Ridge & Downes - Law Firm

  • Decreases in Settlement Values

    The more time that passes since the Workers’ Compensation reforms of 2011, the more the effects of those reforms become apparent. One category of workers’ compensation benefits that have seen a substantial decrease are permanent partial disability (PPD) benefits. As you may know, you generally are entitled to receive three different categories of benefits when you sustain a work-related injury: 1) medical benefits, 2) off work benefits (TTD), and 3) permanent disability benefits.

    “Permanency” is a term used in workers’ compensation to represent the monetary compensation an injured worker is entitled to based on the permanent injury that he/she suffered. The “permanency” portion of a workers’ compensation claim is generally the lump-sum settlement or award an injured worker receives at the end of the case. The 2011 reforms changed the method by which a workers’ compensation Arbitrator must decide how to calculate and determine the permanency (or value) of a workers’ compensation claim.

    We have generally seen a substantial decrease in permanency awards as a result of the changes included in the 2011 reforms. It is now more important than ever to take action to protect yourself and to ensure you receive the compensation you are entitled to should your case proceed to hearing. The best way to improve the chances of a fair permanency award starts as soon as you sustain a work-related injury. When seeking medical treatment, it is vital to be very clear and detailed to your doctors when explaining both how the accident occurred, and what you are feeling. As you progress through your medical treatment, it is always important to tell your doctors exactly what you are feeling, and what limitations you are experiencing. Never assume that your doctor knows what you are feeling, or that he or she will document all of your complaints.

    Providing this information to your doctor is important because one of the factors an Arbitrator will consider is evidence of your disability, your testimony, corroborated by the treating medical records. This means that the symptoms and complaints you provide to the Arbitrator will be given weight only if they also are contained in your medical records.

    The details you provide to your doctor should not be limited to the pain or stiffness or other physical complaints you have. You should also make an effort to tell the doctor how these physical complaints are affecting your everyday life including the effects on your ability to perform job activities and activities of daily living. For example, if your wrist hurts, do not simply tell the doctor that your wrist hurts. Instead, try to be as detailed as possible as to how the pain affects your daily life. Does it hurt when you brush your teeth? Does it hurt when you drive? Can you button a shirt by yourself? What things could you do without issue before that now give you difficulty? You should always be honest with yourself and your doctor, but never assume that your doctor knows how your injury is affecting you. If you are detailed, informative and honest, you will greatly increase your chances of receiving fair compensation for a work-related injury.




  • How the AMA Guides can affect your case

    Section 8.1b of the newly amended Illinois Workers’ Compensation Act states that Arbitrators must now consider the American Medical Association’s “Guides to the Evaluation of Permanent Impairment” as a factor in deciding permanency awards.  This means that employers and insurance companies will hire doctors to rate an injured worker’s impairment based on the guidelines in this book. 

    An arbitrator recently approved a settlement contract for an injured worker who suffered a torn meniscus.  The injured worker did not hire an attorney and negotiated his settlement with an attorney for his employer’s insurance company. The lawyer showed the injured worker a report which stated his impairment was 1% of the lower extremity. The injured worker then agreed to settle his case for 1.5% loss of use of the leg. This is compared to the 15% to 20% loss of use generally awarded in this type of case.

    What the injured worker did not know is that the Arbitrator could have considered more than the impairment report. The Act requires the Arbitrator to take into account the injured employee’s occupation, age, future earning capacity and evidence of disability corroborated by medical records.  By not having an advocate on his side this injured worker agreed to accept about twenty times less than his case was worth.





Read the Ridge & Downes blog – learn about important issues and current affairs.




CONTACT US


Recent Blog Posts




© 2010 by Ridge & Downes - All rights reserved.