Phrenic Nerve Injuries And Illinois Workers Compensation

We are Illinois work injury attorneys who fight for our clients. To speak with a lawyer for free, fill out our confidential contact form or call us at 888-705-1766.

The phrenic nerve starts as a single nerve in the neck and splits into two parts, designated left and right. It is one of the most important nerves in the body. The phrenic nerve plays a critical role in breathing, as it sends signals between the brain and the diaphragm. When the diaphragm moves, it pushes air in and out of the lungs.

The nerves receive signals automatically from the brain to keep the body breathing. We don’t have to think to ourselves to take every breath. But we do have some control over the movement of our diaphragm, like when we decide to hold our breath or take deliberate, deep breaths.  You don’t think of this as a problem that would be associated with a work injury, but we are seeing it more and more.

Since the phrenic nerve is so critical to the work of the human body, an injury to the nerve can cause serious medical problems. The left and right nerves go down each side of the body, very close to the heart and lungs, so any problems in these two organs can negatively affect the functioning of the phrenic nerve and impair breathing.

Phrenic nerve damage is typically caused by:

  • A spinal cord injury
  • Physical trauma or neck injury from a motor vehicle accident
  • A physical assault
  • Trauma caused during a surgical procedure, most commonly cardiac or abdominal surgeries

The symptoms of phrenic nerve damage vary depending on whether one or both of the two nerves are damaged. If only the left or right nerve is damaged, a person may continue to breathe normally and experience no problems. If both the left and right nerves are damaged, one may go into respiratory failure, which can be life-threatening. Diaphragm paralysis is the most severe symptom as breathing is extremely labored and artificial respiration is required. Difficulty with hiccups is a less severe symptom. An irritated phrenic nerve can activate the hiccup reflex and make the diaphragm contract abnormally.

Restoring normal breathing is often accomplished with a breathing pacemaker, which takes over control of the diaphragm from the damaged phrenic nerve. The pacemaker electrodes are implanted around the phrenic nerve, the device activates the electrodes and contracts the diaphragm, restoring breathing.

If you are suffering from phrenic nerve damage due to a work-related injury, you are likely entitled to workers’ compensation. For example, if you were driving for your job, and a car accident caused the nerve damage, or if you had trauma caused by surgery for a work injury, your medical care and expenses should be covered by your employer’s insurance and you should be paid for all of your time off work and also get a settlement.

If you have any questions about workers’ compensation and your phrenic nerve injury, feel free to contact us at 888-705-1766.

Workers Compensation When You Are Attacked But Not Injured

I had a tough call with a really good guy recently. He works at a nursing home inpatient care and has been attacked by residents multiple times.  He’s been kicked, punched in the face, scratched, and most recently, had someone grab and break his glasses.  He doesn’t have a ton of money and was frustrated when his boss told him that they wouldn’t pay for new glasses.

According to my caller, they are understaffed and there aren’t enough people to pay attention to the residents or help him. His boss acts as if this guy is lucky to have this job.

He wanted to know if work comp would cover his new glasses. Unfortunately, it doesn’t.  As we talked more it became clear that he was really anxious about going in to work at all.  I’m not a doctor and don’t try to diagnose people (just like I don’t want doctors giving legal advice) but I did suggest that he talk to a psychologist or psychiatrist.

If his need for mental health treatment is related to being attacked, worker’s compensation would have to pay for it even if he doesn’t have a physical injury that required medical care.  And if his doctor feels that due to his anxiety he needs to be off work, they’d have to pay him until he’s cleared to return. That could be days, weeks, months, or theoretically forever.

This is all true because a physical incident, being attacked, lead in part to a mental breakdown. Would that have happened if his boss was more supportive? Who knows, but we do know that he wasn’t.  When you have a physical injury that leads to a mental breakdown, it’s covered under the Illinois Workers’ Compensation Act.  And when that happens, it’s a case just like a back injury or any other common work accident.

The point is that workers should be protected and while Illinois work comp laws aren’t perfect, they do help many workers who are getting treated terribly. If not for the job incidents there would be no need for medical care.  And like any other injured worker, he’s allowed to get this care 100% paid for, get compensated for his time off work, and eventually get a settlement.


Continued At Arbitration And Other Work Comp Words You Might Not Know

One trap too many lawyers fall in to, including myself at times, is to assume the person they are talking to knows things that we take for granted. If you are an iron worker, you shouldn’t expect that someone you don’t work with will understand what it means to be a journeyman or what rigging is.  Lawyers shouldn’t expect clients to know common legal terms either.

I try to talk in plain English, but sometimes don’t. Whether you are a client, potential client or someone just looking around, I want you to know what terms we consider to basic mean because they likely aren’t basic to you nor should they be. Here are some common ones:

Continued at arbitration- It sounds like a big deal, but it’s usually not. Basically every case comes up for a status hearing before an arbitrator. If there are no motions filed by you or the defense lawyer (and the case is three or less years old) then it will automatically get continued to the next status date in 90 days. When someone wants to know what happened at the status hearing, if the answer is “continued at arbitration” it just means it was continued until a status hearing about three months from that day.

Application for adjustment of claim- This is the paperwork you file with the Illinois Workers’ Compensation Commission to make your interest in getting benefits official. If you don’t file in time you will lose your rights.  Every case uses the same form.

The pinks or just pinks- You might here a lawyer say, “We are waiting on the pinks.”  That refers to the settlement contract because they are all completed on pink paper.

Commissioners- They are kind of like arbitrators (Judges) but they get involved when one party appeals a case. Your hearing would be before three of them. It’s not a new trial.  Each side writes a legal brief and then has five minutes to argue their side of the case.

TTD- This stands for temporary total disability which is the pay you receive when you are unable to work due to a work related injury.

Occupational disease- This is a work injury from exposure to chemicals or other irritants at work.  It’s generally filed just like a normal work comp case but is called occupational disease.  For most people it’s just terminology you don’t have to worry about.

Causal connection- This means that you can prove that your injuries are related to your job activities.  It’s usually done from doctor’s statements or your own testimony.

Full duty- This is when you are released to return to work by a doctor without any physical restrictions. Often your doctor will have you off work or on restrictions and a company chosen doctor will say you can work full duty.

MMI- This is short for maximum medical improvement which means you are as good medically as you ever are going to get.  It usually means that no more treatment is needed.

Consolidated- It’s legal jargon for when you have two or more cases filed at the Illinois Workers’ Compensation Commission.  A lawyer will file a motion to have them consolidated which means that instead of having two cases with two arbitrators, one arbitrator will handle both cases.  It’s more efficient for everyone.

Time barred- This means that you’ve waited too long to file an application for adjustment of claim or in other cases, too long to file an appeal or other motion. There are time limits to everything that vary based on the case.

If there are questions about any of these terms or anything else related to Illinois work comp law, you are welcome to contact us at any time for free.

Baker’s Asthma And Illinois Workers Compensation Law

Where the best Illinois work comp attorneys really separate themselves from the ones that dabble in it or don’t give great effort is when there are unique cases and injuries.  If a type of injury is so rare that a lawyer either hasn’t seen it or rarely sees it, they add value to the case and help the injured worker by their dedication and research abilities.  A clear example of a rare case is Baker’s Asthma.

Asthma is a common respiratory condition that makes breathing difficult. Asthma symptoms include wheezing, coughing, shortness of breath and tightness in one’s chest. Asthma is a minor nuisance for some people, but for others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack. Most people and lawyers are familiar with this.

Occupational asthma, or work-related asthma, occurs when a person breathes in fumes, gasses or dust on the job that leads to asthma symptoms. These cases are often fought hard by insurance companies as they will allege that the problem is either pre-existing or not work related.

A number of professions are on the list for being high-risk for developing asthma. The occupation we are focusing on here is baker. At first glance, that doesn’t seem like a job that could potentially hurt one’s respiratory system. You don’t see barrels of noxious chemicals in a bakery. Baker’s asthma is real though, and all too common.

What are the potential exposures in a bakery environment that can lead to baker’s asthma? The possible lung irritants include wheat, rye, barley and soy flours (and the dust from these grain flours), yeast, eggs, sesame seeds, nuts, mold, dust mites, and enzyme additives like cellulose. Those exposures may sound innocent enough on the surface, but when someone is weighing, sieving, and mixing those ingredients (and inhaling the dust generated from those tasks) on a daily basis over a prolonged period of time, the risk is certainly there.

If you are a baker, grain miller, school cook, or a teacher who conducts baking demonstrations regularly, and you believe you have developed baker’s asthma, it is important that you report this to your employer and seek treatment from a doctor.

Your doctor will perform a physical exam, and you may be given lung function tests. These tests may include a spirometry test, which checks how much air you can exhale after taking a deep breath and how fast you can breathe out, and a peak flow test, that measures how hard you can breathe out. Allergy testing may also be recommended.

Where a lawyer comes in is asking the right questions to your doctor in order to prove that the problem is work related and understanding the science behind how your job can expose you to this risk.  It doesn’t matter if you have a prior problem as long as you can prove that your job made the asthma worse or accelerated the issues you were facing.

I’d bet there have been less than five of these cases ever filed in Illinois, but I’d also bet that there have been hundreds of other potential cases that were never filed because the injured workers didn’t know it was a possibility. We love to educate the public and if even one person reads this and gets work comp benefits then it will be worth it.

We’ll always talk to you for free.  Call us any time to speak with a lawyer, 888-705-1766.

The Best Work Comp Attorney In Southern Illinois? They Aren’t In Chicago

We are experienced work injury attorneys who will talk to you for free and give honest advice.  We have a state wide network of attorneys who can help. Call us any time at 888-705-1766 to speak with a lawyer, not a paralegal, for free.

There are a few Chicago workers’ compensation law firms that do a lot of advertising. Billboards, TV, radio, etc.  There’s no law against that, but it’s just not my style, especially when they give themselves a nickname. I know it works because we get a lot of calls from their unhappy clients.

Some of the firms that advertise do a fine job and others, in my opinion, are lousy.  I find that they have so many clients that their customer service tends to suffer.

Their reach isn’t just in the Chicago area.  These firms are taking cases all throughout Illinois. While an Illinois law license allows you to practice anywhere, that doesn’t mean that a Chicago lawyer should take a case five hours away from their office.

Quite simply, the best workers’ compensation attorney in southern Illinois is not going to be someone from Chicago. They could do a good job for you, but what I find is that if a law firm in Chicago is handling a lot of cases far away from their office, they are sending their young, less experienced attorneys to handle the case.

I saw this first hand back in the late 1990’s when my career was starting.  I was sent on a plane to Alton, Carbondale and Belleville on multiple occasions to handle cases.  I did my best, but quickly realized that the local lawyers who were on a first name basis with the Arbitrators were better equipped to get a good result.

These early experiences inspired me to create a state wide network where I identified lawyers that I think do a great job throughout the state.  In other words, if you are hurt in Madison County, Decatur, Effingham, etc, I won’t try and directly handle your case, but instead will refer you to lawyers that I have known for years and who I think do as good of a job as any “big city” attorney.

The goal for any attorney should be to get the best result for their client. Any lawyer who’s so arrogant that they think they are the right one for you in every situation is lying to you.

This whole post was inspired after getting a call from a downstate injured worker who hired one of these firms that advertise a ton. When push came to shove and they needed a surgery that wasn’t approved by work comp, this firm didn’t go to court to get it for them, but instead tried to make them settle their case. Worse yet, it wasn’t even an attorney who was the main contact person but some inexperienced paralegal.

One word of warning. While there are many great downstate attorneys for work injuries, you need to avoid some of them. The best ones are almost exclusively handling work comp cases or have it as the main focus of their practice.  Beware the ones who try to take on any case that comes through the door or handle non-injury cases like divorce, traffic, etc.  I highly recommend that you ask them how many work comp cases they’ve taken to trial in the last year. If the answer isn’t at least five, it’s a bad sign.

The Work Comp Judge And Other Illinois Work Comp Questions

We are lawyers for workers’ compensation claims. If you have any questions you can fill out our contact form or call us at 888-705-1766 to speak with an attorney for free.

We get so many good questions from callers.  Not all are worth a full blog post.  Here are some of the best ones from the last few months:

My case went to trial and the Judge (Arbitrator) interrupted my attorney and asked me questions. Is that allowed or normal?

It’s definitely allowed and to me it’s a good sign as it shows that they are paying attention and thinking about what happened to you.  They are the ultimate decider so they can ask whatever they want.  It doesn’t happen in every trial, but it’s not unusual either.  Bottom line is it’s nothing to worry about.

My settlement contracts had to be mailed to the Arbitrator.  How long until he approves them and mails them back to my lawyer?

Usually it’s pretty quick, a week or so.  That said, there is no time limit. If they get sick or go on vacation or just don’t get to it, you can’t force them to do their job. If it doesn’t come back within a month I’d ask my lawyer to bring them in person to the next court hearing.

Should I expect a disability rating when I get the IME?

Honestly, no. It could happen, but almost never does and really isn’t relevant for Illinois work comp cases.

What happens when I’m put back on work status by my doctor?

If there are no restrictions, you return to work. If there are some restrictions, you see if your employer can accommodate you and if so, you return to work. If you return and can’t tolerate it, you immediately go back to your doctor and let them know.

I’ve been off work for four months from a work accident and now they want me to do a FCE. Isn’t that kind of soon?

It’s really soon and makes no sense to me.

Do insurance companies really check in to social media? Am I safe if I keep my accounts private?

Yes they do that all the time. Even if your account is private, that doesn’t prevent a “friend” from sharing something. Never discuss your case on social media, even if you are seeking out help. There are some good support groups out there. If you want to join one, create a fake profile with a fake name and join that way. Even then you can’t give away too many details.


I hope these help. As always, if you have questions or want to discuss a case, contact us at any time.

A Warning For Injured Jewel Food Workers

For most injured Illinois workers, you get to choose your own physician if you get hurt on the job. If you don’t like that one you have a right to a second opinion. The work comp insurance company has to pay for both of these medical providers as long as the treatment is reasonable and related to your job injury. If you seek out a third opinion without approval or a referral from one of the first two doctors, you have to pay for that.

A few years back the law was amended to allow an employer to create a preferred provider program. Basically this states employers can create an exclusive list of medical providers if their program is approved by the Illinois Department of Insurance.  An injured worker can choose to treat with a medical provider who is not on the list. But doing this constitutes one of the two choices of medical providers. Their doctor is essentially your second opinion.  There aren’t too many companies who have created a preferred provider program in Illinois, but they are out there.

But even before that, a law was passed that until recently hadn’t been used and presents a warning for Jewel workers in Illinois.  The Illinois Workers’ Compensation Act has a big exception to workers choosing their own doctor in the “Panel of Physicians” provision. If a “panel of physicians” is in place by an employer, workers hurt on the job only treat with medical providers from this list, unless there are extenuating circumstances or a panel physician makes a referral to a provider not on the list.

The good news is that these panels can only be created if there is an agreement by the representative of the employees (e.g. a union) and it’s approved by the Illinois Workers’ Compensation Commission.

Why the Jewel union agreed to this is beyond me.  It really is not in the best interests of their workers.  That said, it’s there.  There are two major problems with it in my opinion:

  1. It can take away your choice as to which doctor you are treating with.  You might have an established relationship with a physician you think is great and know cares about you.  If they aren’t on that list, you can’t see them.
  2. If you don’t know about this agreement and get medical care outside this panel, you will get stuck with the bills even if your injury is work related.

Imagine if you hurt your right knee a year ago in a car accident and had surgery.   The surgeon did an amazing job and you made a quick and complete recovery. They checked up on you, got you the best room at the hospital, gave you their cell phone number for emergencies and were available for any questions. If you then hurt your leg again at work, doesn’t it make sense that you’d  want to see this doctor and they’d be the best choice for you?  Of course.  But if they aren’t a part of this panel, the only way you can see them is if a panel doctor turns down your business and gives you a referral.

Not all the doctors on this list are bad, but it doesn’t change the fact that you should have a choice over who cares for your injury. So if you are a Jewel worker, be careful. You don’t want to be hurt and stuck with a bill.  This agreement certainly puts you at risk.

If you have any questions about this or anything else related to Illinois work comp law, please contact us any time for free at 312-346-5578.

How Your Work Comp Case Can Be Accepted For A Year And Then Denied

We are Illinois work comp attorneys who care about our clients. Call us at 888-705-1766 to speak with a lawyer for free any time, or fill out our contact form.

Often in workers’ compensation claims, things happen that don’t seem to make sense or seem like they might be against the law. Often that is true such as when the insurance company tries to have a nurse case manager attend your doctor’s appointments.  That’s not allowed, but some of them act like bullies and will do this if you don’t stand up for yourself.

Other times something happens that seems wrong, but is actually allowed. The most common example is when you get hurt at work, your case is accepted, your benefits are paid, often for a long time and then they get denied. It’s not unusual for your claim to be accepted for a year or more and then suddenly you get a letter saying you have no case.

This usually happens when someone is hurt at work and the insurance adjuster takes their doctor’s word that it’s work related. Eventually a certain amount of money gets paid out on the case which in the insurance company triggers a review by a more senior person.  They do this because they don’t want to pay a lot on any case. This senior person will come up with a strategy which often involves sending the worker to an IME which is an appointment with a company chosen doctor who will evaluate you and offer an opinion on what treatment you need and if your injury is work related.

This doctor often is a hired gun who makes a ton of money by writing reports that benefit the insurance company.  If they do, the insurance company can deny your case.  They are not your doctor and they aren’t looking out for you.

So how is this legal if they’ve paid out benefits for a year or more?

Under Illinois work comp law, payment of benefits is not an admission of liability.  If they discover new evidence on your case such as you posting on social media that you really weren’t hurt at work, they can cut you off.  And as shady as it may seem, their IME is new evidence which can be used to deny a case even after it was initially accepted.

A recent caller to our office had been receiving benefits for about 18 months when his shoulder injury got denied after an IME who said the injury was from something that happened ten years prior.  It’s a ridiculous reason to deny a case, but it is allowed under Illinois law.

The good news is that it’s a solvable problem. Arbitrators at the Illinois Workers’ Compensation Commission aren’t stupid.  They know who the hired gun doctors are and they don’t usually give much weight to their opinions, especially when your treating doctor is reputable.

Quite honestly, this is one big reason to have a lawyer even when the case is accepted.  You’ll have someone who can prep you for the IME and if your benefits do get cut off, getting before an Arbitrator will happen much faster.  Prepare for the worst and hope for the best is our motto.

Do I Even Need A Workers’ Compensation Lawyer?

One thing about our law firm that makes me proud is that people who read this blog seem to feel that we are approachable. I want you to know that you can always call us to speak with a lawyer for free.

We are experienced and honest and will bluntly tell you what we think about your situation, if you have a case and what you should do.

A common statement we hear from people that “Everyone is telling me that I should get a lawyer.  Do I even need one?”

I’m probably one of the few attorneys who will tell you when you don’t need a lawyer.  If it’s a minor injury then a lawyer likely won’t add a ton of value for example.  On the other hand, with bigger injuries it’s usually a good idea to at least have a conversation about it.  Here are some of the reasons:

  1. It costs nothing up front to hire an attorney. So waiting until something seems to go wrong doesn’t save you any money.
  2. You might think the insurance company is being nice or that everything is alright because you are getting paid, but you might getting taken advantage of and not know it. Some shady things the insurance company will do that shouldn’t happen are to ask for a medical release of all of your medical history, have a nurse case manager talk to your doctor directly, record conversations with you or ask irrelevant questions about old injuries. They are essentially doing whatever they can to come up with a reason to cut you off even when they seem nice.
  3. If you wait until your benefits are cut off before getting an attorney, you will likely delay justice by a couple of months as the lawyer has to gather records and investigate your case.
  4. Insurance companies sometimes cut off benefits for no good reason at all. Sometimes when you have a lawyer on the case they don’t play games because they know they can’t get away with it, especially if your attorney has a reputation for fighting for their clients.
  5. Getting a lawyer isn’t bringing a lawsuit.  Work comp is a claim for employee benefits and we make sure you get what you are legally entitled to under the law.
  6. In almost every instance, you will get more from a settlement with a lawyer than without even after their 20% fee.
  7. Experienced Illinois work comp attorneys know the right doctors for your injury and who are insurance company hired guns.  You’d never think that choosing a doctor could destroy your case but it happens.
  8. If your injury is serious, at some point the insurance company will send you to an IME which is a doctor of their choosing. Not having a lawyer prep you for that is a huge risk.
  9. There is no requirement that an insurance company make you a settlement offer but if you get a lawyer they will.
  10. Having an attorney in many ways is a security blanket.  You are protected if something goes wrong, you have someone to ask questions or and you don’t get taken advantage of.

I get why people wouldn’t want a lawyer. Most sane people don’t want any situation in their life when they need an attorney.  It would be nice if insurance companies did the right thing at all times and followed the law, but the reality is that doesn’t happen. They are in it to make money and they do that by paying as little as possible to you.

So is it required by law to get an attorney when you are hurt on the job in Illinois?  No. Is it safe and smart?  Absolutely.

If you aren’t sure what to do or just have questions, fill out our contact form or call us at 888-705-1766 to talk with a lawyer for free.

Bonus Compensation And Average Weekly Wage For Work Comp

Under Illinois workers’ compensation law, the amount you get paid for your time off work and your settlement is based on your average weekly wage (AWW).  If you make $20 an hour and work 40 hours a week, your average weekly wage is $800. It’s not usually complicated. If you are salaried, we divide your salary by 52 weeks.

The goal is for your AWW to be is high as possible.  We want you to get every penny you are legally entitled to.  While the wage calculation is straight forward in most cases, in others it’s not.  This is true when there is bonus compensation.

The good news is that the lines on this issue are getting less blurry thanks to a recent court case.  Ironically it’s all thanks to an insurance adjuster for Zurich Insurance. In her job as a claims handler, she was injured while attending a mediation when a door hit her shoulder and back.  As part of her claim she argued that her bonus compensation should be included in her average weekly wage.

At trial she testified that she had job duties which included a diary management system that measured performance. Every month she met with her manager to discuss how much money they had recovered versus their goals. How well she did or didn’t do affected her compensation.  Failure to complete a diary on time had negative financial implications for her. Her work was clearly part of an incentive-based pay program.

When part of your bonus is a result of incentive payment, it should be included in your AWW calculation.  This case made me smile because work comp insurance companies like Zurich spend a lot of time and effort trying to limit how much compensation injured workers receive. In this case it was one of their own insurance adjusters they were trying to screw over and ultimately their improper actions have helped clarify what the law is.

For you, as an injured worker, if your bonus is at all a result of your performance (as compared to everyone getting the same holiday bonus for example) then we’d argue that your work comp payments should be based on that money.  This means more money in your pocket so it’s important to get it right.

The lesson is that if an insurance company will not do the right thing for one of their own adjusters, you can’t expect them to do the right thing for you.  If you’d like a free consultation with an attorney to discuss what your wage should be or anything else about your claim, please fill out our contact form or call us at 312-346-5578.  We cover all of Illinois.