Two Recent Illinois Workers’ Compensation Trial Wins: Surgeries Approved for Injured Workers
Fighting for Injured Workers Across Illinois
Our firm is proud to share two recent victories at trial before the Illinois Workers’ Compensation Commission (IWCC) — each involving serious injuries where insurance companies denied necessary medical care.
In both cases, the arbitrators found in favor of our clients, ordering authorization for surgery, payment of medical bills, and full temporary total disability (TTD) benefits.
These outcomes underscore our commitment to protecting injured workers and holding employers and insurers accountable when they wrongfully deny benefits.
🩵 Case #1: Total Knee Replacement Approved After Insurance Denial
Client: Hostess at a major national restaurant chain
Attorney: Partner Matthew Jones
Issue: Denied total knee replacement surgery after workplace fall
Our client slipped and fell while working, seriously injuring her knee. After an initial repair surgery approved under workers’ compensation, her pain persisted, and her orthopedic surgeon recommended a total knee replacement.
The workers’ compensation insurance carrier denied the procedure, relying on their independent medical examiner (IME) who claimed the need for surgery stemmed from degenerative arthritis and aging, not the work injury.
Trial and Testimony
At trial in Waukegan, Illinois, Attorney Matthew Jones took testimony from both physicians:
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The treating doctor testified that the work accident directly aggravated an existing condition, making the knee replacement necessary.
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The IME doctor, under cross-examination, was shown to have credibility gaps and unsupported assumptions.
The arbitrator found both our client and her treating physician credible and persuasive, rejecting the IME’s opinion.
Result
The arbitrator issued a favorable written decision, ordering:
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Authorization and payment for the total knee replacement surgery
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Continued TTD benefits during recovery
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Coverage of all related medical expenses
💪 Case #2: Back Surgery Victory for Injured Worker
Client: Warehouse worker at a Chicago-suburb manufacturer
Attorney: Partner Adam Rosner
Issue: Disputed back surgery following serious work injury
Our client sustained a severe lower-back injury on the job. The employer’s insurance carrier relied on an IME doctor who disputed the need for surgery and claimed the condition was unrelated to the work accident.
Trial Findings
After a contested trial before the IWCC in Joliet, Illinois, the arbitrator ruled fully in favor of our client, finding the surgery causally related to the work injury.
Award Summary
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✅ Authorization for back surgery
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✅ Payment of medical bills: $26,774.88
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✅ Temporary Total Disability (TTD): $15,092.96 (less applicable credit)
This decision ensures our client receives the treatment and financial support necessary to recover and move forward.
⚖️ Why These Wins Matter
These two arbitration victories demonstrate key principles of Illinois workers’ compensation law:
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Work accidents that aggravate preexisting conditions remain compensable under the Illinois Workers’ Compensation Act.
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Independent Medical Examiners (IMEs) can be effectively challenged through thorough cross-examination and medical evidence. These are their usual games! They tell you that things are age-related or degenerative, even though you were pain free before. We can fight your case just like we did here!
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Credibility matters — from both treating doctors and injured workers who testify truthfully about their limitations.
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A skilled attorney can make the difference between a denied claim and a fully compensated outcome.
❓ FAQ: Filing a Workers’ Compensation Case and Section 19(b) Trials in Illinois
1. How do I file a workers’ compensation claim in Illinois?
You start by filing an Application for Adjustment of Claim with the Illinois Workers’ Compensation Commission (IWCC).
This formal filing protects your rights and opens your case for review by an arbitrator. You’ll also need to notify your employer of the injury as soon as possible, ideally in writing, and seek prompt medical care.
2. What happens if the insurance company denies my benefits?
If your claim is denied — whether for medical treatment, TTD benefits, or permanent disability — your attorney can request an expedited hearing before the IWCC under Section 19(b) of the Illinois Workers’ Compensation Act.
A Section 19(b) petition asks the Commission to quickly decide disputed issues when an injured worker is not receiving necessary care or pay.
3. What is a Section 19(b) trial?
A Section 19(b) trial is a formal hearing before an IWCC arbitrator. Both sides present evidence — including witness and doctor testimony, medical records, and depositions — to determine whether benefits should be awarded.
These hearings are typically scheduled on an expedited basis when an injured worker needs urgent relief, such as authorization for surgery or payment of lost wages.
4. Do I need an attorney for a 19(b) hearing?
Technically no, but in my opinion it’s really challenging to do this alone. Workers’ compensation law in Illinois is technical and evidence-driven. If this case is important to you, it’s a good idea to talk to a lawyer and get some help.
A skilled attorney can gather medical evidence, cross-examine IME doctors, and present a persuasive case under Section 19(b).
Representation can make the difference between prolonged denial and immediate access to medical care and income benefits.
🏛️ Illinois Workers’ Compensation Attorneys Who Fight for You
At McHargue & Jones, LLC, our attorneys have decades of experience litigating and winning workers’ compensation trials and appeals throughout Illinois.
If your claim has been denied or delayed, contact us for a free consultation. We’ll help you assert your rights and fight for the medical and wage benefits you deserve.
📍 105 W. Madison Street, Suite 1600, Chicago, IL 60602
📞 312-739-0000 | mcharguelaw.com
