Illinois Workers Compensation Legal Questions

Under OWCP you must submit a rating for your listed body part impairment by a competent medical doctor of your choice per the 6th Ed. AMA Guides for your scheduled award.  You are responsible to do this, OWCP will not do this for you. If you ask or choose OWCP to rate you they will send you to their hired MD's who will rate you at very minimal to zero impairment.  Yo do not want to do that.  https://plus.google.com/communities/100194557699660054902... Read More

You have a theoretical cause of action against your therapist group but most likely a very hard claim to prove in practice.  Proving your exacerbation was caused by the lifting or that the additional weight lifted was a deviation in the standard of care could prove difficult. Also valuing this exacerbation next to your original underlying injury could be difficult as far a separate medical negligence case.  Under Illinois Worker's Compensation Law your ongoing medical issues wether being a continuation of your original injury or a temporary exacerbation in therapy should be covered in your work injury claim.  Anyone looking into this further for you should obtain the therapists records and the treatment notes of your physician to see how this incident was reported in your medical records.  Thereafter a determination could be made with you whether you wanted to approve the cost of an expert reviewing these documents in light of the obstacles to recovery. Generally a medical negligence case has a 2 year statute of limitations but you should act immediately to review this situation if you feel it is warranted.  ... Read More

It appears there is a dispute concerning the causally relationship of your needed surgery and a work injury.  The Respondent is denying approval for surgery under work comp. Under law you would proceed to hearing under Section 8a of the Act which could take several months.  Many attorneys who regulary practice before the Commission can tell you of cases where a decision took upwards of a year.  Sometimes this could be due to the treating surgeons schedule and obtaining a deposition date, if this is needed.  Also, there are many new Arbitrators at the Commission following the law changes in the State after 9/1/11.  Accordingly, your attorney may not have a feel on a close call claim which way the Arbitrator will rule.  It sounds as if your lawyer is providing you an option to get your surgery performed now. Your lawyer can then argue the issue of causation for the surgery later.  Customarily having the surgery performed is influential on a favorable causation ruling.  Also, in addition to getting surgery performed in this time period you can also have the assurance to know that the surgery is paid.  Your doctor may be unhappy because the reimbursement for the surgery under workers compensation may be higher than under your group health insurance.  The decision to proceed to a hearing for surgery approval versus proceeding under your group insurance does not appear to be "illegal" if the surgery is not related to work.  In my experience many group health insurance providers will deny surgery under their plans if a work injury is alleged.  The only illegal thing would not be not to report the injury properly to the group insurance carrier. ... Read More

What the insurance adjuster is saying to you is that she has reached her last and best offer. The adjuster is asking you to obtain an attorney to move your claim forward.  The attorney could review the offer and advise on the next best step.  The max fee for an attorney in Illinois is 20% of whatever is disputed or an agreed percentage over your prior offer.  You do not need an attorney and you could try handling this yourself. However this may not be in your best interest to try this yourself and with a final settlement offer already being made you have very little downside in consulting a lawyer.  Many lawyers who regularly practices workers compensation law will provide you a free consultation by telephone.  In light of sweeping changes that occurred with worker's compensation in this State following 9/1/11 law enactments you should at least consult with an attorney.  Accordingly, you must not have a lawyer and can proceed to a litigate this matter on your own but this is customarily not advisable.... Read More

Under North Carolina Gen. Statute 97-10.2(b),the employee or his personal representative has the exclusive right to proceed to enforce the liability of a third party by appropriate proceedings if such proceedings are instituted no later than 12 months after the date of death or injury, whichever is later.During the said 12 months and any time thereafter, the employee has the exclusive right to settle with the third-party and give a valid a valid and complete release of all claims to the third party subject to the lien creation provisions of Section 97– 10.2(h).   As to the second part of your question, I do not understand what you're asking. If you are referring to contributory negligence on the part of the employee, it would not bar the workers compensation claim. It could, however potentially prevent a third party claim.... Read More