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Dealing With Insurance Companies

Chicago Lawyers for Health Care Workers

Health care workers face numerous risks on the job including overexertion, falls, repetitive motion, violence, toxic exposure, and exposures to bloodborne pathogen. Even when it’s clear you were badly injured in a work-related accident, as a health care worker, dealing with insurance companies can prove challenging. If you sustained job-related injuries or illnesses, you should call the seasoned Chicago workers’ compensation lawyers of Katz, Friedman, Eisenstein, Johnson, Bareck & Bertuca about your claim. We have more than 60 years of experience.

Dealing with Insurance Companies in Chicago

Your health care employer is required to purchase workers’ compensation insurance for its employees who are made sick or injured on the job. Unfortunately, just because this legal requirement is in place does not mean your claim for benefits will be paid. Valid workers’ compensation claims are sometimes denied for improper reasons. For example, sometimes insurers deny health care workers’ claims on the grounds that they have preexisting conditions, even though preexisting conditions that are aggravated by the job can still be compensated through the workers’ compensation system.

Notification

It's important to provide timely notification of your injury to your employer. While, technically, notice can be oral or written, it is wise to provide it in writing so there is no question later about whether you provided notice and whether it was timely. You must provide the notice to your employer within 45 days of the work-related injury, or your claim could be barred.

Once notified, your employer should notify its insurance company. The insurer will either accept or deny your claim. When your claim is denied, our attorneys may be able to write to the insurer to try to get the claim accepted, short of taking it to a hearing. However, if an insurer cannot be informally persuaded, it may be necessary to ask the Illinois Workers’ Compensation Commission (IWCC) for a hearing. The arbitrator will hear arguments and evidence for both sides.

In some instances, an insurer will request documents or initiate an investigation into a claim, but also pay benefits before it finds a reason to deny. Accordingly, you should be aware that your benefits could be abruptly stopped if your employer’s insurer decides in the course of investigating or handling the claim that there is a reason to deny the claim. It can be important to put an Application for Adjustment of Claim on file. That way, if your benefits are abruptly stopped, you can get a hearing before the IWCC in a more expedient fashion.

Securing Benefits

Benefits to which you may be entitled through the workers’ compensation system include a portion of your lost wages, medical bills for care that is reasonable and necessary, and vocational rehabilitation benefits. Temporary total disability benefits are calculated at a rate of 66 2/3% of your average weekly wage up to the state average weekly wage; however, disputes can arise with the insurer because of differences in the initial calculation of your average weekly wage. Similarly, your employer’s insurer and you may disagree about what medical expenses are reasonable and necessary. Our experienced Chicago workers’ compensation lawyers work hard to negotiate with insurers or mount strong cases at hearings and on appeal to make sure that the benefits you obtain

Medical benefits may require payment of medication, surgery, hospital care, treatment, or medical devices. However, you and your insurer may disagree about what medical benefits are reasonable and necessary. For example, if you suffer complex fractures due to attack by a violent patient, you may need surgery; because surgery is expensive, your employer’s insurer may try to avoid paying this benefit, even if it paid for other medical care.

It may be challenging to establish to an insurer’s satisfaction you need vocational rehabilitation to move out of the health care field or to a different job within health care based on your physical limitations based on becoming disabled on the job.

Hire a Chicago Health Care Workers Lawyer

As a health care worker injured on the job, you may encounter resistance to your workers’ compensation claim. If you are injured, you should retain a law firm with to represent you. Our attorneys represent construction workers in Quincy, Rockford, Champaign, and Aurora, as well as Kane, Cook, Sangamon, Winnebago, and Adams Counties. Call us at 800-444-1525 or 312-263-6330 or complete our online form.