What Is Workers’ Compensation?
Workers’ Compensation is state system that allows most employees in the state to be compensated for an injury that they have sustained while working or because of their work. Workers’ Compensation ensures an injured employee receives a specified amount of compensation for an injury, while also making sure that the employer does not take a significant financial loss because of an incident. An employee does not have to prove fault in a workers’ compensation case, and unless you fall within one of the very limited exceptions, every worker is covered by workers’ compensation in Illinois from the moment they start the job. However, workers’ compensation also eliminates an employee’s right to file a personal injury claim against their employer in most cases.
I Have Been Injured At Work in Illinois. What Should I Do Next?
In any case of a serious injury, you need to seek medical help as soon as possible. Once the situation is no longer an emergency, you should take the following steps in order to start receiving workers’ compensation benefits:
- Inform your employer as soon as possible.
You will only have 45 days to inform your employer of your injury, otherwise you may lose all of your workers’ compensation benefits. There is an exception, however, if you believe that you have been exposed to radiation you will have 90 days to inform your employer about your concern. You must also inform your employer of an injury that may have developed over time as soon as practical, if you believe that you have developed such an injury. Give your employer a written notice of your injury. In this notice, make sure to include the date you sustained the injury, where the injury took place, and other details surrounding the incident. Keep a copy of your notice, it may be useful when you file a claim.
- Visit a doctor.
After you have informed your employer of your injury, you will need to visit a doctor for treatment. Depending on your employer’s workers’ compensation policy, you may have to select from a limited number of doctors or you may be able to choose your own doctor. Tell your doctor that you sustained your injury while at work. This is let her know that your injury was work-related and your medical bills should be sent to your employer’s insurer. This doctor will become your main physician for your work-related injury, but you can also choose to switch doctors later in the process. Your employer, or his insurer, has the right to request that you undergo a medical examination to confirm your injuries. This means that you may also have to visit a doctor approved by your employer or his insurer. You should start collecting workers’ compensation benefits between 4-14 days after your injury if your employer’s workers’ compensation carrier accepts your claim.
Temporary Total Disability in Illinois
Temporary Total Disability (TTD) benefits compensate employees that cannot return to work for a limited amount of time. In order to qualify for TTD benefits, you must be unable to return to work as recommended by your doctor, or be recommended for light work duties that your employer cannot accommodate. The amount of compensation available for TTD benefits is equal to two-thirds of your average weekly wage (AWW) before the injury. An AWW is calculated by using your gross income within the 52 week period before the injury, this total number is then divided by 52 for an average weekly wage. TTD benefits will be paid until you return to work, or until your injuries have reached maximum medical improvement (MMI). You will not be paid for the first three days after his injury, unless his disability lasts longer than 14 days.
It is important to note that income benefits cannot fall above or below the limits set by the Illinois State AWW.
Temporary Partial Disability in Illinois
Temporary Partial Disability (TPD) benefits compensate workers who work with limited hours or with light duties because of their disabilities and receive a lower income as a result, but these workers are also still in the process of healing. In order to qualify for TPD benefits, a worker must suffer a decrease of income because of the limitations that his injuries imposes. In order to calculate the amount of compensation you can receive for TDP benefits, subtract you AWW from after the injury to what your AWW was before your injury. TDP payments are equal to two-thirds of the remaining number. You will be able to receive TDP payments until you return to regular work, or until your injury has reached its MMI limit.
Permanent Partial Disability in Illinois
Permanent Partial Disability (PPD) benefits are available to workers who have a permanent disability, but can still work for a reduced income. In order to qualify for PPD benefits, you must have an injury that involves:
- A complete or partial loss of a part of the body.
- A complete or partial loss of the use of the body.
- Or a partial loss of the body as a whole.
There are subcategories of PPD benefits that you can apply for, but you may not receive more than one of each category. These categories include:
- Wage differential benefits in Illinois
In this case, you may be paid a percentage of the difference of pre and post work income. To calculate how much you will be paid for this category, subtract the AWW that you make after your injury from the AWW that you made before your injury. You will be paid two-thirds of the remaining number (it’s the same amount that you would be paid for a TPD). If you choose this option, you will be paid for five years, or until you become 67 years old, whichever time period is longer.
- Injury benefits outlined in the Illinois workers’ compensation statute
In this case, the amount of compensation that you receive for your injury depends on the location of your injury on your body, and the extent of your injury as described in Section 8e of the Illinois Workers’ Compensation Act. The extent of your injuries will be determined by your doctor, who will then determine a percentage that represents your disability. This percentage is determined using the American Medical Association’s “Guides to the Evaluation of Permanent Impairment” and other factors including the age, occupation, and future earning capacity of the injured worker. To determine the amount of compensation that you will be paid in this case, multiply the number of weeks allocated to your type of injury under the statute by 60 percent of the AWW that you made before your injury. To calculate the amount of time that you will be compensated, multiply the number of weeks allocated to your injury by the percentage of your injury given to you by your doctor. If the injury you sustained is not listed under the Illinois Workers’ Compensation Act (such as head or back injuries), your injury will have up to 500 compensable weeks, and will be determined by the “loss of the person as a whole”. Loss of a person as a whole is just another way of asking how much affect your injury has on you.
- Disfigurement benefits in Illinois
This type of benefit is meant to compensate workers that have suffered significant scarring or other disfigurement. You can be compensated for up to 162 weeks if you have serious disfigurements to:
- The head
- The hands
- The arms
- The face or neck
- Chest above the armpits
- Leg below the knee
Disfigurement can only be determined after your injury has had at least six months to heal. You can claim loss of use or disfigurement for each body part, but cannot claim both for the same part of the body.
Permanent Total Disability Benefits in Illinois
Permanent Total Disability (PTD) compensates Illinois workers who are permanently unable to work because of their injury. In order to qualify for PTD benefits in Illinois you must have permanently lost the use of:
- Both hands
- Both arms
- Both feet
- Both legs
- Both eyes
- Any one combination of the above part (example: an arm and a leg)
You can also qualify for PTD benefits if your disability makes you unable to do any kind of work in a reasonably stable employment market. The payments that you receive for PTD benefits is equal to two-thirds of the AWW that you earned before your injury. PTD benefits will compensate you for the rest of your life if you qualify.
Medical And Other Benefits
Besides income benefits, you are also entitled to medical, vocational rehabilitation, and maintenance benefits. All of your medical bills will be paid for if they are considered reasonable. This includes; travel costs, medication costs, tests, operations, examinations, etc. You will also be covered for any costs need for additional training or rehabilitation in order to return to work. Cost of living payments will also be available if your disability lasts longer than a couple of years.
I’ve Been Denied Workers’ Compensation in Illinois. What Should I Do?
If you have not received any payments for your injury after a few weeks of the incident, you should start by contacting the Illinois Workers’ Compensation Commission (IWCC). The IWCC will be able to provide information on your case and inform you of what your options are. It is possible that there was a simple misunderstanding in the filing claim, as the process is very complicated. However, the next step would be to hire a workers’ compensation attorney to file a claim on your behalf.
The claims process is complicated and will require a hearing by the IWCC if the claim is accepted. You will need to fill out an Application for Claim Adjustment form, which your attorney can help you fill out. After this point, your application will be reviewed by the IWCC who may or may not call a hearing for your case depending on the amount of evidence that you have and the context of the case.
You have the legal right to retain an attorney at any point in the workers’ compensation filing process. If your claim goes to trial, your employer’s insurer will have an attorney to represent them, so having an attorney representing you as well would be a wise choice.