Were you injured on the job? If so, you may have been covered by workers’ compensation from the moment you began working. An employee who is injured during the course of performing work duties is almost always eligible for workers’ comp benefits. However, depending upon the severity of the work injuries or illness suffered while on the job, the benefits provided by the system may vary greatly.
Your workers’ compensation benefits may include:
Injured workers often assume that there will be no problem getting benefits, but in many cases, it can be much more difficult than expected. Employers dispute certain cases, often claiming that the injuries are either exaggerated or happened outside of the workplace. But even in those cases in which the employer doesn’t dispute the injury, the employer’s insurance company will often offer an unfair lowball settlement, knowing that the injured employee isn’t knowledgeable about what a fair offer should be.
As a result, the injured employee who tries to represent himself or herself is sometimes left struggling without income and may feel compelled to accept an unfair offer from the insurer. Don’t do that! Once you begin to negotiate with the workers comp insurer, you may compromise your case or make it more difficult for an attorney to help you out later. So, if you or a loved one was seriously injured at work, it is imperative that you seek legal help to assist you, sooner rather than later.
At Mitchell S. Sexner & Associates LLC, we have extensive experience with all aspects of the workers’ compensation system in Illinois. Our Chicago-based workers’ compensation lawyers fight for the rights of all injury victims, including workers. Call our law office at (800) 996-4824 immediately for assistance after any work-related injury or illness.
On a very basic level, workers’ compensation is a system of laws that protects an employee if they are injured on the job. Depending on the injury, it may provide long term benefits, short term payments, lump sum awards, or vocational rehabilitation. In the case of a worker who died as a result of a work injury, it may also provide death benefits for the worker’s family and dependents. Although people often assume that any injury that happens on the job is automatically eligible for workers’ comp benefits, this is not always the case.
To be covered, the injury first must be from an accident that arises out of your employment. This means that what happened was accidental, not on purpose, and not planned. If it is determined that the injury was in fact accidental, then we need to determine if it arose out of your employment.
This requires the accident to have happened because of some risk that was specifically connected to how you were supposed to perform your duties. If you worked in the warehouse and hurt your back lifting a box, that certainly sounds like a compensable injury. But, if you were throwing a football in the warehouse while waiting to fill a work order and you hurt your back, that’s almost certainly not a workers’ comp injury. It wouldn’t matter that you were on the job during work hours, because the injury was not connected to how you were supposed to do your job.
This requires that you were at work, during work hours, and performing work activities. Depending upon the circumstances, you may be covered on your way in or on your way out of work though. These days, many employees travel for work or telecommute from home, so there are many considerations when determining if the injury occurred during the course of work.
Under the present Illinois workers’ compensation laws, you have 45 days to notify your employer that you were injured on the job or had a work-related accident. Period. No allowances are made if you forgot or just didn’t know about this time limit. So, the very best advice is always to tell your company right away whenever you suffer an injury, whether large or small. When you tell your employer about the problem, it doesn’t mean that you have to sue them or that you have to file a personal injury case or a workers’ compensation claim for compensation. It just means that you have preserved your right to do so later if you choose. That’s all.
This hard and fast 45-day limit applies any time that there is a specific, single accident. Examples of specific events include if a package falls off a shelf onto your head, if you cut yourself, if you bend down to pick something up and you feel a pain, or if you break a bone. In each of these cases, you would clearly know that something bad just happened - and under workers’ compensation laws in Illinois, the clock begins to tick. You must then notify your employer within 45 days to be protected.
Some exceptions, however, do exist. Not all work injuries are the result of a single event. Repetitive stress or trauma injuries like Carpal Tunnel Syndrome (CTS), for example, often take many years to appear. Similarly, occupational diseases, cancers and illnesses do not just appear overnight. Exposure to asbestos and chemicals slowly progress over long time periods before problems appear.
Our Chicago workers comp attorneys can help you with a variety of workplace injuries, including:
A workers’ compensation claim, like any insurance claim, can be denied by the insurer for any number of reasons. It’s always best to have a knowledgeable attorney file the claim in the first place to have the greatest chance for success. But if your claim is then unfairly denied, your lawyer can file an appeal to argue your case further. You should not typically try to file an appeal by yourself, but should instead contact an experienced workers’ compensation lawyer to help you understand the process and protect your rights properly.
When you appeal a claim, you will need to demonstrate why your claim is valid and show that the insurance company was wrong to deny it. In some instances, there may even be an act of bad faith from the insurer that might open them up to additional civil litigation, which an experienced lawyer can recognize and help you with if appropriate.
Workers’ compensation benefits are often inadequate, as only a portion of the wages you were earning are compensated. But in some workplace accidents, a third party may be either fully or partially responsible for the injuries. Faulty equipment, electrical accidents and other situations may have led to the injuries you suffered. In cases of third party negligence, a separate claim can also be filed against that party to seek compensation beyond the benefits from the state workers’ compensation system.
You owe it to yourself to discuss your case with us. In some cases, our attorneys have collected hundreds of thousands of dollars for our clients in the workers compensation claim, but millions of dollars for the related third-party lawsuit.
So we are prepared to help you fight for every form of compensation available to you.
While worker’s compensation is designed to cover just about any workplace injury, regardless of negligence or liability, there are typically much stricter requirements for filing a third-party lawsuit to try to recover additional monetary damages. For any civil suit to be successful, liability and negligence need to be proven. This can be difficult to do without an experienced lawyer to represent you.
Liability means that a third-party is responsible for damages that occur to a person or property, typically through an act of negligence or a failure to act,. Negligence means that a person or company knew about a risk or danger and failed to act in a reasonable way to prevent the injury. Falling from a scaffolding at a construction site for example, can cause a serious injury covered by worker’s compensation, but might not be the result of negligence and therefore the property owner or construction company may not be liable for additional civil damages. If however, the fall was due to a scaffolding that was improperly stabilized or needed to be replaced, and the owner knew about the issue but failed to act to resolve it, then liability may be provable and a civil suit for additional money damages would be worth pursuing.
In Chicago and the rest of the United States, OSHA has set strict rules and guidelines for how most workplaces must be run, and how potentially dangerous machinery and chemicals need to be used and kept. Businesses that violate these rules can open themselves up to fines and other punishments from OSHA and the government. These kinds of violations do not typically impact workers’ compensation, since the compensation is provided based on injury and without regard to blame for an injury or accident.
OSHA violations can be used to provide evidence for negligence and liability in a civil claim however, so they are worth noting if an injury does occur. Violating policies on the use of drugs and alcohol at the workplace can cause the denial of a workers’ compensation claim, so these rules should always be followed.
Here is an all-too-common scenario: You suffer a work injury and notify your employer. The employer contacts their insurance company, who immediately jumps into action and reaches out to you. They say that they’re going to take care of everything and you should have no worries. Everything is going to be so smooth that you won’t even need a Chicago workers’ compensation lawyer. Then, the insurer begins to pay you for your lost time from work and covers all your medical bills. Sounds good. But is it? Most likely it is not.
Without any doubt, your employer’s insurance company is not your friend or partner. They are not your insurance company at all. They were hired by your employer just in case anyone ever became injured to protect them from monetary exposure. And now that you have been injured, the insurance company stands to lose many thousands or hundreds of thousands of dollars.
Is the insurance company in the business of giving away money? Do they want to do whatever is fair even if it might mean paying out hundreds of thousands of dollars? What do you think? Like any other big business, insurance companies make the most money when they pay out the least.
Also, remember that just because an insurance company or employer says that they have “opened up a claim” for you does not mean that they have filed an actual document with the Industrial Commission to protect your rights. 99.99% of the time an insurer will never do this for you. To be properly protected, you or your lawyer must do this.
Oftentimes, the insurer jumps in and begins to pay out lost time and medical bills specifically so that the injured worker believes that he or she is being taken care of properly. But all the while, the clock is ticking. The statute of limitations (which is the time limit for filing a workers’ comp claim) is slowly expiring. If the time expires before the worker hires a lawyer to file a claim (called an application for adjustment of claim) in the special court for workers’ comp cases (called the Illinois Workers’ Compensation Commission and previously known as the Illinois Industrial Commission), then time will run out.
If you were injured on the job, then chances are that you and your case may be protected under the Illinois workers’ compensation laws. Not every work-related injury is covered, but if it arose out of and in the course of your employment, then chances are that it can be covered. One of your most important and immediate concerns is likely getting your medical bills covered. You may have been taken to the emergency room, may have required an emergency surgery, or you may be undergoing therapy of some sort.
Even if you’re covered by your own health insurance which is paying these bills, you would probably prefer that your employer’s insurance company pick up the tab, not your personal health insurer. But, if you’re not covered and the medical providers are looking to you personally for payment, you may have big financial concerns.
After all, you want to get better – and to get better, you may need the help of expensive doctors and hospitals. Yet you don’t want to forgo treatment just because it’s expensive. You’re entitled to good medical help no matter what it costs when you’ve been injured on the job.
For many people, one of the most important decisions they make after a workplace injury involves which doctors to use to treat their injuries. This choice can make the difference between a full, speedy recovery and a long, hard road to wellness. When a worker is injured, it’s very common for the employer’s insurance company to contact them and tell them to see the company doctor, or a doctor that the company recommends. Some people are very satisfied with their employer’s recommended medical providers.
On the other hand, many people who use a company doctor for treatment related to a workers’ compensation claim are afraid that the doctor is working more for the company than for them. They worry that the doctor knows “where his bread is buttered.” There are concerns that the medical provider is more likely to pursue a course of treatment that saves the workers’ comp insurance company money rather than treat them properly, because this will make the insurance company happier and they will send the doctor more patients in the future. With this in mind, many patients who pick their own doctors (without the help of the employer) feel more confident that the doctor’s advice is in their best interest.
Every injured worker has a right to choose their own doctor, but under what is known as the “Two Doctor Rule,” this right is limited. The rule means that you can pick up to two doctors to treat you, and their medical bills will be later reimbursed if you have a case. In addition, if those doctors directly refer you to other medical specialists, their bills will also be paid. This is sometimes made more complicated if your employer has a preferred provider network of specific doctors.
Under new Illinois workers’ comp laws, the Two Doctor Rule may be even more restricted. Some employers now have what is called a “preferred provider network,” which is a specific list of doctors to choose from. Although you don’t have to agree to use your employer’s network, if you choose to opt out, then you can pick only one doctor (and referred specialists). This can greatly reduce your choices when seeking medical attention. If you “break the chain” and go to another doctor who was not referred by your last doctor, you may be out of luck in seeking compensation. This is why it is so crucial to have a knowledgeable attorney on your side.
The vast majority of injured workers are concerned about the effect of a workers’ compensation claim on their continued employment. In fact, such questions are among the most common when a prospective client initially calls our office. The typical person might say something like, “I’ve been injured on the job and I want to be properly paid for my injuries, but I don’t want to get fired if I put in a claim. So, I’m not sure I want to file a case.”
This is because most workers incorrectly assume that if they hire a lawyer to pursue financial compensation for their injuries, the money will come directly out of their employer’s bank account, which will make their boss mad and then they will then get fired. This is generally not true. The vast majority of companies have workers’ compensation insurance specifically for this purpose and the benefits do not come out of their employer’s pocket. Even so, you should never expect an employer to tell you it’s a good idea to file a claim with the Illinois Workers’ Compensation Commission or that you “shouldn’t worry about it.” But, that absolutely doesn’t mean that you shouldn’t file. If you’re injured, you should speak to a lawyer.
Most injured workers don’t encounter any issues at all on the job once they file. Most employers know that the law provides you with these benefits and seeking such benefits is simply your legal right. As a matter of fact, once the application for adjustment of claim is filed with the IWCC, it is even less likely that you will encounter any problems. That is because a company that fires an employee after the filing of a workers’ comp claim may be sued for what is called “retaliatory discharge.” Employers and their lawyers know this and tend to stay clear of such potential lawsuits.
The simple answer is that a workers’ compensation attorney, such as those at Mitchell S. Sexner & Associates LLC, costs nothing unless the lawyer wins on your behalf. There are many types of legal cases that do involve paying a lawyer hourly for work and there are other types of cases that often involve paying the lawyer a set dollar amount for each day in court. But workers’ compensation cases in Illinois are done on what is called a “contingency” basis. What this means is that the lawyer will not charge any fee at all unless the law firm is successful on your behalf and gets you a monetary settlement or award. Then, when the case is over and the settlement money has been received, the attorney would be paid a certain percentage as previously agreed to with the client.
Other types of injury cases such as car accidents and medical malpractice are also typically performed on a contingency basis as well, although the percentage for those types of cases is usually a larger percentage. But the attorney fee percentage for workers’ comp is limited by the law to only 20%, so the client will pay a lower fee to the lawyer in the end. That means more settlement money goes to the injured worker.