[broken_elbow]

My husband fell when his ramp in his truck let loose from his truck. He broke his elbow and was off work for 7 weeks healing and then he went back light duty for 1 week. He is back to work full duty now. My question is: The insurance company paid us the 2/3 of his wages without overtime. He usually works 65-70 hours a week. So overtime is a huge part of his pay. His normal bring home was 1250.00-1500 a week. He was paid 800.00 a week. So we were down somewhere between 450.00-700.00 a week or a minimum of 3150.00 in salary. I know in Illinois you are not entitled to get that made up to you but we were hoping that my husband might be offered a settlement that might make that amount up to us. The accident was Jan 2nd and he has been back to work for 2 weeks now. He can not completely straighten his elbow but he can do his job and the doctor has released him. My question is do the insurance companies usually offer you a settlement of some kind to close the case? When do they make this offer? Do we have to file something for them to make us an offer? How much can we expect, the 7 weeks was a real hardship and we would like to be able to get back on track. It would be great if we at least got the amount we missed out on in wages as an offer.

[4eyedbuzzard]

... The insurance company paid us the 2/3 of his wages without overtime. He usually works 65-70 hours a week. So overtime is a huge part of his pay. His normal bring home was 1250.00-1500 a week. He was paid 800.00 a week. So we were down somewhere between 450.00-700.00 a week or a minimum of 3150.00 in salary. I know in Illinois you are not entitled to get that made up to you...

Was overtime a required or regular part of his job? He may be entitled to WC if OT was a regular part of his schedule. Read these IIC decisions, where the claimant's average weekly wage was calculated using OT hours at straight-time rate:

http://www.chicagolegalnet.com/23_we...s_sufficie.htm
http://www.chicagolegalnet.com/highw...e_wins_bid.htm
http://www.chicagolegalnet.com/WageDifferential.htm

[broken_elbow]

He was paid on the overtime hours but straight time at 2/3 percent. So he was paid for like 60 hours because they took out vacation weeks which he has 5. They figurered an average of all his hours for the year without vacation time and holidays so he actually only worked 49 hours since he had 5 weeks paid vacation and then they added up all the hours actually worked and came up with an average of his actual hours worked so he was penalized for taking his vacation time. Then they took his straight hourly times that and divided by 2/3 which came up to the 825.00. He made 84,000 last year with overtime pay. Will they make a settlement offer?

[broken_elbow]

I know he is not entitled to get the difference from them but if they offered a settlement to close the case that would help with making up the difference as far as we were concerned. In other words we could get caught up again. Even though they call it a settlement to close it we would use it as a payment on a bill we couldn't pay because he was off and getting paid less.

[4eyedbuzzard]

Sorry, I don't know IL WC law well enough to comment more precisely...

But in a general WC sense I would ask why they(ins co) would offer a settlement to close a case where the claimant is back to work full duty? If he has returned to the same job without ongoing medical restrictions or any documented permanent impairment, there's nothing else to settle. It's essentially closed with the possible exception of continuing medical treatment. The 2/3 of the average wages(up to state maximum benefits) is all you get. The reasoning is that it is not taxable income(it's insurance proceeds) and that the claimant doesn't have other work expenses like commuting, etc.

Most states provide for additional benefits of 2/3 of the difference between the prior average earnings if the return to work earnings are limited by ongoing medical restrictions(such as no OT allowed per doctors order or no OT by co. policy while on "light duty").