Nominee For Worst Illinois Work Comp Lie Of 2024

By Mike Helfand on Posted in Tips if Injured

If you get injured on the job in Illinois, you can bet that at some point someone will lie to you. Most of the lies or half truths are committed by insurance companies. Some are unfortunately committed by attorneys who will tell their clients lies about how long it takes to get to trial or what the case is worth among other things.

Employers also lie too. And one shop owner is in the running for the worst lie I’ve heard this year. He also sounds like an all around terrible person.

His worker broke their arm while rushing to complete a work task. The boss made them finish out the shift even though they were in terrible pain. A trip to the ER that night revealed a hairline fracture. This was on a Friday. That Monday the worker told their boss that they had gotten medical care and turned in their restrictions which included no lifting more than 20 pounds.

And that’s when the lying and gross behavior began.

First off was the lie. The boss said something to the effect of, “Not sure why you are bringing this to me. Under Illinois law you have to file for workers comp within 24 hours of it happening. You didn’t do that so you are out of luck.”

That is not just a lie, it’s not even close to resembling anything that is true. You have at least three years from the accident date to file a case as long as you notify your employer of the accident within 45 days of it happening. I’m not sure why this guy would say something so ridiculous other than to try to get their worker to lose out on their work comp rights by doing nothing.

It got worse unfortunately. The boss told the worker they were a pussy for needing restrictions and kept calling them every day to pressure them to return to work. Mind you, while it was a fracture, it was anticipated they’d only miss a month of work and there was work within the restrictions that could have been offered but wasn’t.

So all of the worker’s friends were telling them to seek out legal advice and fortunately they reached out to us.

The worker actually felt bad for the employer which is nuts to me. The boss has shown that they don’t care about any of their workers and that they are a bad person. It’s unfortunate if they are down a productive worker for a bit, but this is life and these things happen. This worker was busting their butt for their employer and that’s how and why they got hurt in the first place.

I’m not here to tell anyone to look for a new job as they have to live their own life. But I do wonder why people put up with this type of abusive nonsense when they don’t have to.

Taking A Severance Doesn’t Take Away Your Illinois Work Comp Rights

By Mike Helfand on Posted in Benefits

Back in May, there was an article in the Chicago Tribune about a former Highland Park employee who understandably had PTSD after being present for the awful Fourth of July shooting back in 2022.

Now this post doesn’t apply to them as they were smart enough to hire a workers’ compensation lawyer. And as the article states, they negotiated a severance/settlement agreement due to alleged issues in them dealing with his post shooting mental health issues. It looks like that case and the work comp case resolved together which is common.

But what we see a lot happening with other workers is they have a job injury in Illinois and also get fired for sketchy reasons, often having nothing to do with the work comp case. So they get offered a severance and take it because they need the money or they want out.

A typical severance agreement says something to the effect of, “By signing you, the employee, give up your right to pursue any legal action against us, the company, for any reason. In exchange you are getting this severance compensation.”

Some of these agreements even state that you agree you don’t have a workers’ compensation case against them or give up your rights to pursue a work comp claim if you have one. They are of course written heavily in favor of the employer because their lawyers write them up.

That said, under Illinois law, the only way to settle a work comp claim or give up your rights to continue to pursue one is through a settlement agreement at the Illinois Workers’ Compensation Commission.

In other words, just because your severance document says you can’t pursue work comp doesn’t make it true. They can’t enforce a document that violates the law. And the law is very clear that the Illinois Workers’ Compensation Commission is the only place where you can resolve your work comp case.

That doesn’t mean that the severance agreement can’t be used against you. By stating you agree you don’t have any active work injuries, you might create a defense against any claim. But if anyone tells you the severance bars you from filing work comp benefits or continuing to pursue them, they are either lying or don’t know what they are talking about.

This is reason #7,258 why it’s important for you to have at least a consultation with a lawyer to learn what your rights are and make educated decisions before it’s too late. If you’d like a free one with us, call any time, 312-346-5578. We help with cases everywhere in Illinois.

Update To Illinois TTD Rates For 2024

By Mike Helfand on Posted in Benefits

TTD or temporary total disability is the pay you receive when you are injured on the job and Illinois and either can’t work at all or have medical restrictions that your employer can’t accommodate. The pay is two-thirds of your gross average weekly wage and is tax free.

There are caps on how much you can receive for TTD payments. This maximum amount is based on the state of Illinois state wide average weekly wage. This maximum number goes up every six months on January 15th and July 15th.

Obviously we just passed July 15th so there was an update made. The new state wide average weekly wage is $1,430.84 which makes the maximum weekly payout for TTD benefits $1,907.79. That is up almost $10 since January. In the last six years it’s gone up more than $400.00.

That means that if you make more than $2,861.68 a week which translates to $148,807.62 a year, your TTD pay will be capped at $1,907.79 a week if you are injured on the job. In other words, very high wage earners with a workers’ compensation claim don’t actually get 2/3 of their pay when they are off work. Most people who get hurt on the job make less than that amount, but it does come into play sometimes.

The good news for these workers is that they are still getting a lot of tax free money and they can usually make it up with a settlement in the end. Because their wage is so high, they will also get the maximum settlement rate.

Note that this benefit rate change only applies to people who were injured on or after July 15, 2024. It will be in place until January 14, 2025. If you were hurt prior to July 15, 2024, you would be subject to a different maximum rate.

Bonus tip. This TTD maximum rate is also the same top rate for death benefits, permanent disability or amputations. Hopefully that doesn’t happen to you, but we’ve already talked to someone who lost a loved one from a job accident in the last week so this law applies to them. There is also a minimum rate which is now set at $715.42 a week for those catastrophic situations.

These rates will change again in January and we will publish an update then or you can check on the Illinois Workers’ Compensation Commission website. And if you have any questions about your benefit rates, need a lawyer to help you with your case or just have a question, call us any time at 312-346-5578. We help everywhere in the State.

Can Your Employer Make You Use Vacation Pay After A Work Accident In Illinois?

By Mike Helfand on Posted in Benefits

No!!!!

I really can’t believe how many Illinois employers are trying to make their employees use vacation pay, sick time or other earned PTO after they get hurt on the job. If you get hurt at work and your doctor takes you off of work or gives you restrictions that your employer can’t accommodate, you get work comp benefits. Those benefits are called TTD or temporary total disability. It’s 2/3 of your average weekly wage, tax free.

Employers know this, but a lot of them want to screw you over if they can. So if they can get you to take a couple days of sick or vacation pay, that means your claim won’t cost them as much as you won’t have those hours to use later on in the year.

According to one injured worker who called me, there’s a very large Illinois employer who is taking this to the extreme. She said that this employer told her after a work accident that they have a new company policy that requires any injured worker to use one week’s worth of vacation pay if they are injured on the job.

Hopefully it’s obvious, but a company can’t create their own rules that decide they don’t have to follow Illinois work comp laws. This is very illegal. So far I’ve only heard about this from this one employee, but if I hear about it from another I will gladly name and shame this company.

This type of greedy corporate behavior doesn’t surprise me at all. It happens all of the time. It’s almost like a game of whack-a-mole in how they abandon one illegal strategy and then just start another.

The good news is that if you do use these hours, you can get them reinstated by formally filing a workers’ compensation case and showing that you have a work related injury. These are your hours. You shouldn’t lose your right to take a vacation after you get better or use sick time if you need it in the future for some reason.

One of the great things about working in Illinois is the State really does have a lot of strong, but fair laws for workers. The Illinois Workers’ Compensation Act is no exception. If your employer gets the benefit of your labor, they can’t make up their own laws if you get injured on the job. This is no different than them not getting to decide you should make less than minimum wage or anything else.

Son Proves His Dad Died Of A Heart Attack On The Job

By Mike Helfand on Posted in Injuries

Winning Illinois workers’ compensation cases for a heart attack can be tricky. Typically if you have one, you are older and it’s not unusual for that to happen. When you add in factors like high cholesterol, smoking, being overweight, etc. it’s not a surprise when someone with risk factors has a heart attack.

If you are at work and have one, that’s not enough to prove your case and win work comp benefits. You have to show that something about the job increased your risk for having one. Having a stressful job isn’t enough usually without other factors.

An example of a winning case would be if your job put significant physical stress on your body in a way that could affect your heart rate. Working in extreme heat or cold is one example. Having to do a lot of heavy lifting is another.

In a recent case, the financially dependent son of a worker who died of a heart attack on the job was able to win death benefits by proving the job contributed to the heart attack.

In that case, a construction worker was shoveling snow when he began to have trouble breathing. 911 was called and paramedics arrived, but he suffered cardiac arrest and died the next day. On the death certificate, the coroner listed hypertensive heart disease as the immediate cause of death, with coronary artery disease as a significant contributing factor.

The employer through their insurance company hired an expert to review his medical records and felt that the attack occurred due to low good cholesterol and a history of smoking. He went on to state that the death was not related to physical exertion.

The doctor for the family though reviewed the evidence and found that physical exertion brought on or aggravated the cardiac arrest. And that is what you need to show to win a case. The job duties don’t have to be the only factor or even the main one. They just have to play a role.

The Illinois Appellate Court agreed with the family and noted that clearing snow is a heavy physical activity and that the employer benefited from it. They went on to note that the difficulty breathing happened right after the shoveling began which would certainly correlate to those two things being related.

And of course you don’t have to die to bring a case. There have been plenty of cases for workers who had a heart attack and returned to work. You do get your bills paid, your time off paid and a settlement though if you can prove your injuries were in part caused by your job.

If you do have a heart attack, you can expect that your case will likely go to trial as insurance companies fight these cases very regularly. As a result it’s important to get an attorney who has a track record of trying and winning cases. If you’d like our help in being connected with that type of attorney, call us for free any time for a review of your case.

Is This The Scummiest IME Doctor In Illinois?

By Mike Helfand on Posted in Benefits

One of the basic premises of Illinois workers’ compensation law is that your employer (usually via their insurance company) has a right to send you to a one time medical exam of their choosing. These are called independent medical examinations or IME’s. Those doctors aren’t there to treat you, but instead are supposed to evaluate your injury, treatment plan, discuss if it’s work related, etc.

In theory this makes sense. I’m sure when this law was crafted the thought was that the insurance company would pick out a reputable doctor to just double check that everything that is happening makes sense. In reality that’s not how it works.

Many of the IME doctors insurance companies choose are hired guns and in most cases will say what the insurance company wants. It’s big business and a lot of these doctors make over a million dollars a year from these exams and subsequent depositions. Some of these doctors have one day a week where this is all that they do. The exams last just a few minutes and it’s all profit. So they are motivated to err on the side of the insurance company or risk losing the gravy train.

Some doctors have such a bad reputation that I’ve heard Illinois Workers’ Compensation Commission Arbitrators say that they won’t give their opinion any credibility. Most are smart enough to occasionally find in favor of the worker so they can appear objective. But I recently came across one that seems like the scummiest one of them all.

This was a downstate case where a worker tore a muscle in his shoulder while lifting. Because it’s downstate I used our state wide network and referred it to a great southern Illinois work injury attorney. The worker contacted me because after he had a surgery recommendation, the insurance company sent him for an IME. That doctor said that no surgery was needed and the problems were really in the neck. Mind you that this worker had a MRI and no problems lifting his arm before the work accident.

It was one of the most bizarre IME denials I’d ever seen so I asked the downstate lawyer about it. He told me that the doctor doesn’t have an active practice. That means he’s not seeing patients, but instead keeps an office just to do IME’s. That will tell you how much money he makes from this. Apparently his “medical office” is a run down store front.

He also told me this: “Any time I see this doctor on a case, I know it will be a denial for some bizarre reason. And he flat out lies.”

I like making money as much as anyone, but I don’t worship money. And I like to go to sleep at night knowing I didn’t actively try to ruin someone’s life and health in favor of my pocket book. Some people just don’t worry about those things. I don’t get it at all how you can live that way. My guess is that he’s a miserable person.

The good news is that the worker is with a great attorney now who likely can get this sorted out. The doctor apparently has a terrible reputation with the Arbitrators downstate. And because his denial of surgery makes absolutely no sense, the insurance company likely knows it’s a losing battle. Their hope, I believe, was that he’d go away. Instead he was smart and got an attorney to push back.

If I had my way, we’d adopt standards for IME doctors in Illinois. They certainly should be board certified and maintain an active practice. I think if we limited the number they could do a year to maintain credibility it would help. Even if they could “only” do 100 a year it would prevent the out and out whores from being involved to such a great degree.

But the best thing that could happen would be if the Illinois Workers’ Compensation Commission set up an IME panel that doctors had to apply to and had standards. Then instead of picking an IME, the insurance company would have to request one and the Commission would assign one in the right specialty. This would take financial motivation away from doctors to lie as they wouldn’t be dependent on the insurance company to get business. And it would likely prevent insurance companies from seeking out IME’s when they know they should just approve a claim.

Should You Work If The IME Doctor Says You Can?

By Mike Helfand on Posted in Benefits

We have over 25 years experience helping injured workers. If you would like a free, confidential consultation with a lawyer, call us any time at 888-705-1766.

One of the best pieces of advice for any injured worker in Illinois (or anywhere really) is to get a good treating doctor and listen to them. Usually with a work injury this means a good orthopedic doctor, but it could also be a neurologist or a pain doctor. You are looking for someone who specializes in the injury you are dealing with.

Unfortunately, what happens a lot in a workers compensation case is that you’ll have a great doctor who knows you well and has spent a lot of time with you. The insurance company will send you to an IME doctor for a one time exam. This is their right under the Illinois Workers’ Compensation Act. That doctor might spend five minutes with you and then write a report which completely contradicts what your doctor is saying.

So you may be faced with a situation where your great doctor says you can only do work with significant restrictions (e.g. 20 pound lifting restriction) and the hired gun insurance company doctor says you can work your normal job.

As a result, you may be faced with a situation where if you don’t put your health at risk, you’ll have no income coming in. How should you handle a situation like this?

As work comp attorneys, we can solve the problem, but it won’t be overnight. In most cases, an Arbitrator is going to favor the opinion of a reputable doctor who knows you well over an IME doctor who briefly saw you. But to get to that point, we will need to take the depositions of both doctors first. That can take a few months. Your lawyer can then file what is called a 19(b) petition for immediate hearing, but even then there’s no guarantee you’ll get to trial right away.

After the trial happens it can be weeks to many months before a decision is rendered. And if you win, the other side can appeal which usually means another year of delays.

Before a trial can happen we can have a pre-trial where we can discuss the evidence with the Arbitrator. They might lean on the insurance company to do the right thing or recommend an advance against any settlement which could put some money in your pocket. They might also do nothing. It depends on who the Arbitrator is and how strong the case facts are.

You can try to return to work based on what the IME says. If you make a good faith effort to do that, but can’t physically tolerate it, technically your TTD benefits are supposed to start again. That doesn’t always happen, but it varies case to case.

If your restrictions are permanent, you can look for a job within those restrictions while your lawyer gets the case ready for trial. If you do this and show that you are suffering a significant wage loss, you could end up receiving wage differential benefits. That would be 2/3 the difference of what you could make in the old job vs. what you can make now.

There is no right answer. It’s something you should discuss with your attorney. Your case facts and life circumstances should dictate your decision. What you shouldn’t do is consider settling until you are working a job comfortably for at least a few months. If you settle and then things get worse, you likely will be on your own at that point.

ACL Surgery Paid For By Work Comp, But Not The Physical Therapy

By Mike Helfand on Posted in Benefits

Here’s an inquiry we received that I thought people might find interesting.

I hurt my knee at work and was eventually diagnosed with a torn anterior cruciate ligament, ACL injury. I had surgery that the workers’ compensation insurance company paid for. I’m half way through my post surgery physical therapy process. I showed up to PT today and the therapist told me that the adjuster said they were no longer going to pay for my sessions. Any idea why and what I can do?

The answer I gave was that I needed to talk to them to learn more, but even before that happened, there were a variety of reasons this could have happened. Here are some of them:

  1. The insurance company got new information that gave them a reasonable belief that the injury wasn’t work related. That could be something like a tipster calling up and saying that you actually hurt yourself when you slipped on ice in your own driveway, not at work. Or it could have been a social media post that indicates you are lying.
  2. They came across medical records that contradict how you got hurt.
  3. An IME or records review doctor stated that additional physical therapy isn’t needed. That would be odd as in most cases PT starts within two weeks of the surgery and is expected to last 4-6 months. That said there are plenty of doctors for hire who would state whatever the insurance company wants.
  4. They don’t think the physical therapy office is legit. Most places are, but there are some doctors who run it out of their office schedule more therapy than is medically necessary or even get caught billing for work that doesn’t take place.
  5. The insurance company is messing with you. They will do this. If they think that you won’t do anything about it or that you’ll just put the treatment through your own insurance, they’ll cut off your benefits to save some money. It’s gross, but it happens a lot.
  6. They made a mistake. Believe it or not, this could have been someone at the PT office calling for treatment approval and somebody mistakenly saying it’s not authorized.

If you watched the most recent season of “True Detective,” Jody Foster’s character frequently says, “You are asking the wrong question.” That’s what’s happening here. The right question is, “How do we solve this problem so the injured worker can get the physical therapy they need and get healthy?”

The first thing a good workers’ compensation attorney would do is pick up the phone and call the insurance adjuster. Many of the possible reasons for this happening can be solved in a five minute phone call by an attorney who knows what they are doing.

If that doesn’t work or as sometimes happens, no adjuster will actually answer the phone, a good attorney would force their hand by filing a petition for immediate hearing. That can get your case in front of an Arbitrator relatively quickly and would force the insurance company to either do the right thing or disclose how they made a decision that defies accepted medical practices.

In other words, this is annoying and frustrating, but we are goal focused people and there is a solution. So it’s important to find out why benefits get cut off in work comp cases, but even more important to figure out how to fix it.

Chiropractors And Illinois Work Comp

By Mike Helfand on Posted in Tips if Injured

My job as an Illinois workers comp attorney and hopefully as a good guy is to tell people the truth. I’m really direct even when I know I’m telling someone something they don’t want to hear.

A great example of this is when talking about chiropractors and treatment for job related injuries in Illinois. Now full disclosure, I’m not a chiropractor fan. The thought of someone grabbing me by the neck and quickly twisting it freaks me out a bit. Plus I’ve heard too many stories of patients having strokes from being adjusted negligently.

I’m not really a fan of any doctors though. I hurt my knee back in the 90’s, explained to the orthopedic doctor that my #1 goal was to return to marathon running and he told me, “Why don’t you just not run any more?” And while I’ve been lucky to not have any major surgeries, the thought of going under also freaks me out.

But when it comes to chiropractors, the truth is that they are not viewed as very credible at the Illinois Workers’ Compensation Commission. This is especially true when you put their opinion about your injury and need for care versus a respected orthopedic doctor.

Part of this is because medical doctors have much more training and their treatment is much more accepted in the medical community. Part of it is because there are a lot of chiropractors who over treat their patients and run up huge bills. Whatever the reason, the blunt and honest answer is that if you get hurt at work in Illinois, if you treat with a chiropractor instead of an orthopedic, it will likely harm your case.

In one case we worked on, but withdrew from, the worker could not find an orthopedic doctor to state his injuries are work related and wanted us to rely on the chiropractor’s opinion. This would be put up against the IME doctor who while they are a hired gun, is an orthopedic. We explained to the client that we did not believe they’d win at trial.

This belief is based on 27 years of experience as well as statements by Arbitrators who have unanimously made clear that most chiropractors aren’t viewed as credible in their court rooms. That might not be fair. That might take away a treatment option you are comfortable with. But again, it’s my job to be 100% honest and not tell you what you want to hear. So even though I think it medically makes much more sense to see an orthopedic doctor in most situations, it also makes way more sense for your claim itself.

The big exception could be if your orthopedic recommends you see a chiropractor as part of your therapy. It almost never happens, but it’s certainly possible.

We don’t ever force clients to certain doctors, but are always happy to give opinions on who would be a good one if we know who you are considering. If you want to discuss that or any part of your case, please contact us any time.

When To Hire An Illinois Work Comp Lawyer? Here’s Why Earlier Is Better

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

Sometimes I feel I’m in the middle of a Dr. Seuss book when I hear the variety of bogus reasons that an injured Illinois worker has had their case denied. I’m not the best ryhmer, but it could be:

We are looking for more information. We are doing an investigation. We heard a different story. We are just going to ignore ya. We have a doctor who is a hired gun. Wrongly denying your case is lots of fun.

I won’t quit my day job.

In all seriousness, every day I hear from injured Illinois workers who have clearly compensable work comp claims and are getting jerked around by the insurance company. The latest was a guy who has never treated for knee problems until he twisted his knee stepping off a forklift. He needs surgery, but his case was recently denied by an IME doctor who said that his need for surgery is not due to the torn meniscus the MRI shows, but instead due to arthritis which is pre-existing.

It takes a lot of balls to write something so ridiculous, but some IME doctor did it. The problem is that this worker was hurt six months before the IME and got a surgery recommendation four months ago. He never hired a lawyer so he allowed the insurance company to convince him to try ice, rest and therapy even though he was in terrible pain and his orthopedic doctor said that they wouldn’t fix the problem. And then eventually they found their hired gun and cut him off.

The point of all of this is that whether you realize it or not, the insurance company is playing games. They may seem nice (not usually). They may approve your case and seem to be doing everything right. But behind the scenes they are not worried about your health, but instead are trying to make sure that they can limit what they pay on your claim.

In this case, had the injured worker gotten a lawyer sooner, they would have had surgery a while ago. The insurance company likely wouldn’t have even wasted their time on such a non-sensible IME and even if they somehow did, a case would already be on file and the worker could get their day in court much faster.

There were other issues in this case. A nurse case manager was talking to his doctor which is a big no no and is designed to interfere with his medical care. It wouldn’t surprise me if they were doing surveillance on him. They took a recorded statement of him which he didn’t have to agree to. All of these things are issues lawyers would have given him a heads up on and protected him from which is the best thing an attorney can do.

A good lawyer, whether you find it here or elsewhere does just that. They protect you. And as it costs nothing up front and they don’t take a penny of your TTD or medical that is already being paid, it’s honestly a no brainer to hire an attorney as soon as you realize you have a significant injury. It’s not too late when a problem has occurred, but the whole idea is to avoid problems in the first place.

I don’t say this to try and get us more business. I say it because it’s simply the truth. If you want a free, confidential, no commitment consult, call us any time.

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