Post Surgery Complications and IL Work Comp Law

By Mike Helfand on Posted in Injuries

I was in a year round Christmas store recently. They had a lot of fancy Christmas ornaments and other items. Many or these were made of glass or otherwise appeared very fragile. In every section of the store was signage that said, “You break it, you buy it.” Some of these items were really expensive and I walked very gingerly throughout the store. It was almost a relief to get outside unscathed.

You break it, you buy it can apply to a lot of areas of life. That includes Illinois workers’ compensation law. A recent caller to our office is a great example why.

Long story short is that she had a lifting injury resulting in a hernia that required surgery to repair it. That part of the case and surgery went fine. The problem was that there were post surgery complications including blood in her urine, diverticulitis, and severe intestinal pain.

The work comp insurance company is balking at paying for additional treatment for her for these post surgery complications. The problem for them is that the saying of “you break it, you but it” applies to Illinois work comp cases too.

In other words, any injury that stems from the original injury is part of the work comp case. That means that any post surgery complications that would not have happened without the surgery are part of the work comp case.

So all of the medical care that is related to this should be covered by work comp insurance. They are trying to argue that she had diverticulitis before this, but the reality is that it was not something that required any medical care in any way for years for her. This surgery triggered the need for additional care. It’s just as much a part of the work comp case as the hernia injury itself.

And if for some reason this becomes a permanent, life altering injury, they will have to pay for that too. As long as your problem can be traced back to the original work related injury, it is all a part of one case.

This scenario is a lot more common than you think. It might not always be an intestinal injury, but could also be PTSD, arm injuries from being placed in a weird way during surgery, foot drop from a spinal surgery, sepsis from infections during surgery or even death.

The job of the insurance company is to look out for their bottom line. That is why they fought this case and will usually fight any similar situation. They are hoping that you as an injured worker will not know your rights. But the reality is that they do not usually have much to stand on when push comes to shove. They will need a credible doctor to state that the surgery did not result in these other problems needing medical care. That is a huge hill for them to climb.

So if this happens to you, do not stress. It is a solvable problem and one we would love to help you with. Please call us any time for a free case review at 312-346-5578.

Amazon Vendor Tries To Deny Injured Worker (and Loses)

By Mike Helfand on Posted in Tips if Injured

One thing we do as Illinois workers’ compensation attorneys is constantly read case law on newer cases. Every month there are new decisions at the Illinois Appellate Court. Sometimes these decisions change what the law is, or at least how it is interpreted. Other times these cases provide a road map on how similar cases should be decided in the future.

I do not always agree with these decisions, but most of them make sense. That is certainly the situation on a case that was decided this year for an injured worker who was hurt in August of 2023.

Side note. A lot of Illinois work comp attorneys lie to their clients and claim that if you go to trial it will take forever. I often hear that some attorneys tell injured workers that just going to trial will take 2-3 years. In this case, the worker got hurt, went to trial, won within a few months of getting hurt and the appeal was decided a few months after that. There were two more appeals which is why the case was not finally resolved until this year, but a normal trial does not take very long to happen if your attorney fights for you.

Here is a summary of the case:

Jose Avila was working as a delivery driver for I Deliver Logistics, delivering Amazon packages. While driving in Aurora, another driver cut him off. Avila honked and made gestures. The other driver got out of his SUV, approached Avila’s truck, and punched him. A short scuffle followed.

Avila got back in his truck and drove a few blocks away to make his next delivery. About four minutes later, the same men followed him, jumped him from behind while he was delivering a package, badly beat him, and stole his chain. He suffered facial injuries, broken teeth, a broken nose, headaches, and PTSD. He needed medical treatment and was taken off work.

An arbitrator awarded him workers’ compensation benefits, finding the attack was a “street risk” of his job as a traveling employee. The employer appealed, and the Workers’ Compensation Commission reversed, saying Avila was the aggressor and caused the fight.

The circuit court disagreed and reinstated benefits. The Appellate Court agreed with the circuit court.Even if Avila acted angrily at first, the video showed the other driver threw the first punch. More importantly, the second beating happened minutes later, after Avila had driven away and returned to work. The attackers chose to follow and assault him again, which broke any connection to the earlier argument.

The court reinstated his benefits and sent the case back to the Commission to decide whether penalties and attorney’s fees should be awarded against the employer. Eventually this case settled because the insurance company had no other choice.

My Thoughts On This Case

This is clearly the right decision. It can be expected that if you drive around for your job, you will encounter other drivers. Some of these drivers will be assholes or criminals.

These crazy drivers attacked him. He was injured. The argument against him was that he started it by making gestures. That is nonsense. The attack happened after he left the scene and these people chased him down. They clearly were the aggressors.

What is nuts about this case to me is that aside from it being so clearly a compensable case, his injuries were not that big. They likely spent almost as much on fighting the case as they paid for the settlement. They probably thought that an attorney would not spend time fighting a case like this and fortunately they were wrong.

The key point is that you need to have an attorney in your corner who is both aggressive and willing to go to trial. The attorney could have given up after the original decision was reversed, but they kept fighting because they knew their client was in the right.

Reddit Legal Advice On Illinois Workers’ Compensation

By Mike Helfand on Posted in Tips if Injured

Although a lot of people are going to ChatGPT for legal advice and getting bad information. This isn’t a new phenomenon. People have always gotten legal advice from friends, family, neighbors, co-workers, etc.

And in the last few years, getting legal advice from Reddit has become very popular. Makes sense because an injured Illinois worker can be frustrated and has nothing to lose by reaching out online. Or at lease they do not realize they do because these non-lawyers are very often wrong.

You can look through these posts here. Here is a random one that was posted that I picked.

I spent 14 months in physical and emotional limbo after my body took a beating as a ramp agent, and I’m beginning to wonder if reporting my injury was a mistake given how I’m being treated. Despite undergoing a major left shoulder surgery involving a biceps tenodesis and four anchors, and struggling with a second shoulder injury that the company is trying to dismiss, the IME has hit me with a “0% permanent restriction” rating that feels like a bad-faith setup to force me back and fire me. My own doctor warned me to get legal representation because the system is treating me like a criminal rather than an injured employee. This has completely stalled my life; I’ve been married for three years but remain stuck in a long-distance relationship, unable to move or even feel like a husband because I am so physically and financially limited.

It’s not that the responses to this person are awful. Some are offering prayers. Some are discussing their cases which doesn’t really help this guy, but at least it makes you feel like someone understands. But there are two problems that stick out.

First is that he mentions getting a 0% impairment rating. That is completely irrelevant in Illinois and does not impact what the case is worth at all. Years ago Illinois work comp law was changed to make impairment ratings a factor that could be considered in settlements. In reality it is not used and has not changed what cases are worth in any way.

In other words, do not lose sleep over a hack IME doctor giving a fake rating. It won’t hurt you.

The second issue is that the obvious solution, which even his doctor mentioned, is to get a lawyer. It is free and will solve his problems. With all respect to the commenters, the reality is that is the best advice a non-attorney can give. It sounds self serving for me to say that, but it is true.

If you were pregnant, I’d tell you take advice from an OBGYN. If your pipes are leaking, I would recommend you seek out a plumber. And if you have a legal issue, getting with a lawyer makes sense.

And for Illinois work comp cases, not having an attorney is crazy because it literally costs you nothing and can prevent so many problems. So if your goal of going to AI or Reddit or a friend is to get free advice, why would you not do it with someone who handles these cases every day?

The only risk in getting an Illinois work comp attorney is hiring a bad one. That is one reason we created a state wide network of top attorneys. We connect you with lawyers that other lawyers respect and that we as attorneys know have a great track record of success.

If you have questions and want a free case review or to discuss representation, please contact us any time. We will do whatever we can to help. I can’t guarantee a result, but do promise that the answers will be more accurate than Reddit.

Fractured Diaphragm and Illinois Workers’ Compensation

By Mike Helfand on Posted in Injuries

A fractured or ruptured diaphragm is a serious internal injury involving the large muscle that separates the chest cavity from the abdominal cavity and plays a critical role in breathing. This type of injury usually results from major blunt force or crushing trauma and is often associated with other internal injuries. It is not the most common Illinois work comp injury, but is one that we have helped with multiple times.

Because the diaphragm is essential to normal breathing, a rupture can quickly become life-threatening and often requires emergency surgery. When a diaphragm fracture happens because of a job-related accident, the injured worker qualifies for benefits under Illinois workers’ compensation law.

This post covers how these cases happen and work. If you want a free case review, please contact us any time. We help everywhere in Illinois.

How Do Diaphragm Fractures Happen at Work?

Diaphragm ruptures almost always stem from high-impact events. In the workplace, these injuries are typically linked to severe accidents involving force to the torso. Workers in construction, manufacturing, warehousing, transportation, and heavy industry face higher exposure, but any worker can suffer this injury if subjected to major trauma.

Common job-related causes include:

• Heavy equipment or forklift accidents
• Crushing incidents involving machinery or materials
• Falls from height with torso impact
• Vehicle collisions during work duties
• Structural collapses or explosions

It can also happen to people who drive for work from a car accident. What makes it unique is that it is almost never from a repetitive activity unlike most other Illinois work injuries.

Symptoms and Medical Complications

A diaphragm rupture is often difficult to diagnose at first because it can occur alongside other big injuries. Symptoms can include chest pain, abdominal pain, shortness of breath, and signs of internal bleeding. In some cases, abdominal organs can shift upward into the chest cavity, creating other complications involving the lungs and heart.

Diagnosis usually requires advanced imaging like CT scans and specialized radiology studies. Treatment commonly involves surgery to repair the tear, followed by hospitalization and careful monitoring. Recovery time can be substantial, particularly if there are related lung or organ injuries.

It is incredibly important for your health, not just your case, that you get to a doctor right away. Going to a local emergency room usually makes the most sense if you have these symptoms.

Medical Treatment Under Illinois Workers’ Compensation Law

If the injury happened while at work, workers comp should cover all necessary medical treatment connected to the injury. This generally includes emergency care, surgery, hospital stays, diagnostic testing, follow-up treatment, medications, and rehabilitation. The goal of the system is to ensure that an injured worker gets appropriate medical care without paying a cent out-of-pocket.

Because diaphragm injuries are severe and costly, insurance companies sometimes dispute medical the extent of “necessary treatment” or whether later complications are related to the original accident. Detailed medical documentation as well as an experienced attorney on your side are especially important in these complex cases.

Temporary Disability Benefits While You Recover

Most workers with a diaphragm rupture cannot return to work for a significant period of time. While you recover, you may qualify for temporary total disability benefits. These payments are designed to partially replace lost wages while your doctor keeps you off work. The amount is based on a percentage of your average weekly wage. Benefits should continue as long as you remain medically unable to perform your job duties or your employer can not accommodate your restrictions.

These payments are called TTD benefits and are 2/3 of your average weekly wage. They are also tax free.

Permanent Effects, Long-Term Disability and Vocational Rehabilitation

Some workers recover well after surgical repair, but others are left with lasting damage. Ongoing breathing limitations, reduced endurance and stamina, chronic pain, or complications involving the lungs or digestive system can interfere with a return to full-duty work. Whether you make an amazing recovery or have long term problems more compensation is available through a permanent disability award or settlement,

Long-term effects may include:

• Reduced lung capacity
• Chronic respiratory symptoms
• Permanent activity restrictions

If your restrictions prevent you from returning to your former job, work comp should provide vocational rehabilitation benefits. These services help injured workers reenter the workforce in a position suited to their current abilities.

Legal Representation Matters

Diaphragm rupture claims tend to involve extensive and expensive medical care. Because of this, insurance carriers are more likely to closely review these claims and often dispute them. An experienced workers’ compensation attorney can help coordinate medical evidence, address any questions brought up by the employer or insurance company, and handle all hearings and settlement negotiations.

Contact us for a FREE case review with an attorney who has substantial experience representing workers with serious internal and diaphragm-related injuries. An attorney with an understanding these injuries can literally make your case worth tens of thousands of dollars more. Call us at 312-346-5578 or complete our contact form.

Illinois Work Comp, Your IME May Be Rigged

By Mike Helfand on Posted in Benefits

I am a part of a group chat that hundreds of Illinois injury lawyers from across all fields are a part of. It is really helpful as we share information, discuss cases and how to best win them and generally work toward helping clients.

As part of this group chat, there was a conversation about who is the biggest hired gun IME. A lot of names were said, but there were three in particular that were heavily discussed.

If you are not aware, IME stands for independent medical examination. It gives the insurance company/employer the right to send you to a one time exam with a doctor of their choosing. That doctor is not there to give you medical treatment. They are there to offer an opinion as to what your injury is, is it work related and what future treatment and time off work you need if any.

For an overview of IME’s, here is everything we have written about it. Illinois IME Overview

In theory, this doctor should just give an honest opinion. Doctors are supposed to “do no harm” according to their oath. In reality, it is a big business for many of them. Some make more than seven figures every year from these exams.

Who Is The Worst IME Doctor In Illinois?

Most of the doctors who do IME’s are orthopedics. That makes sense because most work injuries involve treatment by orthopedic doctors. There is one in particular who was described in a bunch of colorful ways by various lawyers on this chat, including:

  • “He is a Whore with a capital W. Worst one around.”
  • “He does around 200 of these exams every year. I have seen around 75 reports from him and they all read the same. Only one time did he agree with the treating doctor.”
  • “I’m convinced he uses AI to generate these reports. They are so similar and have common mistakes associated with AI like messing up the actual surgery date.”

There were a bunch of other interesting comments to say the least.

The most relevant is that he pretty much never agrees with the treating doctor. If you ever have an injury and go for a second opinion, you will find that doctors tend to agree with each other’s findings over 90% of the time. That is because the treating doctor usually gets it right. And those doctors are only motivated to help you. IME doctors are motivated by their pocketbook. If they hurt hundreds of people along the way, they have their yacht and multiple homes to make them feel better.

So Am I Screwed If I Get Sent To One Of These Doctors?

The good news is that not only do lawyers know who the hired gun IME doctors are, but so do the Arbitrators who make rulings on Illinois workers’ compensation cases. They are not dummies and even ones that tend to lean toward favoring the insurance company do not usually give any credibility to these bad faith physicians.

The bad news is that an IME like this could be used to deny your benefits. It can take 3-6 months before you can get a trial hearing because your attorney has to take a deposition of your treating doctor and the IME. So it is certainly possible that your claim will be wrongly denied for a bit before you get a ruling in your favor.

And that is why insurance companies continue to use these doctors. They know that they have no credibility, but it gives them cover to act badly and put pressure on you. Their hope is that you will be financially desperate and need to settle your case too soon or forgo medical treatment that you need.

It is why having an attorney file the case BEFORE the IME is so important. We can be prepared to strike back quickly so any delay has minimal effect on your life. We also often have pre-trials before the Arbitrator if we know they are aware of how bad the IME doctor is so they can make clear to the defense attorney and insurance company that they are fighting a losing battle.

A good lawyer can also prepare you for the IME, including properly documenting what happened which will aid in taking that doctor’s deposition.

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If you have any questions or concerns about an IME or want a free case review, please call us any time at 312-346-5578. We have a state wide network of great lawyers and would love to help you.

Work Comp – Do You Need A Lawyer When The Insurance Company Is Working With You?

By Mike Helfand on Posted in Tips if Injured

This post comes from a recent live chat that I had with an injured worker. He had been injured on the job a few months prior and posed this question to me:

Should I even consider a lawyer if my employers insurance is working with me at the moment?

It is a common question we get and certainly one that goes through the minds of a lot of injured workers. My usual response is to ask what is your injury? If it is a relatively minor injury and your care will be over soon, you probably do not need a lawyer. On the other hand, if it is a bigger injury that is going to require medical treatment for a month or more, it is always at least worth a discussion.

It is always free to talk to an Illinois workers’ compensation attorney. It’s also confidential and no commitment. If you ever want a free consult with an experienced, just contact us any time.

In this case, the worker had a major leg injury that already required surgery. What I told him was that even when it seems like the insurance company is trying to do everything right, they are always looking for ways to deny, delay or minimize your care.

What Do Illinois Workers Comp Insurance Companies Do To Fight Your Case?

I gave this worker some warnings as to what could happen and it turns out the actions work comp takes, even when they seem to be doing everything right, were already happening. In his case this included:

  • A nurse case manager had been assigned to his claim. She was scheduling medical appointments for him based on her schedule so she could attend (that is not allowed by law).
  • She lied and told him that the medical bills will be paid, but only if she is allowed to talk to the doctor to discuss a treatment plan. This is another lie. It is against the law for them to talk to your doctor without your permission and they have to pay 100% of all related and reasonable medical expenses. She was hoping to talk to the doctor to try and find a way to reduce care and time off work. None of this is in the best interests of the patient/worker.
  • They got him to sign a general release form to access all of his medical records including some he doesn’t want them to see that have nothing to do with his injury.

There is more that they can and likely will do include sending him to an IME and conducting surveillance on him. The good news is that the nurse has not interfered enough yet to cause significant harm. The first thing any experienced Illinois work comp attorney would do would be to make clear she can not attend appointments or talk to the doctor other than to request copies of medical records and bills.

This is why it is always smart to talk to an attorney early on. It is our job to protect you. You do not know what you do not know. In 29 years of doing this, I have never met an insurance person whose primary goal was to do what is best for the injured worker. In fact their whole business model is based on limiting what they pay.

But If I Get A Lawyer, Won’t It Cost Me Money?

This is the other question we get a lot. The answer is it costs nothing to hire a lawyer. We do not take a penny from the medical bills or from the money you are already getting for being off work due to the work injury.

An Illinois work comp attorney works for free and does whatever they can to make sure a case does not go sideways. When you are all better, we can get you a settlement and that fee is capped at 20% of what is recovered for you.

The key thing to know is that insurance companies do not usually offer voluntary settlements without a lawyer and if they do, they will lop off more than 20% right away. In other words, you will end up with more money in your pocket with an attorney than without.

More importantly, getting a lawyer early on prevents problems from happening or at least gives you a chance to get ahead of them. It also means you no longer have to talk to the insurance company and can focus on your health and recovery.

If you would like to discuss a case, our state wide network of top Illinois work comp lawyers is here for you whenever you want.

Absolutely Gross Illinois Workers’ Compensation Claim Denial

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

We are experienced Illinois work comp attorneys who would love to help you with your case. Please contact us an time for a free case review. We cover all of Illinois.

It’s the job of an attorney to take the emotion out of a legal situation. We are trained from law school to look at things objectively so we can make calm, rationale decisions or recommendations for our clients.

Lawyers are also, believe it or not, human. And if your lawyer does not have any human emotions, it can be a bad thing.

I bring this up because I recently talked to the family of an injured worker whose case was so wrongly and illegally denied that it made my blood boil. My emotion didn’t change my recommendations, but I was still really ticked off about this.

With the caveat that insurance companies wrongly deny Illinois workers’ compensation claims all of the time, there are some that are so gross and so far beyond acceptable behavior that it needs to be called out.

In this case, a worker was carrying a jug of water at the grocery store he works at. While walking he got bumped into and it fell and splashed all over the floor. He got up to try and clean it up, took a few steps and slipped on the wet floor, badly injuring his leg. This was all caught on camera.

He inquired about workers’ compensation and was told that he was not eligible for it because the company did nothing wrong. Now that is blatantly not what the law is. Illinois workers’ comp is a no fault law so he does not need to prove negligence on the company.

This type of denial is really bad on its own, but when you learn about the injured worker, that is what will really make you mad.

The worker in question is a high functioning autistic man. He can work and communicate, but is not able to live independently. He also is kind, sweet and very trusting. In this case, his parents have guardianship over them and were smart and caring enough to reach out on his behalf because what the insurance company said did not seem right.

In the end the only harm will be a slight delay in getting medical bills paid as well as compensation for lost time benefits. But it could have been so much worse. Every day people fall for insurance company lies about whether or not they have a case.

In this case I truly believe they thought they could take advantage of an autistic person. Their goals are no different than when they wrongly deny someone not on the spectrum, but the thinking is. This case is so clearly a case. It’s caught on camera! But they knew they had a kind and trusting injured worker and rolled the dice that he would not learn the law or have someone looking out for him.

I don’t get how people that do things like this sleep at night or justify their actions. You are actively trying to harm people. It does beyond “it’s just business” and is truly disgusting.

The One Thing You Must Do Before You Settle A Work Comp Case

By Mike Helfand on Posted in Benefits

We notice various trends in handling Illinois workers’ compensation cases since 1997. A lot of those have to do with how insurance companies are fighting cases. They recycle through various dirty tricks in order to try and deny or delay benefits.

Some trends though have nothing to do with the insurance company. And one of those has popped up a lot lately. And it leads me to telling you that there is one thing you have to do before you ever consider settling an Illinois workers’ compensation case. And it sounds so simple, but this problem keeps coming up.

What To Do Before You Settle Your Illinois Work Comp Claim

The one thing you must do before you settle is call EVERY medical provider who was a part of your case and make sure that your bill was paid. It quite honestly is something that either your attorney’s office should handle or should coordinate with you.

I say this, because six times in the last two months we have received calls from people who have settled their Illinois work comp cases and been paid, but now have gotten a bill in the mail from their work comp case. Oddly enough three of them were people who had the same firm.

In the most recent one there was a very large ambulance bill that was not taken care of. I am kind of surprised that her law firm didn’t figure that one out and make sure it was paid.

The Danger Of Unpaid Bills

The problem is that often these bills pop up a year or two after a case is closed. While some of that is a reflection of how bad health care and medical billing is in this country. But it can also create some other problems:

  1. You can’t stop collection efforts against you because your work comp case is no longer active. It’s actually illegal for bill collectors to go after you in Illinois when your case is active.
  2. Because of that you will likely feel pressure to pay this bill out of pocket.
  3. You have to count on your old attorney to solve this problem for you. But they won’t get paid to do this so you have to hope they are willing to do the right thing.

On your settlement contract there is a box that states the employer has/hasn’t paid all medical bills. If it says they have, then it’s arguable that they are responsible for paying the bill that popped up out of nowhere. Unfortunately that problem is not typically solved with a phone call and requires an attorney willing to do the work.

If the settlement contract says they have not paid all of the medical bills, then you are stuck with it. If it’s $50 it probably won’t matter. But if it’s for thousands of dollars, that can be a big deal and is likely something you would have wanted taken care of BEFORE you agreed to settle.

Ultimately nobody cares more about you than you. So before you settle you should reach out to every medical provider and get an itemized copy of your bill and make sure nothing is owed. It is also a good idea to keep a journal of all of your medical care so you can keep track of all of the providers. This includes specialists like MRI groups or anesthesiologists that do not bill through the hospital or your doctor.

This isn’t fun work, but it is necessary work. And for whatever reason, a lot of people are getting caught up in it now.

Walgreens Work Comp Claims In Illinois

By Mike Helfand on Posted in Injuries

Walgreens employees work in a variety of roles that keep stores running smoothly. Cashiers, pharmacy technicians, pharmacists, stockers, shift leads, and managers all perform duties that can expose them to workplace injuries. Because most Walgreens jobs involve standing, lifting, repetitive tasks, and interacting with the public, workers’ compensation claims in the state of Illinois are common. They have had thousands of cases filed against them over the years at the Illinois Workers’ Compensation Commission.

Slip and fall accidents are a frequent cause of injury for Walgreens employees. Spills in aisles, recently mopped floors, cluttered stock areas, and wet entryways can create dangerous conditions. Employees may also be injured while working outside the store, such as taking out trash, receiving deliveries, or clearing snow and ice near entrances. Falls can result in injuries to the head, back, knees, shoulders, and wrists.

Many Walgreens workers are hurt while lifting or moving merchandise. Stocking shelves, unloading deliveries, and moving heavy boxes can strain the back, neck, and shoulders. Even lifting items that do not seem particularly heavy can cause injury when done over and over again or in awkward positions. Reaching overhead or bending for long periods can also contribute to injuries to muscles, bones, joints, etc. over time.

Repetitive motion injuries to the hands and other upper body parts are another common issue. Cashiers and pharmacy employees often perform the same hand and arm movements throughout the day, including scanning items, typing, counting medications, and handling prescriptions. Over time, this can lead to wrist, hand, elbow, or shoulder problems that may require medical care and time off work.

Walgreens employees also interact with the public on a daily basis. Most interactions are routine, but employees may occasionally encounter angry, frustrated, or unstable customers. In some cases, these situations can become physical and result in injuries that are covered by workers’ compensation. There are a lot of crazy people out there. We have seen situations where workers have been physically attacked or have PTSD after being robbed at gun point. These are all cases we can help with.

No matter the cause of the work injury, it is important for Walgreens employees to get medical attention as soon as possible. It’s important for your health and helps show that the injury is work-related. Plus, injuries that seem minor at first can become more serious if they are ignored. You also need to report it to a supervisor within 45 days of it happening, but the sooner the better.

A workers’ compensation attorney can help injured Walgreens employees through the Illinois workers comp claims process. Walgreens is a “self insured” company which means that they pay the benefits directly. They work with a company called Sedgwick to process the claims. You can Google Sedgwick and see a bunch of nightmare stories from how they treat injured workers. They are not there to look out for you, but to try and minimize the costs to Walgreens. They make a lot of money doing that.

Having an attorney who is experienced dealing with Sedgwick can level the playing field and protect you. You can focus on getting better. The attorney can take care of the paperwork, the communication with the insurance company, and getting you a fair settlement to cover your medical expenses, time off work, and future medical care. There is no fee to hire an experienced Illinois workers’ compensation lawyer. They only get paid if they win. Almost every case is entitled to a settlement and having a lawyer will help you get the most money possible, even after their 20% fee.

For a recommendation to a reputable Illinois workers compensation lawyer who has handled tons of cases for injured workers against Walgreens and Sedgwick, contact us today at (312) 346-5578 or fill out our contact form.

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Things To Look Out For In Illinois Workers’ Compensation Claims

Here are five things that every injured worker needs to be aware of:

  1. Do not give a recorded statement – Sedgwick will ask for one, but you do not have to do that and should not. It can only be used against you.
  2. Beware the nurse case manager – In some cases, they will assign a nurse case manager to monitor your case. They make it seem like they are on your side, but they are not. They work for the insurance company and will try to get your benefits limited or cut off.
  3. You usually can choose your own doctor and do not need health insurance to do so – Workers comp pays for 100% of your medical expenses related to the injury. Beware your employer or the insurance company telling you who you have to treat with. Find a doctor that is looking out for you.
  4. If your injury is going to be a bigger one, the insurance company will likely send you to an IME or independent medical exam – These are hired gun doctors that are there to help the insurance company. You need to be prepared for this exam ahead of time so you do not make mistakes that will harm your case.
  5. Having a pre-existing condition does not take away your rights to work comp benefits in Illinois – This is a common reason insurance companies like Sedgwick wrongly deny cases.

Having a strong attorney in your corner can protect you from all of these shenanigans. Please do not hesitate to contact us if you have any questions or need help. We will give you the same free legal guidance that we would give to a family member or friend.

This Is How Little Some Doctors And Lawyers Think Of You

By Mike Helfand on Posted in Tips if Injured

Lawyers are regular people, just like you. We like to have fun. We have favorite sports teams. We have hobbies and families. We also deal with the annoyances of life like everyone else, including getting spam emails and calls from telemarketers.

The phone call I get the most as it pertains to my business goes something like this. Actually it goes exactly like this:

Hi Michael. I am calling from Dr.’s office. We work with attorneys just like you to take care of injured workers. The reason I am calling is we would like to invite you to lunch at a fish house so the doctor can give a presentation on our services and we can discuss providing treatment for your clients. We would also like to discuss using your services for our patients that do not have legal representation but require it. Please RSVP at …

That is from a voicemail I received recently. I get that type of phone call at least once a week.

If you can not see what is happening, doctors want to buy attorneys an expensive lunch. In exchange for that, they want us to send our clients to them, and, in some cases, also offer to send their patients to us.

Now there are certainly times when an injured worker comes to us and needs to be pointed to a good orthopedic doctor, pain specialist, or other medical provider. There is nothing wrong with that. When we or anyone we know are asked, we typically give a couple of names for them to reach out to to try and get an appointment.

What we would never ever do is insist that our clients seek treatment with a specific doctor. And rest assured this is what many of these doctors are doing with a select group of law firms. These are people who care about their pocket books way more than they would ever care about your health.

I know getting clients is not easy, especially if you are starting a new business. It takes a lot of work. Some of these doctors and lawyers might actually be good at what they do. But if they are insisting that you work with a certain firm/practice, that is them looking out for them and not for you. To me that is a huge red flag and an indicator that there will be other times they won’t look out for you.

I know that a lot of law firms engage in these relationships because we get a lot of calls from injured workers when things have gone bad. Some of these doctors and physical therapists are trying so hard to build up a new practice that they will do two things:

  1. Over treat their patients so they can bill a lot.
  2. Stop treating their patients once work comp insurance denies the case.

In one case we got contacted on, we reviewed the medical records of an injured worker whose benefits got cut off after a year of “treatment.” Almost every exam note looked the same. It would rate her pain on a scale of 1-10 and make treatment recommendations for physical therapy that they provided in house.

The week before work comp denied the case, the doctor wrote that the patient’s pain was an 8 and they need six more weeks of therapy. Once the worker’s case was denied, the doctor wrote a note that they did not need any more care and could go back to work even though they had only done one additional week of therapy. This case was too much of a mess to get involved with.

That example seems extreme, but we see stuff like this all of the time. If you are hurt at work, you need an honest, independent physician in your corner. This is especially true if it’s a bigger injury that will drag on for a while. Some advice is:

  1. Don’t treat with the company doctor. They will look out for the company.
  2. Do seek out an orthopedic doctor or someone specialized in treating your type of injury. A family practice doctor or chiropractor is not the right choice for treatment beyond 1-2 visits. If you have a good family doctor, they likely can refer you to a specialist.

This is the recipe for success in any Illinois workers’ compensation claim. That and getting medical care right away and having a strong lawyer who will fight for what is best for you.

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