Sometimes, getting a settlement in a workers’ compensation or personal injury case involves resolving some unanticipated problems. That’s exactly what happened with one of my recent workers’ compensation cases.
While my client Dennis was at work, he fell from the platform of a machine to the floor several feet below. No one witnessed the incident. All he remembered was that one moment he was standing on the platform, and then he was on the ground several feet below. In the fall, he injured both shoulders and his neck, head, and lower back.
Since workers’ compensation covers all injuries that “arise out of” and “in the course of” employment — essentially anything that occurs while performing work-related duties — the case seemed at first to be an “easy” or “slam dunk” workers’ compensation case.
If had been that easy, I would not be writing about it.
One of the best things about being a solo practitioner is that I can pick and choose the cases and the clients I accept. I can assess how cooperative the client will be, whether I like the facts of the case, who’s on the opposing side, and many other factors. While I am not picky, I do hold all the moving parts up to a lens before agreeing to accept a new case and client.
However, that analysis is not always straightforward.
In many cases, I accept referrals from other lawyers who trust my abilities and judgment in handling cases. Some referring lawyers agree that I can pick and choose cases. Others insist that I must accept nearly everything they send, or else they will find another lawyer to whom they will refer their business. This case fell into the latter category.
My radar went up immediately during my initial interactions with the client. I sensed difficulty right away. While being injured and having to navigate the workers’ comp system could frustrate anyone, this case felt like it went beyond that level. Besides that feeling, the client did not use email or a cell phone, making communication challenging. Another factor was that the overall value of the case was fairly low.
I accepted the case despite my reservations. While things worked out in the end, getting there required me to solve some unexpected problems.
After the doctors determined that Dennis reached maximum medical improvement (MMI), I obtained his records via subpoena and submitted a demand for settlement.
With three different defense attorneys and two insurance adjusters during the course of settlement discussions, negotiations proceeded in fits and starts. I went back and forth with all of them. Among other things, they argued that some of the injuries were from normal wear and tear (Dennis was in his 60s and worked at physically demanding jobs his whole life).
In addition to the issue about what injuries were related to this incident, there was (not surprisingly) a dispute over the seriousness of his injuries. His own treating physicians and the “independent” medical examiner hired by his employer’s insurance company (pursuant to Section 12 of the Illinois Workers’ Compensation Act) disagreed on that point. That was not a surprise, since Section 12 doctors frequently side with the insurer who hires them, so that they continue to procure future Section 12 exam referrals from that insurer. (At a few thousand dollars a pop, the cases are a nice source of income).
As I have explained before, workers’ compensation looks solely to one’s ability to perform the job. It does not compensate for deficits in one’s private life, pain and suffering, or loss of a normal life, like in a car crash. Workers’ comp pays three main benefits: medical bills, wages for time off work (TTD, Temporary Total Disability), and compensation for permanent injuries (PPD, or Permanent Partial Disability).
On that basis, we ultimately arrived at a settlement that everyone could live with, although my client was less than pleased.
Just as we were about to prepare settlement contracts, I learned that there was an outstanding medical bill of almost $30,000, which was nearly the entire amount of the proposed settlement.
Remember when I said earlier that workers’ compensation pays your medical bills? Well, sometimes things slip through the cracks. In this case, before my involvement, the early bills were submitted to the client’s group health insurance rather than to workers’ comp. Unfortunately, group health denied payment because the bill was coded as a work injury. Workers’ comp denied payment because the bill was never submitted.
It took me nearly a year of constant negotiation, phone calls, and follow up with the doctor’s office to get this issue resolved. Eventually, the doctor’s office convinced the group health insurer to pay the bill, saving the settlement!
I thought so too. Then I received notice of a child support lien affecting the case.
While workers’ compensation, unlike car crash cases, does not honor or recognize medical liens, it does recognize child support liens. With the support lien being five figures, it endangered the settlement, because it threatened to leave my client with nothing after it was paid.
First, I had to inform my client of the existence of the lien. Then, I negotiated with the lienholder. While they were not required to reduce the lien, I convinced them to cut it down enough so that my client would still walk away with some money.
Remember when I said the client didn’t use email? I sent him the contracts for settlement at least three separate times before he signed and returned them, because he was frustrated. I left him voicemails explaining that the law required the lien to be paid and that he had no choice if he wanted to receive anything for his injuries. Eventually, he signed the settlement papers and sent them back. The arbitrator approved the settlement.
Not every case has as many hidden problems as this one did. But if I could resolve it, I am confident that I can resolve almost anything.
As in all cases involving injury and potential liability, immediately get medical treatment and contact a lawyer with expertise in your type of case, such as workers’ compensation.
If you've been injured at work and have questions, contact Chicago workers’ comp 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 is listed as a SuperLawyer, has a 10.0 rating on Avvo, and is BBB A+ accredited. He is also an Executive Level Member of the Lincoln Square Ravenswood Chamber of Commerce.
Don’t wait another day, contact Stephen now.