I was in the hospital and released from the hospital, however before my physician is able to get me in, my company dr has requested to see me... I find this an odd request and was wondering if this is so the company dr can release me to full duty...
I agree with Peter Corti's answer above. Yes the company doctor can say that you are fit for work or light duty work. You don't have to see the company doctor for treatment. If you received a formal letter from your employer advising that they have a PPP preferred provider program, you can reject their doctor in favor of your own in writing. Special rules apply if a PPP is involved so contact an experienced Illinois workers comp attorney to protect your rights.See question
My injury happend on Sept 24th and it was not a serious injury but I did miss 7 days of work due to it.The first 3 missed days of work were paid by my sick time and work comp owes me 4 days of pay still.My supervisor submitted my lost work time to...
As a practical matter, the workers compensation adjuster in charge of your claim needs sufficient documentation before any benefits can issue and before any medical bills can be paid. They cannot pay your benefits without the proper documentation.
My advice would be to cut through all the red tape and pick up your doctor's office notes, ER or company clinic records and be sure to pick up copies of the off work slips to verify your lost time and then submit all the documentation directly to the adjuster. This directly facilitates payment of benefits without the delay incurred if the adjuster is forced to request the medical records in writing.
Your check should issue shortly after the adjuster has the necessary documentation. The off work slip and confirmation of accident from your supervisor alone is not enough. The adjuster in charge must have the doctor's notes to verify that the treatment and the time off work is related to the work injury. I think that will solve your problemSee question
returned to work with a full release, no restrictions after having neck surgery. Large company, many locations
There is no specific time limit set for settlement by Illinois law. There is no exact formula that applies to each and every case as each claim for injury is different. A back injury with surgery may take a full year or more just to complete treatment. Generally, the case should never be settled until all medical care has been completed and there has been a return to work to make sure that job duties are tolerated. You also need sufficient time to check to make sure all the medical bills have been paid. It is impossible to put a settlement value on a claim until actually returning to work because the injury may have caused a job change with a new lower rate of pay. Those cases are wage differential cases and there are specific provisions in the law for obtaining supplemental benefits to supplement the new lower wages.
Consulting a lawyer experienced in workers compensation is the only way to ensure it is safe to settle and that the dollar amount is fair.See question
We had a delivery driver (required to unload individual bags of 50# fertilizer and drive truck for 6+ hours/day) file a w/c claim related to a back injury and has been out since early 2011. He is undergoing surgery and expected to be on restricti...
When medical care is finished, the workers compensation carrier can set up an FCE ( Functional Capacity Evaluation) to determine his real time permanent work restrictions and have those restrictions reviewed by an IME or by the treating doctor to see if he can return to his regular job.
I would note from my 25 years of experience handling back injury claims that some people can and do heal up far better than others due to their general health, their effort in physical therapy and their overall motivation to RTW. The expected restrictions will vary greatly depending on the type of surgery performed, the age and physical condition of the worker and the actual skills of the operating surgeon.
If you are a union shop, your union contract will determine any RTW rights and whether he can "bump" new hires. If not under a union contract, you have the legitimate right to replace an injured, disabled worker that is currently off work in order to continue to operate your business.
When your employee is actually released to RTW, you will have to review the pertinent restrictions at that time and review any open job positions for which he may qualify. You cannot simply refuse to rehire someone just because they had a work injury. But, if you legitimately have no open positions to fit his post operative work restrictions with "reasonable" accommodation, then there simply is no available work. However this may trigger certain rights available to ongoing workers comp benefits in the form of vocational rehabilitation to assist the worker in finding new work within the restrictions, ongoing "maintenance" disability benefits during the job search process and eventually even an award for wage differential benefits (or partial pension) as an ongoing weekly wage supplement of 2/3 the difference in pay between what he would have been earning in the old job and what he is currently capable of earning in the new job. A failure to return an injured worker to work can result in a very expensive workers compensation claim.
Speak with your workers compensation adjuster and with their designated counsel for specific legal advise when you reach that point where the injured worker has reached MMI and he has permanent work restrictions.
says he doesnt have documents I know I gave him, its a workers comp injury and my pay has stopped coming in and he never told me it was going to stop I am broke and he has nothing for me
The easy answer is talk to your attorney first. Try to set up an appointment if necessary to sit down and find out why you are not being paid and find out the status of your claim.
Most often, I find that its a simple lack of communication with the workers comp insurance carrier or the adjuster in charge of your claim regarding your current medical status or your inability to work. Don't wait for your attorney, if you don't have a current off work slip don't expect to get paid benefits. You must attend your doctor regularly and obtain a current off work slip.
As a practical matter, the adjuster cannot issue any TTD benefits until that off work slip is provided for her file along with the doctor's current office notes to explain why you are still disabled from work.
Note-- your "off work slip" must also be turned into your employer to prevent you from being fired or terminated for being AWOL without an excused absence. Most companies will fire an employee for failing to provide an off work slip in timely fashion. Most companies have a "no call, no show" policy of termination after 3 days if you don't promptly turn in an off work note.
Make sure that everyone is on the same page by providing the "off work" note to your attorney, the workers comp adjuster and your employer. Communication is the key. Don't sit back and expect everyone else to take care of it for you. You can do a lot to insure ongoing timely payment of benefits.
If you haven't seen the doctor recently in well over 30 days, you must return to your doctor get a "current" exam and a "current" off work note.
If you have been released for "Light duty" work you must turn that light duty slip in to your attorney and to your employer and you must report to your employer to see if they might have a job for you that fits your light duty restrictions. Failure to report to light duty work when you have been released to light duty will also lead to suspension of your benefits or result in your termination from employment.
Lastly, if your employer recently sent you for an IME (independent medical evaluation) by their doctor, you may have been cleared for regular work by their doctor or the IME may have determined that your injury is the result of a pre-existing medical condition and therefor not work related. If so, (1) the workers comp adjuster is certainly required to notify your attorney in writing as to the basis for stopping the temporary total benefits and (2) Section 12 of the Workers Comp Act requires that the adjuster provides a copy of the IME report to your attorney.
If that's the case, then your benefits will be disputed and your disability pay will be tied up in litigation. Only the arbitrator assigned to your case can resolve the difference between conflicting medical opinions by a trial or arbitration.
I hope that helps--
Brad BleakneySee question
I am receiving social security benefits (not social security disability) and going to settle my worker's compensation claim. I can't find any info on this matter. My question is, will this settlement affect my social security benefits? P.S. I am...
Medicare's interests must be protected in your workers compensation settlement with a Medicare Set Aside future medical account if you are applying for SS Disability or applying for Social Security retirement benefits. Where your future medical rights are specifically left open in the workers compensation case in settlement terms, this is not necessary.
Where, as a result of the injury, you actually qualify for Social Security Disability benefits, Social Security will take a credit or a deduction or an offset in their monthly disability benefit amounts to the extent of the workers compensation benefits received in settlement.
You must be very careful in the wording of your settlement or all SSD benefits can be denied until Social Security completely exhausts or uses up their credit for your lump sum workers comp settlement.
It is extremely important that you seek the advice of an experienced workers comp attorney or Social Security lawyer in your area before you finalize your settlement to take advantage of the allowed settlement language to maximize the combination of your workers comp benefits coordinated with receipt of your Social Security disability benefits.
Social Security can and will allow payment of combined disability benefits up to 80% of your former monthly income subject to a rather low maximum monthly benefit. The general rule is that the combination of benefits between your Social Security disability and Workers Compensation benefits cannot exceed 80% of your former monthly income.
See the Workers Compensation and Social Security Offset in the Soc. Sec. Act, Section 224(a) , 20 CFR § 404.408 ( https://secure.ssa.gov/apps10/poms.nsf/lnx/0452101001!opendocument )
See the SS Handbook ( http://www.ssa.gov/OP_Home/handbook/handbook.05/handbook-0504.html )
There is no similar worry of offsets or credits for workers comp settlements if you are qualified for and receiving regular SS "retirement" benefits rather than "disability" benefits There is no similar deduction from regular SS retirement benefits for the workers compensation settlements.
For your possible "Calpers" pension you are really going to need to consult with a lawyer to review the specific pension plan provisions and any offsets or credit language. We are not familiar with those specific terms or plan conditions.
Please be sure to seek out legal counsel in your area for a full explanation and complete understanding.See question
My dad settled his worker comp case with libety mutual May 5th, he passed June 6th. LM is saying that the settlement was not finalized, something about a hearing that my dad had to attend June 4th, however they never contacted him about this so c...
A settlement is not final until the pink settlement contracts are signed and actually approved by the IL Workers Compensation Arbitrator or Commissioner. Here, I assume that this was not able to be done due to your father's illness.
Some cases for permanent injury can and do survive the unrelated death of the worker. Often the worker's dependents or the surviving spouse is entitled to receive that amount that would have been paid out in settlement but for the unrelated death.
If the cause of death is in fact related to the original injury at least in part, based on the medical evidence, the dependents or surviving spouse do have a separate claim for death benefits under IL law.
A spouse or minor child does not have to prove that they are actually financially dependent in order to be considered a proper beneficiary. But, parents, siblings or grown adult children are required to prove that they are at least partially financially dependent upon the worker before they are considered a proper beneficiary to receive death benefits under the IL workers comp laws.
Your particular circumstances and the type of injury need to be reviewed with an Illinois workers comp attorney for proper legal advice. Time limits do apply and medical opinions on the cause of death are important. Seek legal advice without delay.See question
my attorney came to me and said they made an offer of 50,000.$ take it or leave it. i asked him how long would it take to receive compensation, he told me six to eight weeks. In the meantime i'd received a letter showing the amount to be 45,000.$....
It sounds as if your attorney is cleaning up loose ends. Workers shouldn't pay the medical bills out of their portion of the settlement unless there are problems with the case or problems with relating the particular treatment for that bill to the workers comp case.
You don't have a final settlement agreement until both sides actually agree on all the exact terms of settlement (in your case for example, who pays that medical bill) and when you have signed settlement contracts that are presented to the arbitrator for approval.
Generally, the company has about 30 days from receipt of the approved settlement contracts to pay the settlement. You don't have an actual "final" settlement until your attorney has you sign the pink settlement contracts and then the arbitrator approves them.
I would generally advise clients to expect money within 45 to 60 days from the time that they sign the pink settlement contracts-- that allows 2 weeks for approval, then time for mailing the approved contracts to the other attorney, he/she mails it out to the insurance carrier for payment and the carrier processes the settlement for issuance of the settlement check.See question
My adult son has workman's comp insurance in California and was just approved for SSDI and Medicare. He does not have a final settlement. WC has insisted that his back injury from work is the only thing they will cover. My question is:...
Yes, Medicare will cover all non-accident related normal medical expenses just like usual. The Medicare exclusion on coverage (when dealing with a workers compensation claim per the Secondary Payer statutes) only applies to all work accident related medical care. That is to say, after a workers comp settlement, Medicare will not pay for future medical bills which are specifically related to the work accident.
That is why Medicare requiresreview and prior approval of all workers comp setlements over $25,000 for Medicare beneficiaries. They want to be sure that all anticipated work related future medical expense is covered and funded by the workers compensation settlement so that Medicare will not be forced to pay for those injury related medical expenses at some point in the future.
Normally, Medicare requires the set up and funding of a Medicare Set Aside Account to be funded under the workers compensation settlement. If they approve the amount of the funding, then they will later pay for unexpected injury related medical expense once the MSA settlement funds have been properly exhausted.
I hope that relieves some of your worries on future Medicare coverage. -- you can view our article on the interplay between workers compensation and Medicare at http://wc-chicago.com/Medicare.aspx or check our Resources page for links to actual CMS Memos for guidelines on handling of the set aside accounts.--- BradSee question
My name is Ronald Washington. I was hurt on the job, now the job has let me go. I'm still under doctor care. I can't get unemploment, S.S.I or P/aid. My wife, two little sons and myself is about to be homeless. I go to court on 11/13/08 to be put ...
If your job injury resulted in light duty work restrictions and you are still under a doctor's care for medical treatment, your employer may be responsible for paying on going disability benefits during a layoff where they make no work available for you within your restrictions.
If the layoff is permanent and you can't get a new job because of the injury related medical restrictions, you may be entitled to disability benefits or assistance for vocational rehabilitation, job placement or ongoing maintenance benefits during an active job search.
If however, you were fired for just cause, rights to disability or maintenance benefits may be properly terminated because of a legitimate firing where light duty work would have otherwise been available per a recent workers compensation case decision.
If you are able to work light duty, you can in fact apply for and receive unemployment benefits which should also be payable unless you were fired for proper cause. Unemployment is properly denied where you are fired for just cause. The unemployment benefits are to be reimbursed if you recover work comp for the same periods.
Often, a firing for slow performance due to the work injury disability or doctor authorized absenteeism related to the injury will not prevent recovery of workers compensation benefits. You should contact a workers compensation lawyer right away to review your options. The time limit for applying for benefits is 3 years from the injury date or you may be forever barred from recovery.
If the firing is related to a disability or a perceived disability there might be a discrimination case. Those time limits are very short and you should seek advice from a qualified discrimination lawyer right away. Those cases are often fought heavily and are slow to produce the immediate money needed. Getting a new job or getting unemployment benefits may be the quickest way to money if your workers compensation claim is disputed. Contact the unemployment office to see if you qualify.
I hope that this information provides some general direction but as lawyers, we cannot give accurate advice without a complete review of all your relevant details. Best of luck for you and your family---BradSee question