Guidelines to Maximize Your Claim Under the Illinoies Workers' Compensation Act

Immediately after reporting the injury to your employer and seeking medical treatment you should contact the attorney. It is critical to learn immediately what your rights are and to make sure that your treatment process is being properly pursued.

When discussing the condition with your doctor, you should describe your complaints, limitations, treatments and symptoms. You should describe all complaints in detail so that the doctor understands the nature and extent of your injuries. The doctor must understand the nature of an employee's work. Sometimes a physician will want to return you to "light duty" and they should understand that that is sometimes not practical. You should be prepared to explain to the doctor how your activities around the home have helped you recognize your restrictions. With those restrictions he will know that you are unable to perform your activities at work. The doctor should sign an off duty slip on his own stationary.

You should complete a written list of your limitations and restrictions when your condition becomes permanent. The list should be reviewed with the doctor so that he can understand your disabilities and limitations. Please give the doctor examples of your restrictions. If you have trouble standing long periods of time, then you should be prepared to tell him how long is too long; if you have trouble lifting heavy weights, then you should be prepared to tell him how much is too much, etc.

The employer will frequently send a person to a doctor whose opinions are predictable. The company doctor will often return a person to work even if the employee's treating doctor states that the patient cannot yet resume job duties.

An employee need not return to work at that point. The employer, however, will stop paying temporary total disability benefits. The matter can be taken to an Arbitrator but usually it takes so long to get a final decision from the Arbitrator that most people cannot endure the wait.

There are emergency provisions under the Workers' Compensation Act that entitles an employee to an immediate hearing before an Arbitrator. The Arbitrator may award penalties and attorney's fees in addition to other required compensation.

Another approach is to return and try to work. If you are able to return to work, more power to you. If you are unable to return to work, however, then you have proven it by making an effort. Naturally, the effort should not be so hard as to result in further injury. If an injured worker is unable to return to work then he should report to the emergency room and obtain an off duty slip. The emergency room doctor will routinely tell the employee not to return to work again until they treat with their family or treating doctor. The best approach is to consult legal counsel in these circumstances to ensure that your rights are not being compromised.

B. What if a "rehabilitation expert" or "rehabilitation nurse" is hired by the employer?

These days it is very common for the employers to hire a person whom they call a "rehabilitation nurse" or "rehabilitation expert." Some really try to rehabilitate the injured but many are simply investigators. We always ask the "rehabilitation expert" for their qualifications and background. We ask what their goals are in the case. We insist that all reports authorized by the rehab person be forward to us so we can show them to our client.

There are a few other guidelines: 1) The rehab person should not be allowed into the room with the treating physician. An injured person has every right to privacy with his own physician. 2) The rehab person should not be allowed to communicate ex-parte with a patient's physician. Anything that the rehab person has to ask or say to the doctor should be said in the presence of the employee. 3) The ordinary form medical release from the rehabilitation service should not be signed. A form which guarantees that copies of all medical will be given to the employee should be used instead. The perfected form should have a limit as to its period of use. The perfected form should have a limit as to what types of medical information can be requested.

C. What if the company wants to make tape-recording or asks you to make a signed statement?

No tape-recordings or signed statements are required by the Illinois Industrial Commission. A simple notice explaining in general terms how an accident happened is all that is necessary. If a tape-recording is requested the employee should decline. He should contact his attorney promptly. We routinely tell insurance companies that if we can take a tape-recording of their witness that we will allow them to take a tape-recording of ours. I've never had an employer take us up on that request.

D. What if the employer doesn't pay workers' compensation benefits promptly?

When the employer hesitates for no good reason in paying workers' compensation benefits they can be penalized. The penalties are rigorous. They include a payment of one-half the otherwise outstanding workers' compensation, $10.00 for every day that they are late in making payment and payment of the injured employee's attorney's fees. This is a law that really does have some teeth in it. If your doctor is keeping you off work and there is not an opinion to the contrary and they are not paying workers' compensation benefits, you should contact your attorney immediately.

The first question that should be asked is whether or not the employee can return to some other position with the employer, for example, inspector or lab worker. Since normally the employer will decline, the employee should consider retraining. The employer normally will select a rehabilitation person whose primary interest is in returning the employee to some work, with little concern for how satisfying or secure the job is or with what benefits the job has to offer. The employee should check with their own rehabilitation expert. The most accessible rehab expert is through the Department of Rehabilitation Services, a branch of the State of Illinois. Attorneys normally will have rehabilitation experts available also.

B. If an employee is unable to perform any kind of activity whatsoever

then he or she should consider filing for Social Security Disability

Benefits.

There are three ways to get disability:

a. If a person has a condition which is listed by Social Security as being absolutely disabling then they qualify. Such a listing might be blindness in both eyes. Most of the time, however, we are working for an employee who qualifies because of muscular or bony conditions such as a low back injury.

b. Sometimes a person is unable to sit, stand or walk throughout an 8-hour day. No employer is going to let someone lie down on the job. If a person cannot sit, stand or walk for 8 hours a day then the doctor should so state in the Physical Capacities Evaluation form. If that is the case, then the employee is entitled to Social Security Disability.

c. Frequently, a person will meet another criteria for disability called "the grids". The grids are available primarily to people over 50 years of age. A person's education and work experience are important to demonstrate in looking over the grids. Again, it is best to talk with an attorney before you apply for the disability to make sure that there is nothing said which may hurt you later on.

Frequently the employer and employee have major differences over what particular percent of disability should apply to an arm, leg, back or other injury. The percent of disability determines the number of weeks that are paid. Sometimes the employee overlooks an issue just as important; it is critical to determine whether or not the employer is paying the right amount for each of the weeks. Wage records for the year preceding the date of injury should be obtained and reviewed regarding an employee's average weekly wage.

In conclusion, it is critical to make certain that the injured worker receives the maximum compensation for the work-related injuries. The above information is provided as guidelines. I realize the hazards that employees face each day. Hopefully, these guidelines will help explain some of your rights.