Workers’ Comp is Paying Me, so Why Get a Lawyer?
Workers’ Comp is paying me, so I shouldn’t need a lawyer, right?
Wrong! That’s what my client Charles thought. He had fallen while working as a supervisor for a major Chicago-based airlines and injured his shoulder. His rotator cuff was torn and he required surgery. He called me but told me that he was being “paid by workers’ comp” and didn’t think he needed a lawyer at that point.
What Was Workers’ Compensation Paying and Why and What Does That Have to Do With a Lawyer?
What he was being paid, TTD, or Temporary Total Disability, is what workers’ comp pays injured employees who cannot work. After the “waiting period” of 3 consecutive days following the injury, TTD begins at a rate of 2/3 of the average weekly wage (AWW) of the employee. TTD is tax-free, so, while it is “less” than the AWW, the fact it is not taxed should make up the difference.
Well if Workers’ Comp Was Paying Charles, What Difference Would a Lawyer Make?
Workers’ Compensation benefits consist of three things:
- TTD
- Medical benefits
- PPD, or Permanent Partial Disability
TTD is paid if the employee has a medical excuse from work.
Medical benefits are paid through a reduced rate according to the Medical Fee Schedule. Once a provider is paid at that reduced rate, he or she cannot seek the balance of the bill from the worker!
PPD is often the “lump sum settlement” that concludes most workers’ compensation cases. It can also come as the result of a trial.
How Did All This Apply to Charles?
Charles and I were in contact by phone and email for close to a year before he retained me. He had heard stories from peers that once a lawyer was hired, the workers’ comp insurer could become difficult to deal with. Besides, he ultimately required three shoulder surgeries, and he figured that as long as the workers’ compensation insurer was paying for that and his TTD, why rock the boat?
Then He Retained You—How Did That Help Him?
The pressure placed upon him by the comp insurer ratcheted up over time. The adjuster became less friendly, more combative, and demanded more documents. They utilized their right to send him for a Section 12 examination by a doctor they chose and paid (commonly and incorrectly referred to as an independent medical examination or IME).
Further, the workers’ compensation insurer for the employer is under no obligation to offer a settlement, apprise you of your rights, or even give you options on how to resolve your case.
What Are the Filing and Time-Limits for Workers’ Compensation?
Once I became involved, I immediately filed an Application for Adjustment of Claim with the Illinois Workers’ Compensation Commission. This document formally notifies the employer of a claim. It must be filed within three (3) years of the date of injury, or within two (2) years of the date benefits (TTD or medical) were last paid, whichever is longer. (A worker must report the injury within 45 days of the injury to his employer). Failure to file within that time limit forecloses any right of recovery for an injured worker.
My involvement stopped the shenanigans, stopped the adjuster from communicating with Charles, and allowed me to be his advocate. After he recovered as well as medically able from his last shoulder surgery, we were able to negotiate a sizeable settlement. Not only would he likely never have been offered anything without an attorney (and most likely never known he had to file an Application within the time limit), even if he had received an offer, he would have no understanding of the system or the value of his case, and would not be able to evaluate it properly.
Takeaways
- Workers’ comp is not a DIY project—the terms are odd, the rules unfamiliar, and the employer and its insurance company not your friend
- Not rocking the boat and sitting on your hands can cost you lots of money in the end
- It is a unique area that requires specialized expertise of an attorney
- The employer will not offer you anything in most cases
Contact Chicago Personal Injury Lawyer Stephen Hoffman
If you've been in an accident and have questions, contact Chicago personal injury attorney Stephen L. Hoffman for a free consultation at (773) 944-9737. Stephen has nearly 30 years of legal experience and has collected millions of dollars for his clients. He has been named a SuperLawyer, has a 10.0 rating on Avvo, and is BBB A+ accredited.
Stephen handles personal injury and workers' compensation claims on a contingency fee basis, which means you don’t pay anything upfront and he only gets paid if you do. Don’t wait another day, contact Stephen now.
