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 allow 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 affect my case in the Rockford area?

The new Illinois Workers’ Compensation Act went into effect in September 2011. There are new procedures that went into effect in 2012. These procedures affect 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 Woodstock in February and your case will follow this arbitrator to Woodstock and then in March that arbitrator will begin Waukegan and your file will follow him/her to Waukegan 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.

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 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 online 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.

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. Attorneys Jim Black and Tracy Jones maximize 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. Black and Jones Attorneys at Law 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 Black and Jones 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.

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.  Black and Jones advance 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.

Tripping over your own two feet while working is not a work related injury. To be eligible for work comp benefits, you must meet a 2-prong test.

1.    The injury must have happened in the course of employment. This is the one most people believe is all that is needed. You are injured while on the clock, therefore it is work-related; this is not the law.
2.    The injury must also arise out of your employment. There must be some risk associated with the employment. Tripping over your own two feet generally does not constitute a risk peculiar to your employment unless your employer sets things up so you must rush.

A local employer provides a very short lunch period. Individuals only have 15 minutes within which to eat their lunch. Our client left his workstation and went to the vending machines to get some snack food to supplement his lunch. The vending machines were empty. At that point, he had two choices; go back to his workstation without finishing his lunch and get there in a timely fashion, or race to the next nearest vending machines. He chose to race and tripped over his own two feet, breaking his hand. The claim was denied.

The Illinois Workers’ Compensation Commission agreed that because the employer put such heavy rigid rules down and did not provide adequate time for an individual to get supplements for his lunch, that the rushing and tripping over his own feet were indeed work related.

For a fall at work to meet the two prong test and be work related is very fact sensitive. What the injured worker may see as insignificant may be the fact which changes the event from being not work related to being work related. If you suffer a fall at work, give notice to your employer of the event and see legal counsel right away. Do not give a taped statement.

Staring at lights can cause injury, as can working outside week after week, day after day.

Two pending cases involve staring at lights or working in the bright sun. A doctor has tied up these work activities as placing an individual at greater risk causing eye injury. These cases are proceeding to the Illinois Workers’ Compensation Commission.

An accident caught on surveillance videotape appears to be a simple matter of a person’s foot giving out while descending stairs.

Upon further investigation, it was determined that at the top of the stairs was a wastebasket that was overflowing with milkshake cups. It was more likely true than not, that what was viewed on the video tape was not some sort of personal problem with the knee giving out, but rather the individual’s foot slipping because of the milkshake caught on the bottom of his foot. The case was denied and ultimately resulted well into a six-figure payment at settlement.

A chemical mix normally would not cause serious injuries unless exposed in excessive forms, which was shown to be the culprit in the workers’ compensation case.

Toluene is the substance in glue that glue sniffers sniff to get high. Generally, it takes an excessive amount of glue sniffing for brain lesions to develop. An individual came to me with a single demyelinating lesion of the brain and an exposure to Toluene. All the research indicated that he would have to be exposed to greater amounts of Toluene than at first blush appeared for the demyelinating lesion to be caused from the Toluene.

On further investigation it was determined that the Toluene he was exposing himself to inadvertently was quite excessive. His job required him to wipe down machines with Toluene as the cleaning substance. He was constantly dipping his hand into the Toluene with a rag and wiping down the machines. Left at that, it was probably not sufficient exposure to cause the demyelinating lesion. However, the claimant had a mustache and like most people with mustaches, he was constantly playing with it with his Toluene-soaked fingers. Inadvertently, he was exposing himself to as much Toluene as glue-sniffers sniff in chronic problems. The doctors then agreed that this type of exposure would cause the single demyelinated lesion.