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What Happens When an IME Conflicts with Your Doctor’s Report?You may have appointments with multiple doctors after suffering a work-related injury. Your treating physician is your primary doctor who will diagnose your injuries, administer your treatment and monitor your recovery until you have reached maximum medical improvement. If you are filing a workers’ compensation claim, your employer can order you to visit a physician for an independent medical exam (IME). The IME doctor will give the workers’ compensation insurer an opinion on whether the workplace incident caused your injuries, the extent of your injuries, and whether you are capable of returning to work. Sometimes, the IME report will contradict your physician’s report, forcing you to settle the dispute with an arbitrator.

Difference of Opinion

Workers’ compensation attorneys often find the opinions from IMEs to be dubious because the insurance company is paying the physician for the service. An IME doctor is supposed to be independent, but insurance companies will regularly use doctors who have a history of giving opinions that favor the companies in workers’ compensation cases. How can an IME doctor give a credible medical report that contradicts the findings of other physicians? The doctor may:

  • Search your medical history for other potential causes of your current condition
  • Be less thorough in examining your current condition before reaching a conclusion
  • Simply have different opinions about the causes and effects of injuries.

Arguing Your Case

The IME may conclude that your injury was unrelated to your work, that your injury is not as severe as your treating physician claims, or that you are physically able to return to work in a full or limited capacity. Based on these findings, your workers’ compensation insurer may try to deny your claim or stop your disability benefits. When a workers’ compensation arbitrator receives conflicting medical reports, they will use the report that they deem to be more credible. You can help your case by:

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Cold Temperatures Can Be Dangerous for WorkersThe cold weather that is typical of winter in northern Illinois is more than an inconvenience for workers. Prolonged exposure to cold temperatures can cause severe or even fatal damage. In some cases, people will suffer permanent damage that creates a disability. Workers can take precautions to protect themselves against the cold, but employers also have a duty to protect their employees. If you have suffered damage due to being exposed to the cold while working, you can qualify for workers’ compensation benefits.

Cold Stress Injuries

As your body temperature drops when you are continuously cold, your body will work to warm itself. Your body prioritizes keeps your organs warm and functioning, which means that your extremities receive less blood flow and are at greater risk of cold stress conditions such as frostbite and hypothermia. Frostbite is the freezing of the skin and tissue, which can cause neuropathy in or require the amputation of:

  • Fingers
  • Toes
  • Hands
  • Feet
  • Ears
  • Nose

Trenchfoot is a less severe form of frostbite that can cause blistering and an itching or burning sensation. Hypothermia is an extreme drop in body temperature that can be fatal if not treated. The long-term effects of hypothermia can cause stress to the heart, which is particularly serious for people with pre-existing heart conditions.

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Why You Should Not Immediately Accept a Workers’ Compensation SettlementWhile workers’ compensation insurers will sometimes fight your claim in court, there are other times when they will be eager to offer you a settlement for your injuries. However, an immediate settlement may benefit them more than it benefits you. When an insurer knows they cannot avoid paying a claim, they will try to settle the claim as soon as possible so they know how much it will cost them. There are several reasons why you should wait before settling your workers’ compensation claim:

  1. You Do Not Know the Full Cost: There are more expenses related to a workplace injury than the cost of your initial treatment. You may need to pay for continued rehabilitation, and your doctor may discover other damage that requires additional treatment. You also must consider whether you may need disability pay for your missed time at work. Even after you return to work, it is possible that your injury will worsen, requiring you to miss more time. It may take months or years to know the full cost of your injury, and agreeing to an immediate settlement will prevent you from seeking additional compensation.
  2. The Insurer Is Not Giving Their Best Offer: It is common in negotiations for someone’s initial offer to be lower than what they expect they will have to pay. Workers’ compensation insurers have experience paying claims for injuries such as yours, which means they know how much it usually costs. They know how to make an initial offer that sounds reasonable but is actually much less than what you would receive if you took your claim to arbitration. Though they may talk tough if you reject their initial offer, they will likely return with a better offer.
  3. There Is No Rush to Reach a Settlement: You have three years after the date of your workplace injury to file a workers’ compensation claim, giving you plenty of time to understand the full extent and cost of your injury. The insurer may try to pressure you into accepting their settlement by giving you a deadline to respond, but it is highly unlikely that they will withdraw the offer because they would still rather settle than take the claim to court.

Contact a Crystal Lake, Illinois, Workers’ Compensation Attorney

You should not decide on whether you will negotiate a workers’ compensation settlement until you have consulted with an attorney. A McHenry County workers’ compensation lawyer at Botto Gilbert Lancaster, PC, can make sure you receive all of the benefits that you will need. To schedule a free consultation, call 815-338-3838.

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Workers’ Compensation Covers Violence Against EmployeesThe threat of workplace injuries can sometimes come from intentional actions by other people. Acts of violence against workers are not uncommon in jobs that require people to work overnight and frequently interact with the public. Employees at 24-hour fast food and convenience stores are often at risk of being attacked or threatened by robbers or irate customers. As with any work-related injury, you can file a workers’ compensation claim in order to pay for healthcare expenses and reimburse you for lost wages due to time missed at work.

How to Qualify

Workers’ compensation benefits can cover your injuries from a physical attack as long as:

  • You were put in the position to be attacked because of your work
  • You were not the aggressor in the incident

For instance, being attacked while walking from your vehicle to the building where you work would qualify because you would not have been there if not for your job. As for being the aggressor, you are allowed to defend yourself against attack, but the Illinois Workers’ Compensation Commission has denied claims when the worker was injured because they decided to pursue and engage the attacker after the attacker had already withdrawn. In other words, you risk losing your claim if you continue the fight after your attacker has stopped, even though you were not the one who started the fight.

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Receiving Survivor’s Benefits From Workers’ CompensationWorkers who have been seriously injured on the job can take some comfort in the fact that they survived. According to the U.S. Occupational Health and Safety Administration, 5,147 workers in the U.S. died in 2017, which is more than 14 workers a day. When someone dies on the job, it is their family that suffers the most – both emotionally and from the loss of a financial provider. Illinois’ workers’ compensation system allows surviving family members to receive benefits when someone has died due to a work-related incident.

What Can You Receive?

The death benefits paid to survivors is equal to two-thirds of the deceased worker’s gross weekly wages from the 52 weeks before their death and also includes compensation for funeral expenses based on the average rate in the state. The benefits will be paid at the same interval as the worker received their wages, or weekly if that is not feasible. Twice a year, the state adjusts the maximum and minimum weekly benefits that survivors can receive based on the cost of living. Until Jan. 14, 2020, survivors can receive no more than $1,529.84 per week and no less than $573.69 per week. Beneficiaries can also negotiate to receive the payments in a lump sum.

Who Can Receive Benefits?

Workers’ compensation benefits are meant to go to the people who were financially dependent upon the deceased worker:

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