What do I need to look out for with my workers' compensation claim?
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Chicago Work Injury Attorney Answer
Things can be going perfectly well with your Workers' Compensation case. Then, treatment is being denied, bills aren't being paid, and your Temporary Total Disability is totally cut off. There are several red flags that will pop up before these things happen, and you need to know how to recognize them. That way, you can sometimes avoid or at least anticipate these problems and plan accordingly.
The Individual Medical Evaluation (IME)
The insurance adjuster is not spending money on an IME to get the same information your treating doctor is already providing. The IME is often used to get an opinion stating that:
- Your restrictions are less than what your treating doctor says, or are non-existent and you can go back to work full duty
- You don't need that expensive treatment your doctor is prescribing, but rather some cheaper treatment or no treatment at all
- Your work accident didn't cause your "current condition of ill being," the health problem that you currently have and need treatment for
- Your treatment has not been reasonable and necessary
- You are faking or exaggerating your pain
- You are a malinger
Some IME reports contain several of the above. As mentioned in chapter 7, you need to get a copy of the IME report to your treating doctor and get your doctor's opinion in writing. Your doctor will be able to clear up the confusion often caused by a negative IME opinion. However, don't expect the Worker's Compensation insurance carrier to give up the fight just because you an opinion from your doctor tearing apart the IME doctor's opinion. They paid good money for that IME report, and by gum they're going to stick by it till an arbitrator gets involved. Get thee to an attorney.
*This was an excerpt from Mark Weissburg's book, "How to Win a Workers' Compensation Claim in Illinois."
How to Win a Workers' Compensation Claim in Illinois
For more red flags on things like prescriptions for MRIs or surgeries, Temporary Total Disability checks being late or light, medical bills not getting paid, no call backs, and more, get a FREE copy of the book, "How to Win a Workers' Compensation Claim in Illinois". Horwitz, Horwitz & Associate's very own, Mark Weissburg wrote this book to help Illinois employees learn more about Workers' Compensation law in Illinois. Mark Weissburg is an Illinois workers compensation lawyer and partner at Horwitz, Horwitz & Associates.
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