Repetitive Work Injury In Illinois? You Must Know This

When it comes to insurance companies that handle Illinois workers’ compensation claims, you have to know that no matter how you got injured or what your case is about, they are always looking for reasons to deny your claim or limit what they pay on it. That is the business model of insurance companies, plain and simple.

The most common way they do this is through independent medical examinations or IME’s.  These are doctors who choose to examine you and offer an opinion about whether or not your condition is work-related or if certain treatment is necessary or not. They aren’t all hired guns, but it’s a lucrative business for many doctors.  So all things being equal, they usually find in favor of their client even if their “exam” of you takes three minutes.

Other times they will just say they have done an investigation and determined that you aren’t entitled to benefits.  What was the investigation? Often nothing. Other times it could be that they talked to you or your supervisor. Sometimes they just make it up and hope you go away.

It’s hard to deny benefits if your accident obviously happened and it’s clear your injuries are from that accident.  If you are in a warehouse and a forklift runs into you and your leg snaps in half, it’s pretty hard to state that isn’t work-related. That doesn’t mean they won’t drug test you to try and get out of it or ask to see all your old medical records.  In those cases, it’s more likely that down the road the IME will say you are fine before you are rather than benefits being denied in the beginning.

The more common cases, where IME’s act as hired guns to deny you, or insurance companies just do it with no reason, are repetitive trauma cases. I’m talking about people who type all day and get carpal tunnel. Carpenters that do overhead work and have shoulder problems. Workers that lift a lot and get back injuries.

If your injury is from repetitive activity, there is one thing you MUST know.  There is a great chance that your case could end up going to arbitration someday. Most of the cases that do go to trial are like this.  So it’s not enough to hire a lawyer who handles Illinois workers’ compensation cases all day, every day.  You absolutely need a trial attorney if you want the best chance of a good outcome.

What is a trial attorney when it comes to Illinois worker comp? It’s a lawyer who actually takes cases to trial, is happy to do so, has a track record to prove they do it a lot, and won’t lie to you and say that trials aren’t happening because of Covid. They are absolutely still happening all of the time.

My suggestion is that you ask the lawyer how many cases they’ve taken to arbitration over the last year. There is no magic number, but if the answer isn’t at least 10 (or wasn’t 12 or more prior to the pandemic), they probably aren’t eager to go to court for their clients when it requires it. Those attorneys will sell out their clients for less than a case is worth.  It’s not that going to trial takes great effort; it doesn’t. But it does take some effort and preparation even though it’s never been easier to get ready for trial than now with electronic records and remote hearings when needed.

You’d think that every lawyer would be a trial lawyer. That’s their job, right?  The truth is that in the work comp business where you have hundreds of clients, some attorneys choose to focus on the easy cases and will only go to trial in extreme circumstances if they go at all. It should absolutely not work that way, but it’s the truth that it does. I don’t respect those attorneys or work with them on cases, but they are out there in great numbers.  From the outside, they look like they run a great practice and they might, but just for themselves, not their clients.

Bonus tip.  Often getting a case ready for trial is what allows it to settle for a fair amount. So if an attorney tells you that they tried five, but had 10 others ready to go that settled, I don’t view that as a bad thing.

By Mike Helfand

Courtesy of Illinois Workers Compensation Law Blog

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