Denial—Workers’ Compensation Edition

In a recent blog, I discussed denial of personal injury claims by insurers.

What about workers’ compensation cases? Insurers deny these claims all the time, for all sorts of reasons. Many people torpedo their own cases by failing to do a few basic things.

What can you do to protect your rights if you are injured while working?

A Person Walks into Work and Gets Hurt

That heading sounds like the beginning of a joke, but that’s how it all starts.

The basis of workers’ compensation law in Illinois is contained in the Illinois Workers' Compensation Act and the subsequently propounded regulations. In essence, if you suffer an injury “arising out of” and “in the course of” employment, and report this within 45 days, you have a viable workers’ compensation case.

Sounds simple, right?

Nope. It just isn’t. You could read literally thousands of pages of case law just interpreting “arising out of” or “in the course of.”

There is a case where a worker decided to experience an “afternoon delight” in a hotel room, injured his back, and that was deemed a compensable workers’ compensation case.

But not everyone who slips on ice in the company parking lot has a compensable case.

Some cases involve injuries from increased walking, yet not every case of this type is a winner. What if your job involves a “neutral” or “no increased risk” of injury from the general public?

If you’re scratching your head by now, you’re getting the point.

But even some seemingly straightforward cases are denied. Why? Usually because the potential claimant fails to take one or more of the actions I recommend below.

Document, Report, Don’t Talk

While the deadline to report an incident is 45 days, making a report just under the wire won’t cut it in most cases.

If you get hurt while working (and reference my past blogs on workers injured while traveling, going to work appointments, even flight attendants in foreign countries tripping on the sidewalk), make sure you report the incident to your employer immediately.

This documents what happened, when it happened, and gives you a written report (usually).

Most importantly, it sets a date of injury. I can’t tell you the number of times someone has a legitimate work injury case but they have absolutely zero idea what day it occurred.

If you don’t have a date of injury, you don’t have a case.

The next thing you should do is seek medical treatment. Now, many people assume this means they are required to go to the “company clinic.”

NO! You are NOT required to go to your company’s doctor! Pick your own. Go to urgent care or the ER. Go to your own doctor. Don’t let the employer and its insurance company send you to a place that it sends people to a lot. Why would it send lots of injured workers there? Because that clinic will bend over backwards to find that those employees aren’t badly hurt and send them right back to work!

Going to the doctor also documents the date of injury. Get hurt on a Friday? Do not wait til Monday to see a doctor, or be prepared for the argument that you hurt your back or shoulder bowling, lifting your child, or wrestling with your friends over the weekend.

The IWCA allows you to seek two of your own doctors or referrals from those. Meaning, you can see the ER, the ER can send you for an MRI, and then send you to an orthopaedic doctor to review the MRI, and the ortho can send you for physical therapy, and that counts as one doctor choice.

While there are times you are required to see the employer’s choice of medical professional, don’t do this initially!

Finally, never talk to the employer, insurance company, or insurance adjuster. They will use whatever you say against you.

Talk to a lawyer as soon as possible after you are injured and let them handle things. You risk nothing, as workers’ compensation lawyers only receive a fee if they collect a settlement or arbitration award for you, and then that fee is capped at 20% by law.

Takeaways

• Work injuries need to be documented, ideally immediately after they occur
• Medical treatment with your choice of provider is your right; use it!
• Do not talk to the insurance company or your employer
• Call a lawyer and let them handle all communications

Contact Chicago Personal Injury Lawyer Stephen Hoffman

If you have been injured, whether by an auto accident, bike or pedestrian crash, dog bite, work accident, or slip and fall, seek medical attention immediately. Report accidents to the police and your own insurance company, or to your employer if you were injured at work. Then contact a lawyer with experience in your type of injury matter.

If you have 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 over 30 years of legal experience and gets results; he has collected millions of dollars for his satisfied clients. He is listed as a SuperLawyer, has a 10.0 rating on Avvo, and is BBB A+ accredited. Stephen is also an Executive Level Member of the Lincoln Square Ravenswood Chamber of Commerce.

Stephen handles injury cases on a contingency fee basis, which means you pay nothing up front, and Stephen only gets paid if you do. You have only a limited time to file a claim, so don’t wait another day; contact Stephen now to get started putting your life back together.