Cornered: Brian McGovern on Workers' Compensation from Reporting to Resolution

Workers seeking assistance with lost wages and medical bills after workplace injuries face lengthy investigations that include interviews, medical evaluations, and more. This week we corner Brian McGovern of Hanagan & McGovern in Mount Vernon, Illinois, to learn about the process injured workers can expect, some of the pitfalls along the way, and why legal representation in these matters is so important to securing a soft landing.

If you're looking for more guidance on recent developments in workers' compensation, the 2025 Workers' Compensation Institute is available on-demand at IICLE.com. It is 6 credit hours of practical guidance including 2.25 credit hours of general professional responsibility credit.

IICLE® is a 501(c)(3) not-for-profit based in Springfield, Illinois. We produce a wide range of practice guidance for Illinois attorneys and other legal professionals in all areas of law with the generous contributions of time and expertise from volunteer attorneys, judges, and other legal professionals.

Chapters

• 0:52 Episode Introduction - Brian McGovern
• 2:08 What should I do if I get hurt on the job?
• 3:58 What typically happens after the report is made?
• 6:03 What about medical exams?
• 6:29 Am I going to get my lost wages?
• 9:55 What are the obligations of an employer after that workplace injury?
• 13:49 What would happen if a person was injured doing their job and they could no longer do that job, but they could do something else at the same company?

Transcript

00:00:01

Oh, you're an attorney. I have a friend who was....

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I've been meaning to update my will, but I just bought a new house...

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I want to start a business...

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So I was wondering, I think we have...

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My brother was fired...

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My friend, got divorced awhile back. I just don't understand how her ex...

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You've been there at a social function, meeting friends of friends. Word gets out that you're an attorney, and suddenly your night is filled with partygoers.

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Asking you quote UN quote, simple legal questions, the questions are seldom in your area. Some of the stuff you haven't thought about since law school, you're being cornered out of.

00:00:32

Court in the cornered out of court podcast from IICLE, you'll hear from fellow attorneys about the questions they get and the responses they give to escape being cornered. Workers seeking assistance with lost wages and medical bills after workplace injuries face lengthy investigations that include.

00:00:52

Interviews, medical evaluations and more.

00:00:56

This week, we corner Brian McGovern of Hannigan and McGovern in Mount Vernon, IL.

00:01:01

To learn about.

00:01:02

The process injured workers can expect some of the pitfalls along the way, and why legal representation in these matters is so important to securing a soft landing.

00:01:13

My name is Brian McGovern. I graduated law school from Southern Illinois University in 1994. I've always practiced in the city of Mount Vernon. I did business litigation the firm.

00:01:26

Four years of my career and then I switched to a law firm that did workers comp and tort only. I introduced that law firm to doing Social Security work, which I also do. I did that from 98 to 2005 in 2005. I then started my own law firm again doing.

00:01:46

Workers’ compensation toward and Social Security. Interestingly enough, in 2010 that previous law firm that had hired me back in 1998, one of those partners came over and join.

00:01:57

Me and that is the law firm we've been at since 2010, Hannigan and McGovern. I've been pretty much specialized in this since 98.

00:02:08

My first question for you is what should I do if I get hurt on the job?

00:02:14

So when somebody gets hurt on the job, the first thing they're going to have to do is they're going to have to tell somebody.

00:02:19

Now it's either going to be the supervisor right there on the floor, or they're going to have to make a phone call or go into human resources, but somebody's going.

00:02:28

To have to be told.

00:02:29

If the injury is obvious enough that medical treatment is going to be needed, then the injured worker should go to an urgent care center or an emergency room and when they go to that urgent care emergency room, they should tell the medical provider exactly what happened on the job. That's important. One of the first things that a lawyer is going to look at.

00:02:50

Is that very first medical record, even if the injury doesn't seem or is not severe enough to get medical treatment, the employee should make a report of it, even if it's just notational, because.

00:03:04

It is very common for a person, especially with back injuries and strains, to wake up the next day and be much more just trying to get out of bed than they were the day before on the job. And in addition to that, there's a lot of injuries that will be nagging injuries, meaning they they think they'll go away. They just think it's an ordinary.

00:03:25

Strain or sprain and it will go away and before you know it, though weeks if not months have gone by.

00:03:31

I I've had people come in and say that four or five, six months later, saying, well, it just didn't go away. And I said, well, did you tell your employer? And they said no. And I go so they don't know anything about it and it's proved it proven.

00:03:43

To.

00:03:43

Be very difficult so it is perfectly normal and acceptable to simply report and say I don't need any medical treatment.

00:03:52

I just want the record to say that I think something happened. It doesn't turn out to be anything. That's fine too.

00:03:58

What typically happens after the report is made?

00:04:02

The employer is supposed to turn that into their workers’ compensation insurance carrier. I'm gonna be honest with you. It's surprising how often that does not happen. Where I will get a call from a client. And the reason they're calling a lawyer.

00:04:19

Is because they haven't heard anything from anybody in in 2345 weeks and I simply tell them then it's simply a matter of insisting, turning in a workers comp claim for their employer is no different than you and I turning in a auto claim. If we get in a car crash.

00:04:37

Get on the phone, call our insurance company and turn it in. They will, their hotline or whatever they have. We'll assign it a claim number. They'll assign an adjuster. That adjuster will should call the injured worker within a matter of days. They will ask to take a recorded statement.

00:04:57

We tell all our clients or tell people do not give a recorded statement perfectly. OK to give a statement, answer all the adjusters questions, but don't let them record it.

00:05:07

And then it's also perfectly acceptable that if the adjuster has not told you what the process is, then you are perfectly fine to ask. So we're talking about the obvious questions. Who's going to pay for my medical? What if I have to miss work? Those kind of things and we can cover that later.

00:05:25

One other thing is when the adjuster or the insurance company call.

00:05:30

Bills before you get started, you should ask her. Get their name, get their phone number, get the name of the insurance company they're working on, and get your claim number. Get all that information because you are going to be needing that as the claim moves forward with or without a lawyer. I have found nowadays it's almost always on a cell phone.

00:05:51

So when a client comes in and wants to hire me and I said, do you have the claim number, they get their cell phone out, the adjusters has texted.

00:05:58

It.

00:05:58

To them or it it's handled through the cell phone.

00:06:03

And what about any?

00:06:04

Medical exams. What kind of things would I have to deal with?

00:06:09

A medical exam that would be covered under section 12 of the Act. The It's specifically for the benefit of the employer, section 12 examination, more commonly known as an independent medical examination, and IME you have to go to these and they have to pay you the expenses of going. So typically the expenses of going.

00:06:29

Or your mileage and make and you should ask them if you're going to be at a lunch hour. You can ask them for some lunch too. Have a lot of employees. Ask me, am I going to get my lost wages?

00:06:44

My answer to them is technically under the act. They are entitled to the wages, their lost wages, but it's it's really rarely paid.

00:06:54

We just let that go because it's it's such.

00:06:55

A small amount.

00:06:57

Employees do want to be cooperative with workers comp. The amount of workers comp claims that end up in fights. Hence that you need a lawyer are actually pretty small, relatively speaking. Most people can handle their own.

00:07:11

It's.

00:07:12

By far the number one reason for the employer sending you to an independent medical examination is when your doctor has recommended a surgery. I will tell you that.

00:07:25

75% of the time, that is what the purpose of the IME is now. When they send you to that IME to get a second opinion on surgery.

00:07:34

They're also going to be asking their doctor to give opinions on the entire case. Can you go back to work? If so, do you need any restrictions? Well, did do they think it's a work related injury in the 1st place and and that's where it can get dicey and it need Needless to say there are many times when do I get hired?

00:07:54

When the employee went to an independent medical examination and then workers comp said our doctor said it didn't happen at work. Your your claim is over. We're closing your file and then they hire me.

00:08:06

One other thing about an independent medical examination.

00:08:08

And.

00:08:09

Workers comp will not necessarily always tell you the results. Stunning to me how often the injured workers off work? There's a surgical recommendation. They send the person to an IME. Workers comp gets the IME and the IME said that the injured worker can return to work even though their doctor's keeping them off.

00:08:30

Work and workers comp just stops paying their benefits.

00:08:34

So the check doesn't show up this week. Of course, the people, the injured workers need that to pay their bills, and then when they try to call workers comp, they don't get their calls returned. And meanwhile they're not getting a check. But it's because the workers comp doctor said they can go back to work.

00:08:51

If everything has been going good with your claim and and then there comes this point in time when they ask for an independent medical examination. I'm not saying you absolutely have to have a lawyer at that time, but that would be one of the key points in time when you might want to consider getting a lawyer because 75% of the time second opinion.

00:09:12

On a surgery, well, the other 25% of the time it could be that simply workers comp is, it is just the adjuster for the insurance company has just simply decided that you've been off work too long. They're tired of paying you, they've been paying you, they've been paying you TTD, temporary total disability benefits.

00:09:33

For three months and they don't feel like you're making enough progress in your medical treatment, meaning you're still undergoing physical therapy. You had a couple of shots or inject?

00:09:44

Questions. They think things are being dragged out too long and they're going to send you their their doctor, so their doctor can say something along the lines of, you know, he doesn't need any more medical treatment and he can return to work.

00:09:55

My next question is more from the employer side. What are the obligations of an employer after that workplace injury?

00:10:06

Once the claims turned in to the employer, then what they need to do is they need to turn it over to their insurance company, get the claim number, get it assigned to an adjuster and have that adjuster reach out to the injured worker and find out what happened. They are absolutely allowed to conduct an investigation into the matter and some investigations.

00:10:27

Should take no longer than 5 min.

00:10:28

It's.

00:10:29

If a ball of rubber fell off a rack and hit the guy on the head, and two people saw it, it's not a whole lot of investigation needed, but if it's a repetitive trauma injury, as far as they're saying, well, I've got Copal tunnel from the repetitive work I do every day that might require more of an investigation, or if it was unwitnessed.

00:10:49

Monday morning accidents, those are unknown, red flag to insurance companies. They might feel that the employee actually got hurt over the weekend and got themselves into work on Monday mornings.

00:11:02

So, but once they they're allowed to conduct that investigation, generally speaking, about two weeks, that's about how much I would give them. So if I have a client, a new client comes in and ask an interviewing them and let's say we're on week 4.

00:11:18

And they can again look on their phone and they got another text message 2 days ago that said, we're still conducting an investigation that's getting too long. But once the employer has then and so the employer can, they can try to deny the claim again. I represent injured workers. So I'm biased about this, but.

00:11:38

I find that workers’ compensation.

00:11:41

Some companies and I won't name names. Not routinely.

00:11:45

But they will.

00:11:46

Deny claims that they should have no business deny they just, they just deny them. But most companies will accept the claim. They'll be honest about it, and once they've accepted the claim then.

00:11:58

Worker needs to know that there's basically three parts to every worker's comp claim is workers comp will then be obligated to pay their medical bills related to the treatment. If the injured worker is being taken off work by a doctor, the the the injured worker doesn't get to decide he can't work. He's got to have a work.

00:12:16

Slip then workers comp needs to pay them TTD temporary total disability which is 2/3 of their average pay and I might add at this point that when we use the word average pay, there is a section in the act which tells us how to calculate that it's called the average weekly wage. It's section 10.

00:12:36

It it utilizes wages in the 52 weeks prior to the day.

00:12:42

With injuries, so some of these injuries can go on a long time. My employees need to my injured workers. My clients need to understand that, at least for the workers comp purposes, they will not get to get the benefit of any wage increases. Like any raises, they were entitled to. That occurred after the date of injury. Just kind of a.

00:13:02

Interesting note. And then the third aspect to every claim is there's some sort of a a, a settlement involved for any permanent partial disability.

00:13:13

Another leading reason I get.

00:13:15

Hired is when a client will call me up and say, hey, I had an work injury last year and my doctor released me about six months ago. Is is workers comp supposed to offer me a settlement? And I'll say, you mean they haven't tried to settle the claim and they'll say no, I haven't heard anything from them.

00:13:36

And then I'll have them come in because again.

00:13:38

The person's they're not required. This isn't an obligation on the part of the employer, but it is not uncommon at all for an employer to not offer a settlement.

00:13:49

What would happen if a person was injured doing their job and they could no longer do that job, but they could do something else at the same company?

00:14:01

So you have taken me into the the settlement area or the OR the resolution of the claim. So they so they get injured, they go through their treatment and they're eventually going to reach a point of maximum medical improvement. It's called MMI for short. The cases should not be settled or resolved until such time.

00:14:22

So once the person's reached MMI, we are going to evaluate the case as to what is the value of the case, what is the?

00:14:29

Value.

00:14:29

Of the settlement, and there's basically, I tell my clients, there's like 3 1/2 ways to settle a claim. The by far the most common means of settling the claim is a percentage of the body parts.

00:14:43

So in the workers compact itself.

00:14:45

Your body is body parts are carved up into a number of weeks. Your fingers, your toes, your your arms, your legs. And then there's also a catch. All provision for your back or your head, and it's called body as a whole. And so we will apply a percentage of disability to percentage of the ARM or the hand.

00:15:04

And.

00:15:05

Again, those are called, also known as specific loss cases, or if you've injured your back, it will be a percentage of a man as a whole.

00:15:12

Or a body.

00:15:13

As a whole, if your doctor has released you from care with some permanent restrictions, meaning you, let's say prior to the injury, you obviously most people have no restrictions.

00:15:24

At all they.

00:15:26

They can lift 100 lbs. They can bend as much as they want. Bend, Twist, stoop, crawl, do anything unlimited. Then they suffer this injury and the doctor puts permanent restrictions on them. And let's say their job required him to lift 50 lbs. And the doctor says no, you've had a back surgery.

00:15:44

You're you're you're permanently restricted to lifting 20 lbs. Well, they can no longer return to their full employment. So what happens at that moment in time during this during the pendency of his case, before MMI, he may have had light duty's been put on light duty with restrictions of £20.

00:16:03

Considered temporary during all this time.

00:16:06

When they're put at MMI, that same restriction becomes permanent and now the employer has to make a decision whether they're going to accommodate that permanent restriction. If the employer does not accommodate meaning.

00:16:20

Now your job requires you to have 50 lbs. We're not going to make any accommodations so that or find you a job that's lifting only £20, basically where your employment at that moment ends, you're terminated and then workers’ compensation is required to assist you in finding new employment. Now we're into a.

00:16:41

Vocational rehabilitation situation.

00:16:44

Volk rehab can take on many different colors, but 90% of all volc rehab cases are helping you find a new job.

00:16:54

Once you do find a new job.

00:16:56

Then how we measure what the settlement is going to be is we can do a decreased earnings case and it's very simple.

00:17:04

If the amount of money you're earning on.

00:17:07

The new job.

00:17:08

Pays less than the old job, meaning the job you had when you got injured. You're entitled to 2/3 of the difference until you turn age 65. If the new job pays about the same as the old job, or.

00:17:21

Or there's no loss of earnings, then there is. This is where the half Member I told you the 3 1/2 ways to settle place. This would become the half is there is a provision in the workers comp act that it's it's called a loss of profession instead of settling on a percentage of disability you would settle on a percentage of body as a whole.

00:17:43

And those are generally high rewards because the injury has caused you to lose your the employment you had. And so you're going to get paid more for that.

00:17:54

And then the last way to resolve the claim is a permanent and total disability, meaning you can't do.

00:17:58

Any work at?

00:17:59

All and those are pretty rare. They they they happen often enough, but for someone to suffer an injury such that they can't do any work at all, it it needs to have been a pretty serious serious injury.

00:18:13

In that case, the person will receive that two third.

00:18:18

For the rest of their life, every attorney in the state of Illinois who represents people and workers comp cases, do those cases on what's known as a contingency fee basis, 20% of whatever we recover for the injured worker, that's our fee. It's set by law. It's in the workers compact. So clients.

00:18:38

Ask me all the time how much am I going to owe you and it's going to be 20%.

00:18:40

Percent plus costs. Now when we request medical records or take doctor's depositions, US workers comp lawyers pay that out of our own pocket. We do get reimbursed for our out of pocket expenses. So it's 20% plus expenses. But like I said, that's all lawyers. So if anybody happens to have a lawyer who's charging them by the hour, there's.

00:19:00

Something wrong there? Workers comp is a highly specialized field.

00:19:08

There are it's. It's a bit like the Wild West. If if US lawyers are practicing in federal court or even state court, there's a whole set of rules of and local rules, and the judges have greater take, great control over their courtrooms and the.

00:19:28

Movement of the cases, not so much in workers comp. And so if you do have a workers comp and you need legal counsel, you should absolutely hire a lawyer who's experienced in workers comp even if you know and I know this is for me practicing so long. Even if you have a relative.

00:19:46

Of or a friend who is a lawyer. You are more than welcome to talk to that lawyer, and you can ask that lawyer, your lawyer friend, or to refer you to a one who specializes in workers comp.

00:20:03

Thank you, Brian. The law firm of Hannigan and McGovern in Mount Vernon focuses solely on injury and workers’ compensation cases of all types throughout southern.

00:20:12

Illinois.

00:20:14

If you're looking.

00:20:14

For more guidance on recent developments in workers’ compensation, the 2025 Workers’ Compensation Institute is available on demand at icle.com. It is 6 credit hours of practical guidance, including two and a quarter credit hours of general professional responsibility credit.

00:20:33

IICLE is a 501(c)(3) not-for-profit based in Springfield, IL. We produce a wide range of practice guidance for Illinois attorneys and other legal professionals in all areas of the law with the generous contributions of time and expertise from attorneys, judges and other legal profession.

00:20:48

If you are interested in our many authorship and speaking opportunities, please give us a call at 217-787-2080 or visit the Contributor Resource Center at iicle.com/contributors. Thank you for joining us for another edition of cornered out of court brought to you by the Illinois Institute for Continuing Legal Education.