Criticisms of the Use of the AMA Guidelines in Illinois Workers’ Compensation Claims

According to the Illinois Workers' Compensation Commission, about 200,000 people in Illinois experience a work-related accident each year. Many of these injured workers turn to workers' compensation to receive benefits.

Last June, major reforms to the Illinois workers' compensation system were passed in an effort to reduce costs. This September several provisions, including the adoption of the AMA (American Medical Association) impairment guidelines, take effect.

Illinois' adoption of the AMA impairment guidelines is probably one of the lesser publicized and less understood aspects of the wider workers' compensation reform measure. The issue, however, is an important one and deserving of further attention.

What are the AMA Guidelines?

The AMA Guides to the Evaluation of Permanent Impairment (AMA guidelines) are used by several state workers' compensation systems as a way to determine impairment and quantify the seriousness of injuries.

In situations where an employee returns to work, but has restrictions or limitations, they are considered to have a permanent partial disability. Previously, factors such as the nature of the injury and accident, job description and an employee's complaints were considered in the analysis of whether the worker had a permanent partial disability. Now, for injuries that occur after September 1 st 2011, the AMA guidelines will be used by an arbitrator in determining whether an employee has a permanent partial disability.

Criticisms of the AMA Guidelines

One major criticism of Illinois' adoption of the AMA guidelines is that they were designed to determine impairment, and impairment is not the same as disability. The Chicago Tribune provided the example of the AMA guidelines giving a four percent impairment rating to a man who is 55 and has a torn biceps. Someone working at a desk job may be able to perform all their job duties with such a rating. Someone like a construction worker, however, may actually be work disabled. Thus, a minor impairment may result in someone being completely unable to do their job, and disabled for the purpose of workers' compensation.

Another major concern is the frequency of errors in determining impairment ratings. For instance, when almost 6,000 cases (most from California) were reviewed, 80 percent of ratings were found to be incorrectly applied, according to a 2010 AMA guides newsletter. These incorrect assessments can often cause injured workers to receive far less compensation than they need and deserve.

Errors are most frequently caused by lack of knowledge or inexperience of the examiner; something that seems quite likely as Illinois begins using the AMA guidelines for the first time. The conditions most prone to errors were spinal injuries, shoulder injuries and carpal tunnel syndrome.

Another criticism of the AMA guidelines is the likelihood that awards for injured workers will be significantly reduced and not adequately provide them with the financial support they require. For instance, in Nevada, a state that uses the AMA guidelines, back injuries necessitating fusion surgeries were frequently only given a 13 percent disability rating. In Illinois (prior to the implementation of the AMA guidelines) 25-35 percent was the typical disability award. In other words, monetary awards for major back injuries could potentially be cut in half after Illinois adopts the AMA guidelines.

Although it may be some time before the impact of the AMA guidelines is felt by injured workers in Illinois, the implementation of the guidelines certainly seems to make the environment for workers' compensation claims more challenging. This makes it all the more important that injured workers have a knowledgeable Illinois workers' compensation attorney to advocate on their behalf.

Verdicts, Awards & Settlements

  • $600,000.00 Neck Surgery

    Our client was involved in a disputed liability motor vehicle accident occurring at an intersection in McDonough County, IL. An IL state trooper was alleged to have failed to yield the right of way of an intersection thereby causing a collision with the vehicle in which our client was a passenger. Our client treated conservatively with chiropractic care and physical therapy and her family doctor and was eventually referred to a spine specialist and received surgery on her neck.
  • $250,000.00 plus lifetime medical benefits carpal tunnel

    Strong Law Offices obtained a lifetime wage differential award for carpal tunnel. As quoted by an IL workers' compensation commissioner in his dissent, "this was the first time in IL that this Illinois Workers' Compensation Commissioner had seen a lifetime award for a carpal tunnel claim in his 50 years of experience."
  • $710,000.00 head injury

    Our client received a head injury in a motor vehicle accident in Fulton County when his vehicle overturned on a state highway. He was helicoptered to a regional trauma center and received treatment for a subdural hematoma and received a full recovery according to his treating surgeon.
  • $750,000.00 drowning accident

    This claim involved the disputed liability against a daycare center and local swimming pool wherein liability was highly contested and the insurance carrier claimed contributory negligence.
  • $415,000.00 neck and back injuries

    Our client was a passenger in a motor vehicle which was alleged to have remained parked on an interstate highway and subsequently rear ended. Our client received chiropractic care and care to her low back injuries.
  • $350,000.00 arm injury involving MRSA exposure

    Our client was a respiratory therapist who received an alleged exposure to MRSA in a hospital setting. The infection necessitated partial removal of the biceps tendon.
  • $300,000.00 policy limit

    Our office received a policy limits tender of the homeowners' insurance policy for an infant who was left in a baby crib with the blowdryer turned onto the baby resulting in scarring and disfigurement of the infant.
  • $275,000.00 back injury

    Our client was an employee who received an aggravation of a pre-existing condition. This client's third back injury resulted in alleged permanent and total disability.
  • $642,000.00

    Our client was a teenager who was participating in bonfire activities on a country farm setting. The bonfire got out of hand and resulted in burn injuries to our client. This was an alleged negligence claim against a tenant in a farmhouse alleged to have negligently attended to the bonfire.
  • $325,000.00 back and neck injuries

    Our client received neck and back injuries and an aggravation of a pre-existing condition. The proximate cause of our client's injuries was highly contested by the insurance carrier. This was an arbitration award in downstate IL.
  • $267,000.00 plus 6 years lost wages plus payment of bills

    This was an injured employee who sustained a head injury on a loading dock as a result of a forklift accident. The Petitioner alleged permanent total disability and wage loss.
  • $250,000.00 plus 5 years of lost wages plus payment of bills

    Our client received low back injuries which necessitated surgical intervention. The Petitioner was a member of a local labor union and was injured during the course of his employment.
  • $250,000.00

    Our client was a retail clerk at a local gas station who was injured while placing placards for gas price signs on the outdoor sign when she slipped and fell and needed a spinal cord stimulator.
  • $250,000.00 plus open medical

    Our client was a employee of a world wide manufacturer who suffered back injuries which necessitated low back surgeon by a local physician
  • $275,000.00

    Our client had a low average weekly wage and ended up with a back surgery from a work related injury.
  • $275,000.00 arm injury

    Our client was a minor child who was thrown from a horse while participating in recreational activities. She received a fracture to her arm.
  • $245,000.00 shoulder injury

    Our client was a truck driver who rear ended another vehicle was found to have been at fault for the injury. However our office showed that the injury occurred in the course of his employment and our client was entitled to payment of all medical bills, 3 years of lost wages and $245,000.00 for his shoulder injuries.
  • $240,000.00 shoulder injury

    Our client was a millwright who was injured while working on a furnace at a local university. Our client was able to return to work. All medical bills were paid in addition to the settlement.
  • Lifetime permanent total disability benefits

    Our client was a union carpenter who received neck injuries and was awarded permanent and total disability benefits for the remainder of his life and lifetime medical benefits.
  • Lifetime permanent total disability benefits

    Our client was a worker at a local hospital and sustained injuries while performing janitor and custodial activities to his low back. He received a lifetime wage loss award and lifetime medical benefits award.
  • Lifetime medical and lifetime permanent and total disability awards

    Our client was a structural steel and structural iron worker working on a power plant wherein he injured his hand, thumb and low back. Our client underwent surgical intervention on his low back and was found to be permanently and totally disabled and required a lifetime medical benefits award as well.
  • Lifetime permanent total disability benefits and lifetime medical benefits

    Our client was a worker for the State of IL working on a road construction/paving project wherein he sustained neck and back injuries. Our client was found to have been permanently and totally disabled and required lifetime medical benefits. Our client was a very young person at the time of his work related accident.
  • Lifetime permanent total disability benefits and lifetime medical benefits

    Our client was a dispatcher for state law enforcement agency. She obtained carpal and cubital tunnel which necessitated surgery and had further complications. She was awarded a lifetime wage loss and lifetime medical benefits award.
  • Lifetime permanent total disability benefits and lifetime medical benefits

    Our office represented a client who was an administrative office worker who sustained carpal and cubital tunnel injuries necessitating surgical intervention. She had post-operative complications which disabled her from returning to her previous work activities. Our client underwent an extensive job search and was unable to find work that accommodated her permanent work restrictions or limitations. She was adjudicated to be permanently and totally disabled and received lifetime benefits.
  • 3 years of back TTD benefits, payment of all medical and a lifetime wage loss award

    Our client was a worked at a local factory refining parts and was exposed to heavy vibratory chipping and grinding. Our client was medically referred for shoulder surgery and was disabled from returning to his previous occupation as a chipper/grinder. Our client was only able to locate work at minimum wage. Our client received a lifetime wage differential benefit award for a shoulder injury requiring the insurance carrier to pay the difference of wages between his previous occupation and his minimum wage job for the remainder of the client's life.
  • 3 years of back TTD benefits, payment of all medical and a lifetime wage loss award

    Our client was a worked at a local factory refining parts and was exposed to heavy vibratory chipping and grinding. Our client was medically referred for hand and arm surgery and was disabled from returning to his previous occupation as a chipper/grinder. Our client was only able to locate work at minimum wage. Our client received a lifetime wage differential benefit award for a shoulder injury requiring the insurance carrier to pay the difference of wages between his previous occupation and his minimum wage job for the remainder of the client's life.
  • 3 years of back TTD benefits, payment of all medical and a lifetime wage loss award

    Our client was a worked at a local factory refining parts and was exposed to heavy vibratory chipping and grinding. Our client was medically referred for elbow and shoulder surgery and was disabled from returning to his previous occupation as a chipper/grinder. Our client was only able to locate work at minimum wage. Our client received a lifetime wage differential benefit award for a shoulder injury requiring the insurance carrier to pay the difference of wages between his previous occupation and his minimum wage job for the remainder of the client's life.
  • 3 years of back TTD benefits, payment of all medical and a lifetime wage loss award

    Our client was a worked at a local factory refining parts and was exposed to heavy vibratory chipping and grinding. Our client was medically referred for wrist, elbow and shoulder surgery and was disabled from returning to his previous occupation as a chipper/grinder. Our client was only able to locate work at minimum wage. Our client received a lifetime wage differential benefit award for a shoulder injury requiring the insurance carrier to pay the difference of wages between his previous occupation and his minimum wage job for the remainder of the client's life.
  • $250,000.00

    Our client was a laborer on a local road construction project who sustained a re-injury of a pre-existing low back condition. He was referred for surgery. He was awarded medical benefits, lost wage and eventually settled for a lump sum buyout of his future wage loss.
  • $210,000.00

    Our client was a factory worker exposed to vibratory equipment who received carpal tunnel. Our client was initially assessed as being disabled from returning to his work as a chipper/grinder. Our client elected to receive a lump sum award and then was medically cleared to return to the workplace.
  • $1.4 million settlement

    OB-GYN negligently failed to order C-section in a timely manner resulting in death of infant.
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Client Testimonials

  • Strong law Offices have been very helpful through my claims. They have kept me informed throughout my claim.
    - Krista C.
  • Everyone at Strong Law Offices is always helpful. They are great at getting back to you. Anytime my WC checks have stopped, they have gotten on it ASAP and the checks have been sent. They have also helped with getting medical procedures accomplished when WC was blocking them. I was also having problems getting my medications and now I get them on time. - Cherie M.
  • Strong Law Offices has treated me with respect and kindness since I've started my case. Strong Law Offices has the most experience and they will get down and dirty to help you through your case. I've never had a problem or went through any problems because Strong Law Offices gets it done right the first time with no mistakes. Strong law Offices is in it with you till the end. - Eli B.
  • Strong Law Office has fought my case strong and hard. It has been a long battle but I have seen progress the whole way. We are fighting a big insurance company and Strong Law is doing a great job. My time working with Strong Law has been pleasant. - Jeff M.
  • Strong Law Office is moving my case forward in a timely manner. The people and staff at Strong are friendly and helpful.
  • I am and have always trusted Mr. Todd Strong with any and all claim injuries that I had or will. Mr. Strong is a man of integrity and believes in explaining any and all processes of the claim. Trust and integrity is what you get form Todd Strong. Highly recommended.
  • I hired the Strong firm a few years back and I felt they did an excellent job for me. I got the exact outcome that I expected and was very pleased. The staff was very helpful at all times and helped me through my experience. - Denise Y.
  • I have had 2 work related injuries both handled by what I believe to be the most honest and result proven law firm in Illinois. Todd Strong and Ed Prill have become my attorneys and friends. This firm has been so good to me that I don't just recommend them but I HIGHLY RECOMMEND this firm to everyone who has been hurt by the negligence of others. I cannot put into words how great the staff is. - Chris P.
  • Strong Law Office is the best law office in Peoria. Todd is one of the top leading attorneys in central Illinois. He has done me a great job so far. I love Strong Law Office and his staff. They're like family. If anybody asked me for an attorney, I would say go Strong. I have faith in my attorney and I believe he is going to do an excellent job. - Kevin Y.
  • Todd has been really helpful with my case. Todd's been up front about everything. It's been a long waiting period but will be worth it. - Joe S.
  • My experience with Strong Law Office was a great experience. They helped me throughout something I should have never gone through. - Molly T.
  • Strong Law Offices has helped me through a difficult time in my life. They were always courteous and made me feel comfortable. They have helped me put my life back on track. Brian F.
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