Workers’ Compensation

Do I have to give a taped statement to an insurance company? No!
In fact, if the investigator tricks you into giving a taped statement, the investigator may be guilty of a Class IV Felony. It is never advisable to give a taped statement to anyone, especially the insurance company investigator. If you recall, the person that controls the question, controls the answer. The investigator knows what the law is and can trick someone into giving an answer which gives the impression that the injury is not work related when in fact it is. Do not give taped statements.

Do I have to sign medical releases that allows the insurance company to talk to my doctor without me present? No!
In fact, never sign such a release that allows the insurance company to discuss matters with your doctor without you present. You would have no control over what information the insurance adjustor or an agent would be giving your doctor. Most insurance adjustors and agents are honest but there are many of them out there that will give misleading information to the doctor that you would be unaware of which could greatly alter your treatment plan. Therefore, never allow this type of conversation to take place behind your back. If they want to talk to the doctor, it needs to be in writing and a copy sent to you or your attorney.

Are there new procedures that will effect my case in the Rockford area?
The new Illinois Workers’ Compensation Act went into effect in September 2011. There are new procedures that are going into effect in 2012. These procedures may effect your case in that it will follow an arbitrator rather than be assigned to a city. For example, your case could be assigned to “Arbitrator A” in January for Rockford. Then “Arbitrator A” will be transferred to Waukegan in February and your case will follow this arbitrator to Waukegan and then in March that arbitrator will begin Woodstock and your file will follow him/her to Woodstock and then back to Rockford in April. Therefore, if your case must be tried in either February or March, you have to either go to Waukegan or Woodstock to try your case. This could slow things down.

How does the Illinois Workers’ Compensation Commission determine the value of a case?
Section 8.1(b) of the Illinois Workers’ Compensation Act provides that disability would be based upon the AMA impairment rating, the age of the injured worker, the occupation of the injured worker, the impact an injury will have on an injured worker’s future earnings, and the medical records. No one factor carries greater weight and it all must be taken into consideration. Do not let anyone say the AMA impairment rating does not count.

Why do I need an attorney?
In Illinois, an insurance adjustor does not have an obligation to advise the injured worker of the law. In fact, the insurance adjustor’s duty is to the insurance company and the employer, not the injured worker. If you proceed without an attorney, you have nobody who is obligated to advise you and represent you. You are out on your own. This is never a good situation, so that is why 97% of the people who have workers’ compensation cases in Illinois hire attorneys.

What are the advantages of hiring an attorney in Rockford? The simple answer is geography.
If you live in the Rockford area and your attorney is in the Rockford area, it is easy to meet with the attorney. Chicago is a long distance away and difficult to meet with your attorney. In Rockford, most workers’ compensation cases are handled by Rockford attorneys. If the Rockford attorneys were not doing a good job, this would not be the case. I would strongly encourage you to hire locally and my office would be glad to be that local attorney.

If you are injured after you punch out can it be work related? Yes!
Even after you punch out, you may be covered by worker’s compensation laws. The law states that for an injury to be work related, the injury must arise out of and in the course of your employment. “In the course of” usually means that you are on the clock, but not always. A person can be asked to stop at the hardware store on the way home from work to pick up some tools needed at work and have an accident. This would be work related because the accident was in furtherance of the employer’s business. Therefore, it is not necessary that you be technically be on the clock for an injury to be work related.

The injury also has to “arise out of”. This is a very confusing concept. “Arising out of,” means that the injury must come from a risk peculiar to one’s employment. These are very difficult questions to answer. Many people mistakenly believe that if they are at work and they get hurt, that is all that is needed. This is often how people get trapped by insurance companies during taped statements. For example, the mere act of bending over at work is not work related. If a person herniates a disk while bending over, the Illinois Appellate Court says that the herniated disk is not work related. An insurance investigator could take a taped statement and ask the individual how they got injured. The individual could honestly respond “I was bending over at work when I hurt my back.” The investigator most likely would not ask follow up questions because he or she had enough to deny the claim. The individual may have been simply bending over at work in an awkward position with a 50 pound box in their hands and failed to mention these very critical aspects of the event. Therefore, be very careful when talking to anybody from the insurance company.

If you are hurt at work does an insurance company have to offer settlement? No!
An insurance company does not have to offer settlement to any individual who is hurt at work. In fact, 97% of the cases that are settled involve attorneys for the injured employee. The 3% who receive offers from insurance companies usually do not receive a full and fair value for their claim. This is because under IL law, the insurance company is not obligated to make an offer. The insurance company may make an offer to keep someone from going to an attorney to get full value.

How soon must they give weekly benefits? Two weeks, sort of.
The question often arises as to how soon weekly benefits must start after a person is injured. Technically speaking, the insurance company is supposed to pay within 2 weeks or state in writing the basis of their non-payment. Often they fail to do this unless someone is represented by an attorney.

If I am working through a temporary agency and I am injured who is responsible? Both employers.
If someone is working for a temporary agency and is injured while working at the company that the temporary agency sent the person to for work, both are technically responsible. This is called “joint and several liability”. However, the temporary agency usually has a contract with the company where the worker is injured where the temporary agency will assume responsibility for all work injuries.

If I step outside to have a cigarette in the designated smoking area and get hurt, is this work related? Possibly.
If you smoke and you have to go outside to smoke during your break and are injured while outside, most likely, this injury is work related under the Personal Comfort Doctrine.

If I develop problems from use of chemicals what should I do?
If you work around chemicals and develop lung problems or rashes, it is very important to get the name of the chemical that you work around and, if available, get the MSD sheet. The MSD sheets should be available to you. If they are not, you can get them on line from the name of the chemical. More likely than not, you will need an expert witness or an attorney to help tie this case up. It would certainly help if you have the MSD sheets.

If I have to travel because of work, does this mean I have special protection? Yes!
Employees who have to travel have special protection. This is because most of their time spent away from home base is in the furtherance of the employer’s work, including some recreational activities while away from the actual tasks. For example, a traveling employee who slips and falls in a hot tub may have a viable worker’s compensation case for the slip and fall because they are a traveling employee.

How long does a Worker’s Compensation case take?
A workers’ compensation case generally is resolved shortly after the individual has finished treatment. Once the injury from work reaches a healing plateau, the attorney can start moving the case toward settlement. On average, a claim takes 1.6 years from the date it is filed to settlement.

How much is my case worth?
The value of a claim depends upon the extent of the injury and the individuals’ average weekly wage. There are many rumors about how much a case is worth. Most cases are settled without trial. However, it is the threat of trial that causes a case to settle. Attorney Jim Black maximizes the trial risk for the insurance company forcing them to offer top settlement dollars before trial.

Will the insurance company make an offer to an individual not represented by an attorney?
Seldom does an insurance company make an offer to an individual not represented by an attorney. A pro se offer as they are called are generally far less than the case is truly worth. Of the fifty to sixty thousand cases filed each year before the IWCC, all but 3% have attorneys. The 3% who proceed without an attorney are at the mercy of the insurance company. It is not the insurance company’s duty to make a fair offer to the injured worker. The insurance adjustor’s job is to protect the insurance company’s dollars. Generally an injured worker must hire an attorney to get a fair offer.

What do I do if I am not receiving benefits or necessary medical treatment?
When a doctor has taken you off work due to your injury or prescribed necessary medical treatment for your injury, the insurance company is to pay the injured worker temporary total disability benefits and to authorize treatment as prescribed. The insurance company often fails to meet these obligations. The Law Office of Jim Black & Associates will file a Petition for Immediate Hearing/19b with the Illinois Workers’ Compensation Commission to get each client the benefits and treatment he or she is entitled to under the Illinois Workers’ Compensation Act. If you are not receiving your benefits or necessary medical treatment, call the Law Office of Jim Black & Associates immediately to initiate the appropriate paperwork.

Am I required to see a doctor selected by the insurance company?
Section 12 of the Illinois Workers’ Compensation Act gives the insurance company the right to have an injured worker examined periodically by a doctor of its choosing.

Must I treat with the company doctor? No!
The injured worker has the freedom to treat with whomever he or she wants. An insurance company only has the right to have an injured worker examined by a doctor of its choosing.

Should my case be tried?
Some cases must be tried especially those that are disputed. It is the threat of trial that moves a case to settlement. If an insurance company is afraid of losing at trial, they will settle. If there is no chance of going to trial, the insurance company will not make a reasonable settlement offer. The Law Office of Jim Black & Associates advances cases to trial to force the insurance company to make a fair settlement offer.

If I try my case, how long will the process last?
Unlike television, the judge does not make the decision at the end of the trial. The judge has 45 days within which to issue his decision. His decision is then sent to both attorneys who have 30 days within which to file an appeal. A little over half of the cases that go to trial are appealed. If appealed it generally takes one to one and a half years more to resolve the claim. For this reason it is best to use the threat of trial rather than an actual trial to resolve the case.