When You Have A Pre-Existing Injury You Never Knew About

Dealing with insurance companies on Illinois workers’ compensation cases often feels like a game of cat and mouse. We only represent honest workers with legitimate claims. Insurance companies will still treat some of these people like scammers and fight cases that shouldn’t be denied. They will also use questionable and sometimes outright gross tactics to deny benefits.

One tactic they try to use deals with injured workers who have a “pre-existing” injury. Of course if you go to a doctor on Monday for back pain and then report a work related back injury that Tuesday, it makes sense they’d fight your case.  Those aren’t the tactics that concern me.

The ones that bother me are injured workers in IL who hurt their back two years ago, have been fine since and then had a big aggravation of that prior problem at work today.  Under Illinois work comp law, any argument that the prior problem should prevent you from getting benefits is ridiculous.

But the worst one of all is for people who didn’t even know about a prior injury?  How is that possible? Let me explain.

Let’s say that you break your leg a month ago at work.  It happens when a forklift runs in to you. Pretty straight forward case, right? Should be.  But then you go for X-rays or a MRI and it reveals an “old fracture” which seems odd to you because you never broke your leg before.  The reality is that maybe something happened to you as a baby or what you thought was a sprain in your later years was really a small bone fracture. You never notice it because it required no treatment and hardly limited you.  We see this a lot with former athletes and people who have been in car accidents.  You can imagine a teenager playing football gets hit in the leg, has some pain, but plays through it.

Now 20-30 years later you are a regular working person and have this accident.  You go to the mail one day and see a denial letter from the insurance company because some doctor says your need for surgery is really related to this old fracture, not getting hit by a forklift the other day.

It sounds absurd but it really happens. People are stunned to be denied for a pre-existing problem they never knew about.  And sadly some people fall for this and stop pursuing their work comp case.  That’s why these insurance companies do it. It’s simply a gamble they take to try and save money.  You end up with out-of-pocket expenses you’d otherwise not have.

The good news is that even in a system where insurance companies tend to get away with a lot, I can’t recall a time in my 24 years of being an attorney with this tactic has worked if they get called out on it.  It’s simply not defendable and defies logic.  What it really is though is a warning sign to any injured worker that you always need to be cautious and look at insurance company claims with a skeptical eye.  They don’t pull this nonsense on every case, but on most claims, they will try something to deny your case even when they shouldn’t if they are following the law.

We are Illinois work comp attorneys who will talk to you for free about your case.  Call us any time in confidence at 888-705-1766.

Illinois Work Comp When Injured Off The Clock

The reality is that many Illinois work comp cases are not 100% straight forward.  By that I mean most cases aren’t caught on film or have an insurance company giving you everything you want. Even when it’s crystal clear that you were hurt at work, at some point the insurance company will try to fight you or limit your benefits through an IME, surveillance or just denying your claim for no reason.

In some cases, the initial facts can cause good cases to get denied because they look a little off.  The best example I can give of that is when someone is injured after clocking out.

If you are an hourly worker, while your pay may be tied to when you are clocked in or out, it doesn’t work that way when it comes to Illinois workers’ compensation law. Let’s say your shift is done at a hospital and you’ve clocked out from your nursing job. You are walking out of the facility when you hear a co-worker asking for help with a heavy patient. You aren’t a jerk, so you go over and help lift that person and injure your back.  That would be a good work comp case because your actions are benefiting your employer.

Even if you’ve clocked out and aren’t doing job duties, you can still get benefits if you get hurt.  I’ve seen workers who punched out and then while walking down a hallway slipped on a wet floor.  Any resulting injury would be a good Illinois workers’ compensation claim. That’s true because you had to walk down that hallway as part of your job and the wet floor put you at an increased risk of injury.  The fact that you weren’t “working” when it happened is irrelevant.

This can also be true if you are hurt before you start your shift.  Any of the same facts I listed would have the same result of you having a good case. If you are required to park in an employee parking lot and get hurt their at the start or end of the day, you’d likely win too.

You can even potentially get benefits when you are nowhere near the job site. The most common example is if you have a job where you drive a company car that has an advertisement for the business on the vehicle.  Your job is promoted by your driving so accidents in that car could be considered work related.

Where you don’t win when you are hurt off the clock is when you greatly deviate from the job. By that I mean if at the end of your shift you stick around and have a bunch of drinks, falling off your chair wouldn’t be a great case for work comp.

Bottom line is that you should talk to a lawyer about any accident, no matter what the insurance company tells you.  We are happy to discuss your situation for free any time.  Call us at 888-705-1766.  We handle cases all over Illinois.

How To Prove Your Injury Is Work Related

We are experienced Illinois work comp attorneys who will talk to you for free.  Call us any time at 888-705-1766 to speak with a lawyer. We cover all of Illinois.

One of the basics of the legal system, no matter what your case is, is that if you are bringing the case, you have to prove you deserve to win.  The defendant generally speaking doesn’t need to disprove anything.

So how do you prove in Illinois that your injury is related to your job?

Like most work comp questions, the answer depends on the facts of your case. In general though, these are the factors that Arbitrators consider in deciding whether or not to say you won your case. They are the same factors that insurance companies consider when deciding whether or not to accept your case or offer you a settlement.

  1. What do you say happened? If you hurt your back lifting a box, is your version of what happened credible. In many cases you are the only witness so your reliability is a big issue.
  2. Did anyone see what happened to you? If you slip on a wet floor, did someone see it?  If they did, their statements can help or hurt you.
  3. When did you report the accident to your employer? While under Illinois law you have 45 days from your accident to report your case, telling them about it right away enhances your credibility. Not doing so gives them a potential defense.
  4. What did you tell your doctor about how you were hurt? Insurance companies will look at your medical records when making a decision to accept or deny your case. If you tell your doctor on your first visit that you were hurt on the job, it enhances your credibility. If you say you don’t know how you got hurt, even if you change your story later, it will hurt you.
  5. When claiming that you are injured due to the repetitive nature of your job duties, you prove you were hurt at work by your doctor stating it’s true. In those cases, it comes down to their credibility. You enhance that by making sure they have an accurate job description of what you do, how often you are doing it, how heavy the stuff you lift is, how much force you use when using your hands, etc.  The number of cases that are lost because workers don’t tell their doctor an accurate description is shocking. Often it’s a sign of a bad lawyer representing them.
  6. What is your medical history?  Pre-existing conditions don’t prevent you from getting Illinois work comp benefits.  But you still have to prove that your work injury was more than a temporary aggravation. If you’ve been treating for a back injury continuously for months and then say your job made it worse, the only way to prove that is likely through a new MRI. On the other hand if you last had treatment for your back a year ago, if a new work injury causes you to need medical care, your old problems won’t likely be a huge factor. The insurance company might try to make it one, but in most cases it shouldn’t be a problem.

These are in my opinion the six big issues in proving you did get hurt on the job and are entitled to benefits.  As always, please call us any time with questions or concerns about your case.

What Can I Expect For A Settlement In My Illinois Work Comp Case?

By far the most common question an Illinois injured worker has is what can I expect for a settlement of my case?

The answer depends on so many things. I get this question a lot when someone has been recently injured or is in the middle of their treatment. For those people, the answer is, “I have no realistic idea,” because we don’t know what your ultimate recovery will be.  We can make educated guesses, but the reality is that if you have surgery, the value of your case will increase. If you can’t return to your normal job or have permanent restrictions, the value of your case will go up.  We, of course, don’t know those things early on right after you get hurt.

We also don’t know soon after you are hurt what the defenses will be to your case.  A good IME doctor for the insurance company can cause your case to be worth less. Surveillance can reduce the value of your case if you are caught doing something that is beyond your medical restrictions or contradicts what you are telling your doctor. Making an unexpected great recovery or having an employer surprisingly give you a job within your restrictions will change the value.

So telling you what you can realistically expect isn’t something we can accurately say at that point.  We can give a range, but the best advice you can get from us early on is to focus on your treatment and things to look out for like nurse case managers, surveillance, insurance company tricks, etc.

Other clients/callers want to know what they can expect for a settlement as their treatment is wrapping up. We can give a much more likely outcome of what will happen at that point.  But if we aren’t your lawyer or even if we are, an accurate expectation of what you will get can only be made in most cases by seeing your medical records.  Those little details matter. And if you are just calling us for the first time we need to know your age, job history, wages, medical history and many other things. In other words, it’s not a quick answer if you want an accurate one.

My bonus tip is that the time to really think about a settlement is when your medical treatment is ending.  And if you are able to get back to work, the time to ask for a settlement is when you’ve gone back to work and are able to do your job without problems.

No matter what your question or situation, our lawyers are happy to talk with you for free. Call us at 888-705-1766 any time.

Truck Driver Leg And Foot Injuries

If you would like to speak to a work injury attorney for free, call us at 888-705-1766 or fill out our contact form and we will call you.

We have helped thousands of truck drivers over the years with workers’ compensation cases.  Many of these are based out of Illinois.  Others were injured while traveling through Illinois.

While the most common truck driver injury comes from accidents in the truck or slip and falls, there is one other cause of leg, ankle and foot injuries that don’t get talked about enough.

Many of the drivers we have helped have been injured due to the repetitive act of jumping out of their truck cab.  Over the years we’ve seen meniscus tears, foot fractures and most recently, a severe case of plantar fasciitis from the pressure of landing from a 3-5 foot drop on a regular basis.

While everyone who drives a car has to get in and out, truck drivers have a unique risk to their job due to the height that they sit at. Under Illinois workers’ compensation law, if your job duties increase your risk for injury and you do get hurt, it is a work comp case.

For our Illinois based drivers, filing the case here is not an issue. If you are based out of another state and drive through Illinois, you’d have to show that either you primarily drive in Illinois or the last time before you got hurt you were here.

While an office worker can get by with many leg injuries, a truck driver of course needs both of their legs/feet in order to do their job.  So usually if they have any medical restrictions it will prevent them from doing any work at all. If that happens they are entitled to TTD benefits for their time off of work and of course payment of all of their medical expenses.

For whatever reason, many truck drivers don’t connect going in and out of the truck with their leg and foot injuries. And of all the professions out there, insurance companies try to screw over drivers more than any other job that we see.  That of course doesn’t prevent you from getting benefits, it just means that they don’t always follow the law as they hope you will simply go away.

The other big cause of injuries to drivers is the heavy pressure on their legs from shifting, accelerating, breaking, etc.  It’s not unusual to see knee, quad and foot problems to develop over time from these activities.

Our best advice is three things:

  1. Make sure you make your employer aware of the problems you are having.
  2. Get medical treatment as soon as possible.
  3. Give a very descriptive account of your job details to your doctor.  If you think your injury is from jumping in and out of the truck, they should know how long you’ve done the job, how often you jump in and out, how far the drop is (measure it), the type of shoes you wear, what you notice physically when you land, etc.

And as always, if you want to discuss any of this for free, get in touch with us at any time.

Illinois Work Comp Insurance Companies Illegally Talking To Your Doctor

We are Illinois work comp attorneys who will talk to you for free about your case. Fill out our contact form or call us at 888-705-1766 any time to speak with a lawyer.

One somewhat unknown and often abused Illinois work comp law is that the insurance company and your employer can not talk to your doctor about your treatment without your permission. Before injured workers get an attorney, it’s common for an insurance company to assign a nurse case manager to your case and/or get you to sign a form that gives them permission. They create the impression that if you don’t sign or allow their nurse to be at your appointments, your bills won’t get paid.

One of the first things Illinois work comp attorneys do is make sure that the insurance company doesn’t talk to your doctor. This protects you because in almost every instance what they want to do is interfere with your medical care in a way that will save them money even if it hurts your health.  Our goal is for you to get treatment based on what your doctor thinks.

Insurance companies aren’t billion-dollar organizations because they just give up.  Stopping their tricks is like a game of whack-a-mole.  You beat one down and another one pops up.

On a case we are involved in handling, an insurance company did something very sneaky.  Once the client has a lawyer, the insurance company can’t talk to them. The employer isn’t allowed to discuss the case with them, but can talk about other things and often will ask questions about the case under the guise of acting like they are trying to plan for staffing.

The worker we are helping has a very serious injury and is completely off work.  Their boss asked them to have their doctor fill out a form that could lead to them accommodating her with some restrictions even though her doctor has clearly said she should do no work right now.  Basically, it’s a Hail Mary to try and bug the doctor enough that they say, “Sure, I guess you can try that.”  If you don’t, then your TTD benefits get cut off.

It’s sneaky, probably illegal, and not done in good faith.  I can tell you that our client really wants to get back to work.  They also don’t want to make their problem worse by going back too soon.

You should never hand off a form like this without your attorney telling you that it’s alright and it almost never will be alright.  This is a protection you have and should not let the insurance company violate those rights. I promise you that they don’t care about your health no matter what they say or how nice they say it.

Being On TTD Doesn’t Mean You Are A Prisoner

So here’s an interesting story, at least as far as Illinois work comp law goes.

This really nice guy called me after getting a back injury at work.  He’s done EVERYTHING right. He reported the accident right away.  He got medical treatment right away.  He told the doctor he was hurt at work.  He has been following closely the doctor’s orders of no lifting more than 30 pounds.

He’s off work for at least six weeks.  His wife was going to visit a family member in Florida and wanting to get out of the cold and bored at home, he joined her. Doing everything right, he packed a suitcase that can’t hold more than 25 pounds and headed on his trip. He’s in pain, but not crippled.  He’s doing his physical therapy partly by Zoom so he won’t be missing any of his scheduled medical appointments.  This guy is a rule follower and wants to do EVERYTHING right, get healthy and get back to work.

He also wants to live life. So while on this trip with his wife he took a stroll on the beach and took a really nice photo while the sun was setting. He then went and posted it on his Facebook page. As you can probably guess, somebody at work didn’t like a guy who is hurt being able to have fun in the sun while they were working. So now they are threatening to cut off his work comp benefits.

Even though this guy tries to do all the right things, one mistake he made was not staying off social media. If you have a case you can expect that people from the insurance company will be stalking you, hoping that they can show you lying or take something out of context to hurt you. This is one of the first thing most lawyers tell their clients when they sign up a case.

All that said, being on TTD benefits or having medical restrictions does not require you to be a prisoner in your own home.  You can go to dinner, the grocery store and even take vacations.  All you need to do is make sure you aren’t violating medical restrictions or missing important medical care that can aid in your recovery.

This great worker was doing nothing to harm his health.  He was on a plane for a couple of hours and then walking around in warm weather with his wife.  There is nothing wrong about that no matter what some jealous or vindictive co-worker thinks.  He’s not gaming the system.  He’s getting better and living his life.

Illinois work comp benefits don’t make you a prisoner in your own home or invalid or anything that anyone else thinks you should be.  And the good news is that while this was a scare for him, nothing is going to happen because he did nothing wrong.

Hearing Loss And Illinois Workers’ Compensation

Hearing loss cases are unique because we all are exposed to loud noises at various times of the day.  If you live in Chicago it’s probably worse for you than if you live in a more rural area like Champaign or Belleville, but no matter where you are, there are likely cars honking, people yelling, trains, etc.

To establish that a hearing loss is work-related, while you do need a doctor’s opinion, you also typically have to show that you work in a high-risk job.  Construction workers, factory workers, those on assembly lines, and surprisingly, security workers (often working at concert venues) seem to be the ones we most commonly see being able to prove a work-related hearing loss. No matter your job you’ll need to show continuous exposure to loud noise over a long period of time.  It’s helpful if your employment screening test also shows a baseline of what your hearing used to be so you can show what actual loss you sustained.

Of course, you can also prove hearing loss from a one-time injury.  We recently worked with a gentleman who ruptured his air drum and had a complete loss of hearing in one ear while on the job.  Those cases are more unique, but they do happen.

When talking to your doctor, we are interested in decibel loss and their opinion as to whether or not your job duties contributed to that happening. You need to make sure they have a clear understanding of the work you do, the noises you are exposed to, the frequency of that exposure, and the safety measures you have used.  In many cases, it makes sense to actually measure the noise level at your job so we can prove your physician had the full amount of information.

The most valuable and unfortunate Illinois hearing loss cases are when your loss is so significant that returning to your normal job duties puts you and others at great risk.  In most of the jobs where hearing loss happens, being able to communicate is not only important to do the work, but it literally could save someone’s life. If you are operating a forklift and can’t hear a warning that someone is in your path, you shouldn’t do that job.

The good news is that if you are forced out of your regular work and your employer can’t find a new job for you, they have to compensate you while you look for a safer job.  And if there is a big wage loss, which is likely since many of these injuries happen to well-paid union workers, the insurance company has to make up the difference of what you could be making on your old job versus what you can make now.

My best advice is to not delay medical care if you notice your hearing starting to slip.  It’s not like a back injury that can debilitate you right away and catching it early can save you.

We have helped many workers with hearing loss issues and would be happy to talk to you for free about what happened to you.  You can start an online chat, send us an email by filling out our contact form, or call us any time.

Illinois Work Comp When You Have Unpaid Medical Bills

A common call for us to get goes something like this:

“I was injured at work in Chicago two years ago.  I went to the ER and told them I was hurt at work. The other day I get a collection notice as it turns out my employer never paid the bill.  I don’t work there any more.  Is there anything I can do?”

One of the first things I advise every injured Illinois worker is to keep a journal which includes the list of EVERY medical provider you see.  Since hospitals bill in a weird way it doesn’t guarantee that you’ll catch every bill out there, but it helps.  I then suggest that within six months of seeing those doctors/providers that you contact them to see if any money is owed.

The reality is though that most people are trusting and when an insurance company or employer says they will take care of a bill, they assume it will happen.  So what do you do when you discover unpaid medical bills?

Under Illinois law, you have three years from the date of an accident to file a case.  So if three years hasn’t passed, you should get with an attorney right away so they can file an Application For Adjustment of Claim with the State.  This prevents you from losing your right to get the bill paid due to waiting too long.

If three years have passed, you need to determine if any medical bills related to your case or TTD benefits were paid in the last two years. If that has happened then your time limit to file has been extended, but you should still act fast.

If all else fails and you’ve waited too long, I’d still contact the insurance company to see if they’ll pay it. Sometimes they will by mistake.

For those of you with active claims already, I highly recommend that before you settle your case that you reach out to every medical provider.  Do not sign a contract until you’ve done that.

If during the case you get a bill, you need to turn it over to your lawyer or if you don’t have representation to the insurance adjuster.  While it’s illegal in Illinois for a medical provider to try to collect from you or harm your credit while you have an active case, you don’t want unpaid medical bills sitting out there for a while. If the insurance company isn’t paying them they have to have a good reason. If they don’t you can file for penalties against them which will force payment  and also result in a fine that will go in your pocket.

Bonus tip, there are no co-pays in work comp cases. So if you get a bill that says the insurance company paid $X and your portion is anything above $0, don’t pay it. There are no deductibles or contributions required on your part.

I hope this makes sense. If you have any questions you can call us at 888-705-1766 any time. We help with work injuries everywhere in Illinois.

Are You Afraid To Bug Your Work Comp Attorney

I recently had an online chat with a very seriously injured worker. He was upfront that he had a lawyer and wanted to know my opinion as to what his case was worth.

I explained that I couldn’t answer it because I didn’t have a copy of his medical records or know about his job duties, age, wages, work history, etc. He went on to tell me that he still needed back surgery.  At that point I let him know it’s impossible to answer his question about what the case is worth. I said that because we don’t know what his ultimate recovery will be.  Whether or not he has any medical restrictions or can return to his job will greatly impact the case value.

The conversation led me to ask why he wasn’t asking these questions to his lawyer. I also expressed concern about whether or not he had the right lawyer for such a big injury.  He told me, “I can call my lawyer, but don’t want to bug him.”

My reply was to tongue in cheek ask this injured worker why he was alright with bugging me. I let him know I was kidding, as I’m happy to talk to anyone, any time.

In the bigger picture though, your attorney is there to help you through the case.  If you have information about your claim or questions about what is going on, you should call or email them. Doing that isn’t bugging them, it’s asking them to do their job.

Customer service or the lack of is one of the biggest issues of the legal profession.  If your attorney doesn’t tell you when you sign up with them that you should reach out to them any time you have questions, it really makes me wonder if they care about you or your case.

What you shouldn’t do is call multiple times a day on a repeated basis.  But calling today and then a few weeks from now and then emailing a week or two after that is really normal, especially early on in the case. And if you are going to an IME or have some other big event, I would expect that you’d call them before it happens as well as after.  Same if you have a surgery.

Whatever the situation, you should never feel like your valid concerns are bugging the lawyer.  They aren’t special. They work for you and this is how they earn their 20% fee. I assure you that if you are calling too much they will let you know.  But if you don’t expect customer service from them, you probably won’t receive it.

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