around $30,000.00 so it’s worth going for.  Had he contacted me one month sooner it wouldn’t be an issue.

The bottom line is that you should never wait to formally file a case because it’s free and it protects you.  But if you do wait too long and it seems like you are out of luck, consult with an attorney to see if there is any way you can revive your case or to verify that you really did wait too long.

Some Random Illinois Work Comp Info

By Mike Helfand on Posted in Tips if Injured

We are Illinois attorneys who will talk to you for free any time for cases everywhere in Illinois.  Fill out our contact form or call us at 312-346-5578.

Every few months I like to put a blog post together of answers to questions I’ve received that don’t need a full blog post.  In no order in particular, here are some interesting ones I’ve heard of late.

My case is settled and I’ve already been paid.  Can the insurance company still do surveillance on me?

Can they?  Yes.  Would they? No.  It would be a huge waste of money.  I’ve never heard of this ever happening in my 23 years of being a lawyer.

Can my doctor make me go back to work?

Nobody can make you do anything, but we do see doctors who tell patients to return to work even though they don’t feel ready.  It happens all of the time and if it happens to you, you should consult with a lawyer about what the next steps to take are.

Should you always reject the first settlement offer?

I wouldn’t say always, but I will say that usually insurance adjusters aren’t making their best offer right away.  You have nothing to lose by countering their offer.

What is a form 45 report?

It’s a report that the employer is required to complete any time a worker is injured.  If a worker misses more than three scheduled work days, the company is required by law to file it with the Illinois Workers’ Compensation Commission.

Is Walmart the worst company to work for if you get hurt on the job?

I laughed when I heard that one. In my opinion they don’t treat their employees well, but that is true for lots of companies like Amazon.  We’ve heard more nightmare stories about Amazon lately than anyone so we love to take cases against them.

How often do workers’ comp checks come?

There’s no law about this, but it’s usually every two weeks when you are authorized off work by a doctor and there is no dispute about your health or how you got hurt.

Will work comp pay for a new mattress?

Yes if it is medically prescribed by a physician.

What does a paralegal do on a workers compensation case?

It depends on the firm, but the proper answer is they shouldn’t be doing more than the lawyer.

 

As always, if you have any questions please do not hesitate to contact us at any time.

Is There An Illinois Workers Compensation Settlement Guide?

By Mike Helfand on Posted in Benefits

A reader of my blog called me up and asked me some questions about his case.  He then went on to ask me where he could get a copy of the “Illinois Workers Compensation Settlement Guide.”

Now one thing I really try to do, and if you read this blog a lot you know this, is give the general public access and education about Illinois work comp laws that isn’t readily available.  The honest answer is there really isn’t a settlement guide for work comp cases.

There is a book called the Q-Dex that does list what some cases have settled for or what the trial results were.  It is not even close to a complete list of cases that were settled and beyond all of that, it’s not free.  So it can be a useful tool for attorneys when someone has a real unique injury or a lack of experience, but it’s not really practical for an injured worker.

In the bigger picture, to properly evaluate a case you need to know a lot of things.  This list includes:

1. A copy of all relevant medical records.

2. An understanding of the medical history of the injured worker and need for future treatment.

3. Their work history.

4. What restrictions, if any, they have.

5. Their age.

6. Their salary or wages.

7. How long they’ve been on the job.

8. What work are they able to perform?

9. What are the case issues?  Meaning does the insurance company have any good defenses?

10. Where is the worker in the process of searching for a job if they can’t work? Have they done vocational rehabilitation.

11. Who is the Arbitrator on the case? The reality is that some cases are worth more or less based on who the Judge will be.

That’s not an exhaustive list, just the first ten that come to mind.  So while it would be great if there was some guide to help workers, it doesn’t really exist and even if it did, it would in many cases cause workers to make bad decisions because they wouldn’t consider everything that needs to be considered.  This happened to me as a young lawyer who went to the Q-dex to find out what a back injury was worth.  I saw one that would have made the case worth $50,000 and the adjuster pointed out another that would have made the case worth $30,000.  Both descriptions of those other settlements were similar, but the point is that neither of us had enough information on either case.

The reality is that attorneys determine what cases are worth based on years of experience of seeing how other cases are resolved in person, seeing what Arbitrators continuously say at pre-trials and via Arbitration decisions and talking to other attorneys about their cases.  It’s very common for lawyers to email 20 or so colleagues, describe a situation and get opinions.  All of these factors help us evaluate what the minimum and maximum value of a case is.

Bottom line is that I’m happy to answer any questions you have, but the truth is “Is this a good offer?” is quite often one we can’t because we don’t have all of the information over the phone.  And if there was a good guide to send you we’d do it if it existed.

AT&T Worker Wins Work Comp Case After She Clocks Out

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

We’ve been involved in a lot of AT&T workers’ compensation cases in Illinois over the years.  They use a company called Sedgwick to administer their claims and in our experience they fight cases whenever they can.  Even if the adjuster you talk to “seems nice” they are looking for a way to deny or limit your benefits.  The more money Sedgwick saves AT&T, the better it is for both of them even when it’s at your expense.

In a recent Illinois work injury case that went all the way to the Appellate Court (this is unique in work comp), a worker was injured when she tripped going up the stairs because the non slip strip was missing.

What made this case unique was the fact that the worker had clocked out for the day.  She was almost out of the building when she realized she left her cell phone at her desk and headed back to the area where she sat. In doing so she caught her foot on the defective step and fell, injuring herself.

AT&T through Sedgwick fought the case and tried to make the ridiculous argument that since she had clocked out and was only returning to her desk to get a personal item, it wasn’t work related.    The reality is that she had been only off the clock for minutes and was still on company property. She hadn’t left the building yet which meant her work day wasn’t over.  Can you imagine if when she went back upstairs if her boss asked her a question she refused to answer because she clocked out?  Of course that wouldn’t happen.

Punching out doesn’t mean the day is over.  Beyond that, there was a defect in the stairs which were on company property.  Clearly the bad stair contributed to her falling which is all she needed to prove to win her case.

Interestingly enough, one of the reasons this case was fought was because the worker’s supervisor didn’t think the missing strip was enough reason to fall. Of course it turned out that was just his opinion and he never examined the bad step until it was repaired.

The bottom line is two fold in this case: 1. Don’t be surprised if Sedgwick gives you a hard time.  Just make sure you are educated on your rights and have a lawyer who knows how to push back. 2. Being “off the clock” doesn’t end your work day or take away your chances at winning a work comp case in Illinois.

And as always, if you have any questions or concerns, you can call us for a free consultation any time at 312-346-5578.

 

Arthritis and Illinois Work Injury Cases

By Mike Helfand on Posted in Injuries

They say the only sure things in life are death and taxes.  But now that I’m 48, I know that the third sure thing is arthritis.  You might have a mild case, but as you get older you will likely get swelling or tenderness in one of your joints.  That’s arthritis.  You wake up and your neck is stiff or your back is sore for no reason.

When it comes to Illinois workers comp cases, insurance companies love to use arthritis as a reason for denying your case.  You hurt your back lifting a patient???  That’s not work comp, that’s arthritis they like to say.  Your shoulder needs treatment and you lift over your head all day?  They will say it’s arthritis, not work comp.

Basically it comes down to them saying you weren’t hurt at work, you have a pre-existing condition that was temporarily aggravated.  They want the court to believe that even though you weren’t in the need of treatment until you had the work accident, what happened at work was just a temporary problem.

The reality is that a pre-existing condition does not bar you from getting Illinois workers’ compensation benefits. If your job aggravates or accelerates an existing problem then you should be covered.

It really can be frustrating.  For most workers we’ve helped they’ve never even known they have arthritis or if they did they didn’t think about it. You’ll see crazy defenses where an insurance company gets a hired gun doctor to say your back pain isn’t from working construction all day, it’s actually because you were in a car accident 15 years ago.  It’s nonsense, but if it works even one out of ten times, it’s a huge victory for them.

This is a way different scenario than someone who’s been treating for a chronic problem and then says after a couple of years it’s the job that made it worse.  That could be a case, but is no slam dunk.  But to say someone who hasn’t either been to a doctor ever or in many months/years for a problem wasn’t really hurt at work is just b.s.

The good news is that we almost always prevail on these cases. The bad news is that there are enough shady doctors who will tell the insurance company what they want to hear that you might have to jump through some hoops before you win the case.  For a work comp insurance company, they are trying to save money however they can, even if it they are clearly in the wrong and it’s at your expense.

Illinois Millwright Wins Workers’ Compensation Case

By Mike Helfand on Posted in Injuries

We are experienced Illinois work comp attorneys who care about our clients. If you would like our help, we have a state wide network of tough, experienced attorneys.  Please call us any time at 312-346-5578 for a free consultation.

Working as a millwright is one of the most dangerous jobs out there.  They are some of the most skilled tradesmen out there and that skill leads them to be put in many situations that can lead to a work injury.  It’s very heavy duty work that involves installing machinery, lifting a lot of heavy equipment, using a lot of tools and quite often working in small areas with a lot of bending, stooping, etc.  They may also be asked to do the jobs of other professions such as welding or transportation.

It’s not surprising that millwrights would have one off injuries such as lifting a heavy box and having your back go out on you.  They also have a lot of repetitive trauma injuries from doing the same activities over and over.

Despite the fact that these jobs are so physically demanding, insurance companies in Illinois work comp cases love to fight repetitive trauma claims.  Millwrights are no exception.

In a recent Court case, a millwright had been doing his heavy duty job since 1991.  Most of his work was with power tools at or above shoulder level.  In 2017 he sought treatment for shoulder pain and in 2018 he had a right shoulder replacement.

Under Illinois law, if you believe that his job contributed to his shoulder problem, he should get work comp benefits.  That doesn’t mean it’s the only cause,  just a contributing clause.  Can anyone say with a straight face that 26 years of lifting, maintaining transmissions and hydraulic systems, continuously working overhead and constantly using power tools didn’t cause any wear and tear? Of course not, but that didn’t stop the insurance company from denying his benefits and forcing him to trial.

And of course the Illinois Workers’ Compensation Commission found in his favor. He credibly testified that about 60% of his work was repetitive and at or above shoulder level working on large, industrial machinery.  The insurance company gave the IME doctor an inaccurate description of what the actual job duties are and of course that hired gun didn’t try to find out the truth from the worker.  In fact the millwright testified that he tried to make clear what his actual job duties were and the IME doctor would not allow him to talk.  Even though he was a millwright, the IME doctor didn’t know or believe that he did activities that put stress on his shoulder.

And the treating doctor did know what the real job duties were and testified that the repetitive duties aggravated the underlying arthritic condition that he had.

So ultimately this millwright won his case, but I’m sure that he has a terrible view of the legal system. He had to go through a battle because the insurance company gave out false information and essentially tried to frustrate him out of pursuing a case.

The bottom line is that insurance companies will fight cases they shouldn’t especially when you have a serious injury like this one.  Their philosophy is that if they lose the case it doesn’t cost them much because they are just paying what they owed anyway.  It’s sad but true and all the reason why you need a lawyer who knows how to win trials in your corner in case it comes to that.

How To Prove You Are An Odd Lot Permanent Total

By Mike Helfand on Posted in Benefits

We are Chicago work comp attorneys who help with cases all throughout Illinois via our state wide network of experienced attorneys. If you want to speak with us for free, fill out our contact form or call us at (312) 346-5578 any time.

You may have heard the phrase permanent total disability.  That’s when you have a work related injury that has lead a doctor to state that there is no line of work you can return to.  It’s a somewhat rare, but in some cases you are so injured that a physician will say that you can not safely return to any type of work.

In other cases though, you may have a very severe physical restriction due to your accident, but not a doctor saying you can’t do anything. In those cases too you can receive permanent disability benefits for life if you can prove you are an “odd lot permanent total.”

“Odd lot” is one of those weird work comp terms that most people have never heard of. It basically means that due to your injury and the other factors in your life like your age, work experience, etc. there is no stable labor market for you.

To prove you are an odd lot, you have to perform a really diligent job search. That means looking for lots of jobs that appear reasonable for you based on your work experience and your physical limitations.  You should keep a log of who you contacted, what the job was, what follow up efforts you made and what the result was.  If you apply at 200 different places and nobody will hire you, that goes a long way to proving there is no job market for you.

This effort is best supplemented by a vocational counselor report.  Just like you can choose your own doctor, you can choose a voc counselor to help you look for a job, prepare a resume and author a report as to what jobs are available for you.

In a recent case, a worker applied for  more than 1,500 jobs without success.  The voc counselor testified that he worked hard to find a job and that in all likelihood would not be able get one.

Now even with all of that, the insurance company can still try to prove that jobs are available.  In this case though they didn’t do that.  They said they offered vocational rehabilitation efforts, but they required him to be able to drive at least 30 minutes which was against his restrictions.  That’s not a good faith effort on their part to help him.  They then did a labor market survey which is a test that is nowhere near as effective as an actual job search.  To them it showed he was “prospectively employable” but the Illinois Workers’ Compensation Commission was not persuaded by this.

The bottom line is that if you put in a good faith effort and can’t find work and the insurance company can’t prove that real jobs exist for you, you should be considered an odd lot permanent total.  This is important as the difference between winning or losing this issue at trial would likely be hundreds of thousands of dollars.

IL Work Comp – Falls On The Job

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

We are honest, experienced Chicago attorneys who help with work comp cases all over Illinois.  We care about our clients and would be happy to offer you a free consultation.  Call us any time at 312-346-5578.

One of the most common Illinois workers’ compensation questions we get is, “Do I have a case?”  The answer of course depends on the facts about how you got injured.  This is especially true when people get hurt after falling on their job.

It’s not enough to say you were at work when you got hurt if you want to have a case.  You have to show something about the job increased your risk of having an injury.

Take for example a recent caller to my office.  She was working outside and tripped over a small hole and ended up fracturing her ankle.  Her job duties required her to be outside.  The hole was on the company’s property.  She couldn’t see the hole because she was carrying work items.  All of those things increased her risk of getting hurt.  She has what appears to be a very strong case.

On the other hand, if she wasn’t paying attention and her feet got tangled up with each other, it’s likely she wouldn’t have a claim.  If she was walking down the stairs and slipped because they were wet it would be a good case, but if she has no idea why she fell then she’d be out of luck.

The biggest way Illinois workers lose out when they fall at work is that they are in so much pain they don’t realize why they fell. If your ankle breaks or you tear your ACL, it can’t be expected that you’d calmly look around and figure out why you fell.  But if you did fall, there are some things you can do to protect yourself.

1. When you can, think about what you were doing before it happened.  Were you carrying work items?  Were you rushing?  Was there something wrong that caused you to fall? All of these things can help your case if they are true.  If stairs are slippery, you don’t have to know what substance you fell on, but must know it was something.

2. If you are able to, head back to the scene of the accident after you get medical care. Perhaps you will find nothing, but you may see that there is still a wet floor or a leaky roof or some other defect. If that’s the case it increases your chances of success.

3. Do not under any circumstances give a recorded statement.  It’s very likely the insurance adjuster will ask for this and might even say that can’t process your claim without one or that it’s just for training purposes.  This is not true. You do not have to give a statement no matter what they say and refusing to give one won’t cause you to lose your Illinois work comp rights.  They can ask an innocent question like, “Is it correct that you don’t know what caused you to fall?”  If you say yes, but mean “Yes I don’t know, but it was something slippery,” your lack of an explanation could cause you to lose the case.  They are trained to ask questions that will twist your words in a way that can harm you.

These cases get fought by insurance companies more often than they should.  If you have any questions or want help with a case, please call us for free any time.

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