Many injured employees wonder when legal representation becomes necessary in an Illinois workers’ compensation case. While some claims are simple and can be handled without legal help, others involve serious injuries, long recovery periods, or disputes with the insurance company, making the work of an experienced attorney critical to the workers claim process.
Not every workplace injury requires a lawyer. For example, if an employee sustains a minor cut or scrape, receives medical treatment, and is quickly cleared to return to work, getting an attorney may not be necessary. In those cases, the main concern is making sure the medical bill is covered by the employer’s workers’ compensation insurance.
However, when injuries are more severe, involve significant medical care, or require surgery and rehabilitation, the risk of disputes and complications increases substantially. In these situations, representation from an experienced workers’ comp attorney can help protect the injured worker’s rights, ensure fair treatment throughout the claims process, and likely lead to a fairer and larger settlement.
Even if an insurance company/your adjuster initially seems friendly and cooperative, remember that their long-term objective is to minimize costs. Over time, they may use sketchy tactics to reduce or deny benefits, including:
• Direct contact with medical providers: Nurse case managers may attempt to speak with doctors or attend appointments, potentially influencing medical opinions. This is illegal.
• Requests for broad medical authorizations: Insurers may seek access to records unrelated to the injury, which can later be used to dispute the claim.
• Independent Medical Exams (IME): These examinations are conducted by physicians selected by the insurance company, who may downplay the severity of the injury.
• Surveillance and private investigations: Insurers may monitor an employee’s activities to find evidence that contradicts what their reported limitations are.
• Recorded statements and social media review: Adjusters may try to get statements or use online posts to challenge the workers comp claim.
Without an attorney in your corner, you may provide information or agree to actions that jeopardize your case without even realizing it.
Hiring a reputable lawyer early in the process is important for a number of reasons. A work comp attorney can stop communication between nurse case managers and your medical providers. They can prepare you for the IME to make sure the assessment is as accurate as possible (because IME docs are often hired guns). A work comp lawyer can fight against delays in benefit payments and take action if the benefits are wrongfully stopped or denied.
If disputes come up, for example whether surgery is necessary, having a lawyer already involved allows for faster access to an arbitrator at the Illinois Workers’ Compensation Commission.
The bottom line is that an experienced work comp attorney helps ensure injured workers receive the medical care, wage benefits, and final settlement they are entitled to. It doesn’t cost you a penny upfront. If you have been injured on the job and are not sure if you need a lawyer, contact us for a free consultation and case review.
