Injured Workers Dissatisfied with Their Workers’ Comp Claims

Dissatisfied man
A man is holding an unhappy face image in front of his face

Injured workers are often dissatisfied with their workers’ comp claims because the system does not fully compensate their losses or provide them with adequate medical treatment. It is a biased system where insurers seek to cut corners and pay as little as possible. Workers’ comp lawyers fight to defend the rights of their injured clients to help them receive the full compensation that they deserve.

Injured Workers Are Often Subjected to Inadequate Medical Care

Injured workers are often dissatisfied with their workers’ comp cases. While their medical costs are covered, the treatment they receive may be inadequate. Insurers seek to keep their costs low, so doctors who are designated as treating doctors have an incentive to minimize the seriousness of an injury. Often workers are sent back to work too soon or do not receive authorization to see specialists, to receive recommended diagnostic testing, or for expensive medical treatments. This can complicate the workers’ recovery, lead to misdiagnoses, and leaves him or her prone to further injury.

Understanding Workers’ Comp Settlement Agreements

It can be difficult for a worker who has been scraping by on worker’s comp benefits to know whether or when they should settle their case. Insurers know that injured workers will reach a point of financial desperation that could lead them to accept settlements that are less than what they deserve. Settling the case too early means that the injured worker may not receive what he or she is fully entitled to. It also leaves them at risk of what could happen with their injuries in the future.

Some settlements might allow the injured worker to receive future medical expenses or collect additional benefits if their condition were to worsen in the future. However, this is not the norm. Most insurers will insist that the claimant agrees to a full and final release of any claims when accepting their settlement. This means that the claimant gives up his or her right to future compensation for the injuries covered with the settlement, including medical care in their condition worsens.

The ability to reopen a workers comp case might be different if the injured worker received an award through a workers’ comp hearing instead of agreeing to a settlement. This could apply if the worker’s medical condition has significantly changed since the award and is still caused by the original work-related injury.

Reducing the Chance of Being Abused by the System

There are steps that injured workers can take to avoid being abused by the workers’ comp system. The most crucial step is for the worker to report their injury immediately to his or her employer. In Illinois, claimants must provide written notice of their injuries within 45 days of the incident. An exception to this time requirement is when an employee may have been exposed to radiation, which then increases the time limit to 90 days after the suspected exposure. An additional exception applies to job-related diseases that should be reported as soon as the worker is diagnosed with the condition.

The injured worker’s written notice should provide a detailed account of the incident, which should include:

  • Date and time that the incident occurred
  • A description of the events leading up to the incident
  • A description of the injury
  • The worker’s contact information

Failure to notify the employer within the time limits could cause the injured worker to become ineligible for workers’ comp benefits.

What Injured Workers Should Know about Illinois Workers’ Comp Law

Once a worker has been injured on the job, the clock starts ticking. While the employer must be notified within 45 days of the incident for most cases, a claim must still be filed with the Illinois Workers’ Compensation Commission (IWCC). This commission oversees all workers’ comp claims. The injured worker must file an Application for Adjustment of Claim form with the IWCC within three years after the date of the injury. A copy of this completed form and notarized Proof of Service must be sent to the employer and three copies sent to the IWCC. The injured worker and their workers’ comp lawyer should keep a copy for their records.

The IWCC will mail a Notice of Hearing to the injured worker, his or her attorney, and the employer that provides the hearing date and the arbitrator handling the claim. After the initial notification, further status dates will be posted through the IWCC’s website. If the claim remains pending for three years, it must go to trial or be dismissed. If the injured party is not ready to settle or go to trial, they or their lawyer must notify the IWCC before the three-year deadline runs out. An Arbitration Case Information sheet must be filed to explain why the case should remain open and not be moved to trial or be dismissed.