Workers’ Compensation Insurance Carriers know the chips are stacked against them. Illinois Workers’ Compensation Law requires them to pay all bills and missed wages as well as a lump sum award for any injuries causing lifelong problems. Many times the plan to not pay these amounts is to say that the injury was not work related. They may claim it occurred outside of work or due to a preexisting condition.
The Insurance Companies are able to make this decision with or without a determination by a physician that they hire to review the records. The physician that they hire and pay for will not render you any medical treatments, but will render this decision based on review of the reports. Sometimes, the physician will schedule an independent medical exam or IME to make this determination. The physician that sees you has no patient relationship with you and is also being paid by the Insurance Company to render the decision on whether the treatment is related to the work injury.
You can see how such a physician would be inclined to continually render opinions denying that the injury is work related to allow the Insurance Company to stop paying. A snowball effect then occurs.
Once there is a denial of the injury being work related, all medical payments, approvals, and all payment of temporary total disability, or TTD payments, will stop. Without an attorney, the injured employee may sometimes have no alternative but to suffer through the pain without additional medical treatment and must return to work to further harm themselves by aggravating the symptoms.
The injured employee will most likely also be in a financial bind in this situation because they will not be able to pay bills without any money coming in to make up for the lost wages. Often times the Insurance Company will then approach the injured person to offer them a small lump sum award to close out the case permanently, thereby saving the Insurance Company a lot of money in making medical payments, missed work payments and an appropriate lump sum settlement.
Therefore, please contact our office right away to begin to assist in the process from day one. We are able to fight improper denials of benefits to get those benefits reinstated as soon as possible. This will allow you to get the medical treatment and wages you need and deserve to then allow you to achieve maximum recovery.
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