Illinois Lawyer Referrals and Legal Guidance

Work injuries are sometimes caused by a third party

You can't sue your employer if you get hurt on the job, even if they do something wrong such as fail to replace old equipment. The law says that you get to file a claim for workers' comp and get compensated that way. It's meant to make things more efficient and predictable for both sides.

You can, however, sue a third party that is not your employer, if they're to blame. For example, a third-party lawsuit might be an option for a worker who is injured while working on someone else's property. An electrician who is doing repairs in an office building might get hurt on the job site. He has the option of suing the owner of the building for negligence. He would not, however, be able to sue the property owner and collect workers' comp.

It's up to you whether to have surgery

It is not up to the insurance company. They might try to convince you by pointing out that the law requires you to follow your doctor's orders and obtain all reasonable medical care, but that rule doesn't apply to surgery. The law recognizes that it's a very personal decision, and the insurance company cannot use your decision against you. Refusing surgery is not a basis for denying your benefits for lost wages or medical treatment. Unfortunately, you can't count on the insurance company to tell you this.

Volunteers are not eligible for workers' compensation

If you get hurt while volunteering and are considering legal action, you will need a personal injury attorney rather than a workers' compensation attorney. Workers' comp is only available to paid employees. It is a system that provides certain benefits, such as medical and lost income to these workers. What you can do, however, is file a lawsuit. Injured employees don't have this option because they have the workers' compensation system to go through. As a volunteer, you can file an injury lawsuit and ask the court for damages to cover medical bills, lost wages and even pain and suffering.

Eligibility for workers' compensation kicks in on your first day

As a paid employee, you immediately become eligible for workers' compensation benefits on your first day of work. There is no rule that says you have to be at the job a certain amount of time before you can file a claim. If you're hurt that first day, you are just as entitled to benefits as someone who has worked there for 30 years.

If your employer tells you differently, check with an attorney. There are some legitimate exceptions (independent contractors, for example), but most workers should be able file a claim. Your employer may not know the law.

A benefit you might not know about: vocational rehabilitation

If it turns out that your work injury is going to prevent you from returning to your previous line of work, but you're not completely disabled, you probably need a new career. It might be a scary thought, but the workers' compensation system in Illinois can help you by providing job training as well as assistance finding a new position. Ask your attorney if they think vocational rehabilitation is an option for your situation. You might have to prove that it would be beneficial, and once approved, you will have to follow the program. The insurance company should continue your benefits during the training.

Functional Capacity Evaluations

A Functional Capacity Evaluation, or FCE, measures your ability to perform your job duties. When your doctor states that you are fully recovered, or as recovered as you can be, you might undergo an FCE to see what you can and cannot do. You may have some restrictions, such as lifting or range of motion limitations. Sometimes, the insurance company or your employer requests that you submit to an FCE; other times it is suggested by your doctor. If you don't already have an attorney, we suggest talking to one if an FCE has been requested in your case.

Always file an official claim for benefits

It may not seem necessary if you are already receiving the benefits you need, but filing an official claim shouldn't be overlooked. If your injury was clearly work-related and your treatment is reasonable and straightforward, your claim might get approved without any resistance from your employer or the insurance company. Filing a claim might seem redundant. However, there is good reason to file an official claim in every case. The reason is that you could face a road block at any time – your surgery gets denied, your wage checks suddenly stop – and you will need to have a claim on file before you can do anything about it. In order to resolve a dispute, you may need to request a hearing with an arbitrator, which happens more quickly if you've already filed a claim. There is no fee for filing a claim for workers' compensation in Illinois.

You are giving up rights when you settle a claim

When you agree to a settlement in a workers' compensation claim, you will have to sign something that says you will not come back and ask for any more benefits, even if your injury gets worse or you have future complications. This is a common agreement, and many workers sign off on it, but don't go down that road unless you really understand what you're giving up. Settlement is the best outcome for many people. The insurance company pays a lump sum and your case is closed. Just make sure you have all the facts. Don't rely on the insurance company to fully inform you of your rights. Talk to an experienced workers' compensation attorney about whether it's the right time to settle.

Arbitrators are the judges in workers' compensation cases

The purpose of the workers' compensation system is to streamline the process of compensating injured workers. A claim is not a lawsuit and you do not go to court and argue in front of judges. The process is similar, however. If you have a dispute about your workers' compensation benefits, you can request a hearing in front of an arbitrator who will make a decision. If you and the insurance company can't agree to a settlement, you can go to trial instead, where an arbitrator will hear your case and determine the outcome. Arbitrators aren't technically judges, but they play the same role in resolving disputes.

You can lose benefits if you don't work toward recovery

Injured workers are required to follow through on their treatment if they want to continue receiving benefits. For example, there was an employee at a car dealership who got a back injury on the job. He was receiving benefits, but five years later his benefits were reduced because he had not followed medical orders to lose weight. On top of that, he hadn't looked for a different job. The purpose of workers' compensation benefits is to help you get back to work. The insurance company isn't going to let you sit back and continue collecting benefits if you don't do your part.

Employer gets penalty for being unreasonable in denying claim

In one workers' compensation claim, an employer was penalized for relying on a single medical opinion in its favor despite several opinions to the contrary. The worker had injured his shoulder pushing a cart at work, and he was still in pain 10 months later when he started noticing popping and grinding in the injured shoulder. The employer's insurance company referred the injured worker to a doctor who concluded that the worker had a rotator cuff injury and a SLAP lesion. The insurance company got a second opinion. The second doctor looked over the medical records and decided that the injury was not work related, that it was degenerative. The employer relied on the second opinion and concluded that the shoulder injury was not work related.

Three additional doctors agreed with the first. The worker had surgery and doctors again confirmed that the shoulder injury was the result of the work incident. The employer refused to budge and eventually an arbitrator penalized the employer for unreasonably relying on the one medical opinion. The penalties were around $18,500, and medical expenses awarded were around $27,000. The worker also received 14 weeks of Temporary Total Disability and 35% loss of the use of his arm.

Many "independent contractors" are actually employees

Your employer can call you whatever they want but it won't affect whether you are eligible for workers' compensation. The actual job title doesn't matter – it's what your job is like that matters. If your employer has a lot of control over your work, then you're more likely to be an employee under the law. Control includes things like whether your employer sets your schedule, gives you deadlines, tells you when and where to do your work or requires that you do your work in a certain way. We also look at whether your employer provided your uniform, equipment, etc.

What to do after a work injury

• Tell your employer. Do this in writing, such as filling out an accident form.
• See a doctor. Delaying medical treatment can hurt your case. Make sure to explain to your doctor exactly how you hurt yourself.
• Be proactive and honest. If you need additional medical treatment, then get it. If you need legal help, get that, too. Open communication and honesty with your doctor, lawyer and employer are important in getting a good outcome.

Evidence important in proving and setting Average Weekly Wage

Benefits are based on how much money you make. Specifically, your checks will be a percentage of your average weekly wage. As an injured worker, you need to make sure that your average weekly wage is correctly calculated. For some, it's straightforward. For others, it's complex. Either way, the more evidence you have, the better. Your pay stubs are key in getting an accurate calculation. There was a case where an arbitrator at the Illinois Workers' Compensation Commission awarded benefits based on a 48-hour work week instead of the typical 40 because he or she only had one pay stub in evidence. The decision was overturned because the evidence was insufficient. Work with your attorney to get everything in order before it's presented to an arbitrator.

Workers' compensation attorneys are concentrated in Chicago

If you are looking for a work injury lawyer, you'll find a large number of them in Chicago. Many travel for client meetings and hearings throughout the state, but being based in Chicago makes sense because of the volume of cases here. Work injury attorneys often have 100 clients at one time. It's what's called a volume practice. This is different from other areas of injury law, such as medical malpractice, where an attorney might have less than a dozen cases at one time. The attorneys who handle workers' compensation best, in our opinion, are those who do only workers' comp. There are more claims at the Illinois Workers' Compensation Commission in Chicago than anywhere else in the state. So even if you were injured elsewhere in Illinois, you might be best served by hiring a Chicago attorney for your claim. Every case is different. Let us know if we can help you find the right attorney for you. (312) 346-5320.

Officially filing a claim after a work injury

Until you file a document called an Application for Adjustment of Claim, you have not formally filed a claim with the Illinois Workers' Compensation Commission. In some cases, you'll start receiving benefits without doing this. Benefits are paid by the insurance company, and if your claim is not disputed, you might start getting checks without formally filing. This is good, but you should still file that claim. You will be assigned a case number and an arbitrator in case you have any issues and need a hearing. If you don't do this and a dispute comes up, it will take a lot longer to get in for a hearing. You have three years from the accident to file an official claim. If you have already received benefits, then you have two years from the date of your last benefits to file.

No lawsuit if your boss causes your injury, unless it's intentional

If your boss does something dumb and you get hurt, you can't sue him. Your only option is a workers' compensation claim in most cases. The exception is when your boss intentionally hurts you. If you get in an argument and your boss pushes you and you fall and get hurt, you can probably sue him because it was an intentional act. The same is true of a co-worker. If they fail to follow safety guidelines and you get hurt, you can't sue the co-worker for negligence, but you should be able to file a claim for workers' compensation if your injury is work related.

Does average weekly wage include overtime?

Your average weekly wage is determined by looking at your last 52 weeks of employment. If you are entitled to TTD benefits, then you will get 2/3 of your average weekly wage while you can't work due to a work injury.

In order for overtime hours to be included in calculating your average weekly wage, they must have been mandatory. Optional overtime generally isn't included. You might have to show that it was part of your regular schedule. And the rule is that the overtime is included at a straight time rate. If you have questions about your average weekly wage, talk to an attorney. It's a safer bet than relying on a calculation by your employer or the insurance company.

You may not get benefits if you were acting recklessly

Generally speaking, fault is not a factor in whether you receive workers' compensation benefits. If you make a mistake and get hurt, you should still be compensated. However, if it's determined that your behavior was reckless, your claim can be denied. In one example, a bartender jumped over the bar while she was working and hurt her knee. Benefits were denied because her conduct was considered reckless and it was something that was forbidden by the employer. If you have questions about the cause of your work injury, give us a call at (312) 346-5320.

Findgreatlawyers.com is a free service, founded by Chicago work injury lawyers, to find an attorney or obtain guidance for any Illinois legal matter, including Illinois workers' compensation cases. We can help with work injury questions and cases in any county in Illinois. If you have questions about your injury or if you would like a referral please call us at (312) 346-5320or fill out our contact us form and we will contact you. All inquiries are confidential.

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