Injured Waitress Gets Compensated
We are extremely proud of an Illinois, Chicago-area workers' compensation case that was recently settled by our office. While it is not the largest case and does not involve the most cutting edge law, it is nevertheless a great victory for our client.
Our client, a waitress at a casual restaurant, twisted her knee while setting down a heavy tray of food she was about to serve to her table. Immediately, she felt a "pop" and pain.
By the time she was done with her shift, her knee had swelled and she was in agony.
She reported the injury and was seen by a doctor, who determined she had torn cartilage (medial meniscus) and required arthroscopic surgery. This seems straightforward so far.
Unfortunately, her employer took issue with several things and refused to pay for any of the things to which she should have been entitled under the Illinois Workers' Compensation Act. One problem they had was that they claimed she had not notified her supervisor in a timely manner. Another issue was claiming that the knee injury might not have occurred at work or that somehow it was undetermined when the injury actually happened.
While sometimes there are legitimate "notice" issues at play, this time the employer's workers' compensation insurer seemed to change its objections on an almost daily basis.
Briefly, a person injured at work in Illinois who was doing what their job entailed is generally entitled to workers' compensation benefits.
These benefits consist of three basic categories:
- TTD (Temporary Total Disability). This is what an injured worker is entitled to receive for time missed from work due to injury once they have missed three consecutive days of work. It is paid based upon the employee's Average Weekly Wage (AWW), which is more or less an average of what that employee earned in the 52 weeks preceding the injury. TTD is paid at a rate of approximately 2/3 of the AWW (with certain minimums, maximums, overtime calculations, and other things that make this less-than-definite).
- Medical Benefits. The employee is entitled to be treated by any two health care providers plus any referrals from those providers and have the employer pay those bills.
- PPD (Permanent Partial Disability). This is generally the "lump sum settlement" to which an injured employee is entitled based upon the permanency of their injury. It is based upon a schedule of body parts, rated by numbers of weeks, and again based upon the AWW. Many employees do not know they are entitled to this.
In our client's situation, the employer's insurer claimed the entire injury was not compensable under the Workers' Compensation Act for several reasons. Mostly though, they relied upon the notice issues and made our job quite a bit more challenging by shifting the file from claims adjuster to claims adjuster at least four (4) separate times. It is difficult to negotiate with the enemy when you don't know who the enemy is!
Ultimately, our office obtained medical records from our client's medical providers that we used to convince the insurance carrier that the case was compensable.
WE CONVINCED THE INSURANCE COMPANY TO CHANGE ITS POSITION AND PAY FOR OUR CLIENT'S TTD, MEDICAL BENEFITS, AND ULTIMATELY, HER KNEE SURGERY AND REHAB.
In doing so, we secured the payment of TTD, as well as back-TTD dating back to her earliest entitlement to it, and got all of the medical bills up to and including the surgery and therapy following the surgery paid by the employer's insurer.
Finally, from what initially started as a "no," we were able to negotiate a settlement based upon the permanent nature of the injury (PPD).
Our client was fully compensated for her lost time (TTD), medical benefits, and received a permanency (PPD) settlement. All this after the initial "determination" was that they would not pay for any of this!
Our client is now back at work in her old job and is fully recovered. She was a pleasure to work with throughout and we are extremely appreciative that she was so patient and pleasant throughout what became quite a long haul.
We thank our colleague from the outlying Southwest Suburbs of Chicago for suggesting our firm to this client! We appreciate fellow attorneys who do not handle the types of matters that we do suggesting us to potential clients. As always, our goal is to treat every client with respect, dignity, and attention to detail.
As always, if you, or someone you know, has questions about an Illinois or Chicago-area Personal Injury, or Illinois or Chicago-area Workers' Compensation case, please contact us at 773-944-9737.