5-6-2019; Don’t Be Fooled When Settling Medical Exposure in Illinois Workers’ Comp; IL WC Appellate Rules are Strict!! and more

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Synopsis: Don’t Be Fooled When Settling Medical Exposure in Illinois Workers’ Comp.

 

Editor’s comment: There are a number of traps and pitfalls in handling/managing IL WC claims. I consider the worst to be

 

  • Amputations;

  • Death claims

  • Medical settlements.

 

If you have questions or concerns about amputation or death claims in IL WC, send me a reply and I can help, I promise. I don’t charge for routine advice.

 

On medical settlements, I recently had several plaintiff/petitioner lawyers send settlement contracts or request settlement contracts that settled PPD but sought this language to settle 8a or medical rights:

“Respondent has paid or will pay all related medical bills up to the MMI date.” Please note my reasoned legal opinion such language is fatally flawed from a defense perspective. 

The main issue you will face is what I call attorney “sand-bagging.” The Claimant attorney may have lots of medical bills for questionable treatment incurred prior to MMI which they are holding back or hiding from you. This may happen intentionally or semi-intentionally.

If there is $50,000 or $100,000 or more in disputed care from one of Illinois’ famous over-treaters, you could be on the hook if you agree “Respondent has paid or will pay all related medical bills up to the MMI date.” Please don’t be a sap.

There is an Illinois WC Appellate ruling where a southern Illinois claimant lawyer (whose name is being withheld on purpose), settled a claim with such language and then dropped $40,000 in “new” and unknown medical bills on the adjuster. The adjuster had literally no idea that care took place and the attorney, in my mind, held the bills back until the settlement was approved and therefore final.

The IL WC Appellate Court basically said—“if you are stupid enough to agree to pay medical bills you don’t know about, don’t come to us to try to get out of it.” Ouch!!

In my view, in response to such proposed settlement language, I advised we will agree to pay all related medical bills of which Respondent is aware up to the MMI date. If there is a Claimant or defense attorney who has a better approach to insure appropriate medical bills are paid but surprise or “sandbagged” bills can be disputed, please send me a reply.

I consider it malpractice for a defense lawyer or adjuster to agree to pay medical bills of which they have no knowledge. If a dispute arises, Claimant counsel has to demonstrate my client or I knew of the treatment and/or the bills. If we know about the care, we need to either pay or actively dispute the bills. You can’t do that for medical care you aren’t aware of.

 

Please also be careful when you are workingonly with a Claimant lawyer and aren’t having settlement documents reviewed by a veteran defense lawyer. In most cases, I will review settlement docs without charge to insure you are fully protected from the pitfalls and traps of this business.

 

I appreciate your thoughts and comments. Please post them on our award-winning blog.

 

 

Synopsis: The IL WC Appellate Rules are Strict!!

 

Editor’s comment: in Conway v. Illinois Workers' Compensation Comm'n, 2019 IL App (4th) 180285WC (issued May 2, 2019) Claimant filed a workers' compensation claim against her employer, a central Illinois school district.

 

Claimant sought review of the Arbitrator's decision before the IL WC Commission; the Commission affirmed and adopted the Arbitrator's decision.

 

Claimant filed a petition for administrative review to the Circuit Court, and requested that summons issue; the summons were issued the next day. Claimant failed to file a notice of intent or an affidavit in the Circuit Court within 20 days of receipt of the Commission's decision.

The newest amendment to Section 19(f)(1) of Workers' Compensation Act requires the appealing party to exhibit proof of filing with the IL WC Commission of the notice of intent to file for review in the Circuit Court or an affidavit of attorney setting forth notice of intent to file for review in the Circuit Court within 20 days of receiving the Commission's decision. Please note there are no extensions allowed.

 

As claimant failed to do so, the Appellate Court ruled the Circuit Court lacked subject-matter jurisdiction over her petition for review. Please note this means the Court is supposed to dismiss the matter on its own motion or on motion of the opposing party.

 

I appreciate your thoughts and comments. Please post them on our award-winning blog.