Workers Compensation Lawyer Proved Employer Had Every Reasonable Opportunity To Get Information

A workman’s compensation lawyer knows how an injured worker may need to borrow money or have help from family during their injury. In the following case, an employer tried to use these sources of money to wrongly stop benefits payments… and the employee’s workman’s compensation lawyer successfully stopped the employer from misinterpreting these deposits into the employee’s savings account. The hearing officer in the case agreed with the workers compensation lawyer, and made a finding that the injured worker was entitled to supplemental income benefits (or SIB’s) even though he did have some additional money (loans from his parents), and also a little self-employment. The insurance company appealed this decision, claiming to have gotten evidence to prove their argument… “after” the hearing was over, stressed the workers compensation lawyer. The injured employee’s workers compensation lawyer then successfully defeated the insurer’s arguments.

Workers Compensation Lawyer Defended Right To Part-Time Self-Employment

The workers compensation lawyer answered the insurer, saying the hearing officer correctly decided the injured worker was entitled to SIBs. The insurer’s real argument, the workers’ compensation attorney pointed out, was that the injured worker “could have worked more,” and claimed he didn’t make a good faith effort to get work, based on these “extra” deposits. But the workers compensation lawyer stressed very detailed medical findings of a serious disability.

Besides, the workers compensation lawyer noted how the hearing officer was the most important judge of the evidence. The hearing officer heard all the evidence from the workers’ compensation lawyer and from the employee himself, as he told the workers’ compensation lawyer about the injury and his job search. As the trier of fact, the hearing officer clearly agreed with the workers’ compensation lawyer about the strength of the medical evidence. Based on evidence presented by the workers’ compensation lawyer, the hearing officer reasonably decided the injured worker (a) was not required to get additional employment, once the workers’ compensation lawyer proved employment at a part-time job and (b) was being self-employed, consistent with his ability to work.

Workman’s Compensation Lawyer: A Serious Injury With Lasting Effects

The insurance company also argued the injured worker’s underemployment during the qualifying period wasn’t caused by his impairment. The workman’s compensation attorney noted the injured worker’s underemployment was also a direct result of the impairment. This was backed up by evidence from the workers comp lawyer that this injured employee had a very serious injury, with lasting effects, and just “could not reasonably do the type of work he’d done right before his injury.” In this case, the workers comp lawyer showed that the injured worker’s injury resulted in a permanent impairment. The employer didn’t prove (or disprove) anything specific about the extent of the injury, the workers comp lawyer observed, but only suggested “possibilities.”

Employer Was Stopped From Use Of “Confusing” Evidence By Workman’s Compensation Lawyer

For example, the workman’s compensation attorney said the insurance company emphasized “evidence” obtained after the hearing. Yet the insurance company said this came from a deposition taken three days before the hearing. At that time, the workers comp lawyer pressed, it learned that the injured worker had a personal bank account for depositing wages. The insurance company subpoenaed copies of the injured worker’s deposit slips, and got the records after the hearing from the workers compensation attorney. The insurance company argued that the deposit slips “proved” that the injured worker earned more than 80% of his pre-injury wages. But the workers comp lawyer stressed how the insurer should have worked harder to prove this argument before the hearing.

Specifically, the workers’ compensation attorney pointed out that documents submitted for the first time (on appeal) are generally not accepted… unless they are newly discovered evidence, noted the workman’s compensation attorney. The evidence offered by the insurance company wasn’t newly discovered evidence, proved the workers comp lawyer. The injured worker testified to his workman’s comp lawyer that the deposits included wages from his self-employment and “money I borrowed from my mother.” The evidence didn’t, proved the workers comp lawyer, show how much (if any, noted the workers comp lawyer) was deposited from the injured worker’s wages versus how much was from borrowing. Though the insurance company had known about the evidence, it made no request to get the evidence, emphasized the workers comp lawyer. Nor, concluded the workers comp lawyer, did the insurance company ask for the hearing record to stay open for evidence once it was received… which, the workers comp lawyer stressed, they had a right to have done. The Appeals Panel agreed with the workers comp lawyer and “refused” to consider the ‘evidence’ attached to the insurance company’s appeal. The workers comp lawyer had completely defended the worker’s award.

There’s often uncertainty about how long an injury may last, an experienced workers comp lawyer knows. In this case, talking with an experienced workers comp lawyer helped deal with issues from this uncertainty. For anyone who survives a period of injury, through self-employment or family loans, it’s important to discuss these matters as soon as possible with a knowledgeable workers comp lawyer.

New Rules Affecting Illinois Workers’ Compensation Lawyers

What is your hand worth? According to the Illinois Workers’ Compensation Commission, the maximum value of a hand lost at work (for a worker who makes the average Illinois annual salary of $42,754.40) is $168,551, whereas that same hand would be worth $156,218 in Iowa and $143,885 in Nebraska.

In Illinois workers’ compensation law, the value of human body parts is determined by an actuarial analysis of probabilities and future values of injuries. The values are continually adjusted to keep up with inflation and changes in the economy. The Illinois Workers’ Compensation Commission uses the fixed values of body parts in order to strike a fair balance between compensating workers without driving insurance companies into financial ruin.

Workers’ Compensation Overview

Workers’ compensation is one of the first examples of tort reform enacted in the United States. Before workers’ compensation law, people hurt at work were faced with two unpleasant alternatives: (1) they could either file lawsuits against their employers or (2) they could suck it up and pay for their own injuries.

Now, employers in every state but Texas are required to hold workers’ compensation insurance. When people are injured at work, it is almost as easy to file claims within their states’ workers’ compensation systems, as it is to file insurance claims after car accidents.

In order to ensure that injured workers, employers and insurance companies are all treated fairly, the Illinois Workers’ Compensation Commission continually makes changes to the Illinois Workers’ Compensation Act.

Below is an overview of the most recent set of changes to the Illinois Workers’ Compensation Act, which took place in July of 2005.

Fraud Statute Established

Any party involved in committing fraud relating to a workers’ compensation dispute is guilty of a Class 4 felony and must pay complete restitution in addition to a fine. In addition, those who knowingly receive benefits by making false workers’ compensation claims can be liable for either three times the value of benefits wrongfully obtained or twice the value of coverage attempted, plus attorney fees required to bring the claim.

Penalties Increased for Uninsured Employers

Employers who fail to purchase workers’ compensation insurance are guilty of creating an immediate and serious danger to public health. As a consequence, a work stop order can be imposed, requiring the cessation of all business operations until the employer obtains proof of workers’ compensation insurance.

Furthermore, a knowing failure of an employer to provide workers’ compensation insurance coverage is considered a Class 4 felony, and each day’s violation constitutes a separate offense.

Medical Fee Schedule Established

The Commission has established a medical fee schedule, setting maximum medical fees that employers are liable for. The maximum fees are 90% of the 80th percentile of charges in a certain geographic area. If a worker’s medical bills are less than what is established by the fee schedule, then the employee will receive full workers’ compensation coverage for those bills.

Benefits Increased and Changed

The Illinois Workers’ Compensation Commission sets maximum compensation for specific work injuries. As of February of 2006, the maximum compensation that a worker can receive as the result of a death injury is the greater of $500,000 or 25 years worth of salary. This is higher than the previous maximum (the greater of $250,000 or 20 years).

Expedited Hearings

When an injured worker is not receiving any compensation for an injury from his or her employer, that worker can request an expedited hearing. An employer can also request an expedited hearing if a worker continues receiving compensation until a judgment is rendered and the employee has been released back to work.

Utilization Review Established

If an employer has reason to believe that an inured workers’ medical treatment was unnecessary or unreasonable, the employer can have the case evaluated at a utilization review. In order to qualify for a utilization review, employers must register with the Department of Financial and Professional Regulation once every two years.

Happy Employees, Employers and Insurance Companies

The Illinois Workers’ Compensation Commission strives to reach fair results for all parties involved in work injuries. Illinois workers compensation laws benefit employees by providing fast compensation for injuries without the stress of filing lawsuits. Employers benefit from workers’ compensation insurance coverage, because it eliminates the risk of lawsuits brought by injured employees. Even insurance companies benefit from workers’ compensation law, because it sets maximum rates, which reduces the chances of unreasonable payouts. Furthermore, when insurance premiums paid by employers are invested at favorable rates, insurance companies can actually stand to gain the most from the Illinois Workers’ Compensation system.

What is the Workers’ Compensation Program?

In the U.S., one of the most widely accessed entitlement programs is Workers’ Compensation. Workers’ compensation is a series of benefits that are paid to employees that are injured or become ill during and as a result of the performance of their jobs. Employers are required by law to provide this benefit to their employees and typically do so through a workers’ compensation insurance policy provided by a private carrier. Virtually every employee is covered by the Workers’ Compensation Act and benefits are paid to the employee regardless of who is at fault for the accident and/or injury.

The actual procedure for filing a workers’ compensation claim is generally straightforward and can be done by the injured party. However, the system has definite filing requirements and depending upon circumstances and documentation requirements, preparing the claim can become a complicated process and should not be attempted without a worker’s compensation attorney. States and cities may also have individual requirements regarding workers’ compensation, so it is important when choosing a worker’s compensation attorney to have representation from the proper state or jurisdiction. Attorneys who do not specialize in workers’ compensation law and are from outside the jurisdiction likely will not be able to properly represent your claim.

A workers’ compensation claim is similar to a claim against an auto or homeowner’s insurance company. It is a claim filed against the employer’s workers’ compensation insurance carrier and is not a law suit directed at the employer. In fact, the law provides that: (1) injured workers cannot sue employers for accidents occurring on the job and, (2) it is also illegal for employers to terminate workers for filing a workers’ compensation claim.

Under workers’ compensation, the main benefit categories are, but not limited to:

Payment of related medical bills;
Benefits paid when the worker temporarily cannot work due to the injury or illness. This is titled Temporary Total Disability (TTD) and is likely a series of ongoing payments until the worker can return to work.
Benefits paid when the worker is injured to the point that he/she cannot return to work at all. This is called Permanent Disability (PD). Based on the nature and extent of the injury, PD benefits are, very often, a lump sum settlement.

It must be understood that all insurance companies are actively reviewing cases for legitimacy and to minimize fraudulent claims and their cost of claims. Depending on circumstances and for any number of reasons, a worker’s compensation insurance carrier may deny benefit payments at the beginning of the claim or may be terminate compensation after initial benefits have been paid. Questions and positions regarding TTD and PD also are often contested as are charges of illegal firing due to the injury. Since the insurance company will employ experts in the workers’ compensation arena, in these situations, it is crucial to have an experienced workers’ compensation attorney who will advocate for you to get your legal benefits restored and the settlements to which you are entitled.

Navigating through the workers’ compensation benefit system can be a difficult task, especially if there are contested issues and/or special circumstances. It is a wise decision to engage the services of an experienced workers’ compensation attorney early in the claim to guide you and represent you through the process

Workers Compensation – 5 Facts That Everybody Ought to Know

Every state has workers compensation laws designed to compensate employees for work related injuries. In some states it may be called workman’s compensation or workmen’s compensation, but it is the same thing. While specific workers comp laws and systems vary from state to state, there are general principles applicable to all states. Here are 5 facts the everybody ought to know.

1. Not every employer is required to have workers compensation.

Every state has set a minimum number of employees that an employer has to have before the employer is required to have workers comp. The number may be one employee, but is usually 2 to 4 employees. Therefore, if you work in a very small business, your employer may not be required to have workers compensation.

Also, not every employee is always covered. Most states recognize that businesses sometimes hire “casual” employees and these employees are not covered by workers comp.

2. You do not need to prove that your employer did something wrong or was at fault.

In normal personal injury situations where you are hurt. you must prove that another person caused your injury in some way. However, to make it easier for workers to receive medical treatment and compensation for injuries suffered at work, worker compensation laws exclude proving fault. Whether an employer was is at fault or not doesn’t make a difference. All that an employee has to do is prove that his/her injuries occurred while at work.

3. You must go to the medical provider (doctor, hospital, etc.) to which your employer sends you.

It may seem unfair, but your employer (or its workers compensation insurance carrier) gets to pick the medical provider that you go to for a work related injury. And, if you refuse to go to the medical provider that is chosen by your employer, you may lose your workers compensation claim.

Employers must pay the medical bills of the medical provider to which you were sent by the employer. If you want to go to your own doctor, you will probably have to pay the bill yourself.

4. Most workers compensation lawyers will handle workers comp cases on a contingency fee basis.

Most states will not allow a lawyer to charge a worker/client a flat fee to handle a workers comp case. They require workers compensation lawyers to work on a contingency fee basis which means that the lawyer is paid a percentage of the amount he/she recovers for the worker/client. If the lawyer does not recover any compensation for the worker/client, then the lawyer is not paid.

5. Lawyer fees must be approved by the Workers Compensation Commission or Board.

Every state has a Workers Compensation Commission or Board. A state may call the commission or board a different name, but its purpose is the same – to settle disputes between the employer and employee that relate to an employee’s injury. As part of settling disputes, the commission or board is also required to approve worker compensation lawyers fees. Normally the fee is either one quarter (25%) or one third (33 1/3%) of the compensation awarded to the injured employee.

This is general information only. If you have any questions whatsoever about workers compensation, talk with a lawyer licensed in your state. This article may be republished, but the wording must not be changed and the author links must remain active.