Illinois Workers’ Compensation Law FAQ
1. HOW LONG CAN YOU BE ON WORKMAN’S COMP IN ILLINOIS?
If you suffer job-related injuries, you can file a financial compensation claim but you have a limited period available to do it. The workers can compensation from injuries under the Illinois Workers’ Compensation Act. In Illinois, there are two deadlines for filing Workers’ Compensation Claims. These are:
- Deadline to Report Your Injury
If you are injured at your workplace, you have 45 days within which you must report your injury to the employer. The report of an injury needs to be done either in writing or filling a form as per company policy.You can seek help from your supervisor or from the human resource department in your company. If you face any resistance to filing of an injury report, you should approach work injury attorneys immediately.
The 45-day deadline is not applicable to cases of occupational illness.If your illness is job-related then you must inform your employer as soon as feasible, once you get to know about it.
- Deadline To File A Claim For Benefits
It is not enough just to report your job-related injury or illness to the employer if you are looking for compensation benefits. It is necessary to file a separate claim for workers’ compensation benefits. You can approach the Illinois Workers’ Compensation Commission to file such a claim within three years of the date of the injury.
2. WHAT IS THE STATUTE OF LIMITATIONS FOR WORKERS COMPENSATION IN ILLINOIS?
An often repeated query from workers who have suffered injuries on job is about the time available to file a compensation claim under the Illinois workers compensation law. It is crucial for you to be aware of this; after this time period lapses you may not be able to file a claim at all.
Workers need to consider two important time frames. The first period refers to the time required to inform your employer about your injury that has taken place while working on the job. Actually, you should inform your employer as soon as possible about your injury while on the job. But as an outer limit, you have 45 days from the date of your work-related injury to file a compensation claim.
The second period concerns the statute of limitations for filing a compensation claim with the Illinois Workers’ Compensation Commission. If you have claimed compensation from your employer, you get two years to file a claim from that payment date. Otherwise you get three years from the date the injury occurred.
In case of repetitive trauma, i.e. when the injury is not a one–time accident, the date of injury becomes the reference point. This is the date the person recognized there was a connection between the occurrence of injury and their employment.
3. IS WORKERS COMPENSATION MANDATORY IN ILLINOIS?
Workers Compensation Insurance is compulsory under law in Illinois. It is mandatory for employers to provide workers’ compensation insurance to every worker on the job. The exempted categories cover corporate officers, sole proprietors, business partners and members of limited liability companies.
But Section 3 of the Act has a complexity. This section says that employees in extra hazardous occupations have to be included by the law. While looking at subsections 3(17) and 3(20), you find that corporate officers, sole proprietors, business partners and members of limited liability companies are allowed not to cover them. However, the Act is estimated to cover 91% employees working in Illinois.
There exists a provision to impose a penalty on employers if they do not fall in line with the law. If they intentionally fail to obtain insurance cover for their employees, they may be liable to pay $ 500 per day for non-compliance and a minimum fine of $10000. Failure on the part of the company to pay the fine can put the onus on corporate officers who will be liable to pay the fine. Since 2006, the fines collected by the Commission add up to over $7 million and are added to the Injured Workers Benefit Fund. Thus workers in Illinois have necessary legal protection and employers a competitive field for fair play.
4. HOW MUCH WILL I RECEIVE FROM WORKERS COMP ILLINOIS?
An injury at the workplace can disrupt your daily life whether in terms of earnings, health, or career. Therefore the Illinois Workers’ Compensation law is framed to compensate workers for damages suffered and get fit to rejoin the work. The benefits can be received only after filing a claim for compensation under the scheme. When a worker receives compensation under the scheme, it limits the amount received from the employer.
There are partial temporary disability benefits for workers. These become available when a worker rejoins to undertake light or part-time work that results in a smaller pay. These benefits work out to two thirds of the difference between pre-injury normal wages and the current wages.
Sometimes severe injuries, such as loss of eyes, hands, legs, arms etc., cause permanent disabilities which result in inability to work. In such cases, workers can become eligible for additional benefits if the doctor certifies the permanent disability. Four types of permanent partial disability benefits are provided under the workers compensation law. These are scheduled losses, disfigurement benefits, unscheduled losses, as well as wage differential benefits.
5. CAN WORKERS COMP STOP PAYING WITHOUT NOTICE?
When a worker suffers an injury, he/she is entitled to certain benefits from the workers’ compensation insurance company. The payment must continue till the worker regains health to resume work and also some other issues are resolved. It is necessary to understand workers’ rights in the matter of compensation.
When Does The Payment Of Benefit Stop?
The workers’ compensation insurance company needs to send you a notice before discontinuing payment of the benefits. Such a notice will mention the date from which the benefit payment will stop and the reasons as well. The commonly cited reasons for stoppage of benefit payments to workers are:
- A doctor’s opinion that the worker is healthy to resume work.
- Employer’s willingness to offer work suitable to the worker’s health.
- A doctor’s view that maximum medical improvement is achieved.
- The insurance company’s decision that the injury did not occur at the place of work.
- The doctor detects that the worker had a pre-existing condition.
The payment benefits are denied for other reasons as well but they may not be so often cited.
If your company denies you worker’s compensation benefits, you should immediately contact the claim adjuster to settle the issues that resulted in stoppage of payment.If it does not yield results, the worker has the option to file to hire a lawyer to file the claim.
6. HOW LONG CAN YOU STAY ON WORKMAN’S COMP?
When injured at the workplace, you think of the benefits you can get. Injured employees are entitled to four types of benefits under the workers’ compensation claim. An immediate benefit covers weekly compensation paid to the injured employee. If an employee is disabled, permanent impairment benefit is available. Medical bills benefit and vocational rehabilitation benefit are the other compensations the might be eligible for.
Weekly Compensation Benefits
In case of a disabling injury, the employee can claim weekly compensation benefits. The timeframe varies from state to state and it also depends on the kind of benefit. There are two categories of disability and the benefits related to these respective categories:
- Temporary or permanent disability
- Total or partial disability
The Injured employee is entitled to the following four combinations of benefits depending on which category their case falls under:
- Temporary total disability
- Temporary partial disability
- Permanent total disability
- Permanent partial disability
What Is The Duration Of Weekly Compensation Benefit?
The period of weekly compensation is not a fixed one and is different in various states. But states do place a limit on the period a benefit can be received. The range of limitations lies between three to seven years. However, no limit is generally imposed in case of permanent disability benefits. Exceptions exist where the states cease to provide weekly benefits once the injured employee reaches 65 years. Some do not give permanent partial disability benefits.
7. HOW DOES WORKMAN'S COMP WORK IN ILLINOIS?
When an employee is injured at work, he gets benefits under the insurance program mandated by the state of residence. Every state frames its laws and regulations related to workers compensation. In Illinois, workers’ compensation benefits are given when an employee suffers work-related injury irrespective of how and why the injury occurred.
The compensation income received by the injured employee is not taxable. Illinois has Workers’ Compensation Act and the injuries covered are:
- All injuries, in whole or in part, arising from work
- Pre-existing conditions that worsen due to job or work-related injuries suffered outside of the work place.
Injuries caused due to following reasons are not covered by the workers’ Compensation Act:
- When an injury is self-inflicted (includes injuries caused by a person who starts a fight)
- When an injury occurs in the act of the employee committing a serious crime
- If the employee is injured when not on the job.
- When the injuries were inflicted while the employee’s conduct violated company policy.
It is mandatory for employers in Illinois to provide workers’ compensation insurance. This is aimed at offering benefits to the employees for work-related injuries of varying kinds and severity.
8. CAN WORKMAN’S COMP PAYMENTS BE STOPPED?
An injured worker’s compensation benefit cannot be stopped without a legitimate reason.The employee must know his entitlement- type of injuries and payments – under the worker’s compensation law in the state, if injured on the job.
When are Workers’ Compensation Benefits stopped?
When an injured employee has resumed work, there is no valid reason to continue the payment benefits.The worker is fit to start normal duties related to their job.
The workers’ compensation law provides that an injured employee on benefit must receive notice (the number of days varies per state) that includes an explanation for ceasing the benefits and the circumstances. Here are some examples for terminating the benefits:
- No significant improvement from the injury is expected according to the medical provider’s opinion.
- The employee is medically fit to resume the same or similar job.
It is a requirement that the employee is informed of his right to file a claim by approaching the Workers’ Compensation Commissioner, in case of disagreement.
When Is Termination Of Benefits Not Warranted?
A valid reason is needed to terminate an injured employee’s benefits. An employer who does not want to pay benefits to the injured employee may just remove the employee from the job. Actually an employer cannot use retaliation as a tool to terminate the services of an employee who is either not working, is given light duties or is on temporary partial workers’ compensation benefits.
9. HOW DO I FILE FOR WORKERS COMPENSATION?
If you have suffered an injury that is related to your job, you have a right to claim workers’ compensation benefits. You get entitled to medical care, part of income lost due to being off-work during the recovery period. In addition, you get permanent disability benefits if your injury results in disability to work at all. You get these benefits when you report your injury and file a claim for benefits as per the state’s law. This is how you need to file for worker’s compensation:
- Report The Work-Related Injury– Report your injury to your employer immediately without wasting time. If you allow a wide gap between the date of your injury and reporting it, your employer and the insurance company may doubt your claim. If you file your claim as soon as possible, your benefits too will start soon.
- Filing A Workers’ Compensation Claim Is Important– After you report the injury, you should obtain a claims form from your employer. They will submit your form to the insurance company as well as the state workers’ compensation agency. This will be the official beginning of the processing of your claim. It means that you will approach the workers’ compensation agency with your paperwork only if your claim is denied and you want to go in appeal against the decision.
Your state’s workers’ compensation agency is the source for information, forms, and assistance in the matter.
10. DO I NEED A LAWYER FOR WORKMAN’S COMP?
If you are injured in your workplace, you simply need to file the claim with your employer and wouldn’t need to hire legal services. But you should approach a worker’s compensation lawyer if:
- There is no clear relation between your work and injury.
- Your injury needs long-drawn-out medical treatment over a period of time.
- You remain away from work for a long period.
- The injury results in permanent disability.
As mentioned, every case does not need the services of a lawyer. The workers’ compensation system takes care to provide the services to process the employees’ injury-related claims. Employees will handle their claim with ease if it isundisputed by the employer and the insurance company. Somehow, the claim process is often fraught with difficulties. This is when you might need to employ a lawyer to process your claim.
There are fewer cases when employees injured at work try to claim benefits outside the workers’ compensation program and need to use personal injury attorneys.
You do not need a lawyer if your injury is minor and heals with regular treatment. Insurance companies generally do not deny claims for injuries that are:
- Clearly related to work.
- Treated without extensive medical treatment.
- Require short periods of absence from work.
- Not related to permanent injuries
If you find that you have a dispute with the insurance company about your claim, you can benefit by getting a lawyer to present your case.
11. WHAT QUALIFIES AS WORKERS COMP?
When you are injured or sick because of the work you do, you can receive workers’ compensation benefits that may include bills for medicines and lost wages too. It does not matter who was at fault in case of your injury but you do get the compensation. But for this protection, you forfeit your right to file a legal case against your employer for compensation. Exceptions are possible in a few cases where you can file a lawsuit outside the workers compensation system.
Winning A Personal Injury Claim
If you want to win a personal injury claim, you need to fulfill four basic requirements to be eligible for your workers’ compensation benefits:
- You have to be employed in that company
- Your company must have provision for workers’ compensation insurance.
- Your injury or illness has to be work-related
- You need to meet the set deadlines for reporting the injury and filing a compensation claim.
Special Rules Categories
- The employees falling into certain following categories are covered under special rules.
- Domestic workers
- Farm and agricultural workers
- Seasonal and casual workers
- Workers placed with an employer by temporary agencies
Most of the employers need to provide their employees with workers’ compensation coverage. While the law varies from state to state, employee’s responsibility to provide workers’ compensation insurance depends on factors like number of employees, nature of work, and the nature of the business.
12. CAN AN EMPLOYEE REFUSE WORKERS COMPENSATION?
An employer can bar an employee from further compensation if an employee unjustifiably refuses to accept medical service or vocational rehabilitation. In such a case, the employee will not receive payment for the suspension period and the bar will continue till the refusal ends. This will be reverted if the Commission views that the circumstances justify the refusal on the part of the employee.
The Commission may then order a change in the medical as well as vocational services received by the employee. It means that if an injured employee presents a justifiable case, then the Commission will not impose a penalty on the employee.
This also means that employees view in the matter of refusal and the evidence available to him must be taken into consideration while adjudicating his refusal to accept the medical treatment or rehabilitation services. An employee will have strong case for refusal if he can establish some of the following situations:
- A prior surgery or procedure had an adverse outcome.
- The doctor under whom treatment is received cannot guarantee success of the surgery.
- The employee is searching a better alternative treatment to treat injuries.
- The doctor has failed to provide satisfactory explanation about the usefulness of the surgery or procedure.
These are some of the basic conditions under which an employee can refuse workers compensation.
13. DO I HAVE TO RETURN TO WORK AFTER WORKERS COMP?
If case of a serious injury suffered on the job, it is not easy to decide when the employee will resume work. Apart from the fact that two injuries are unlikely to be the same, the healing period of individuals too differs. Therefore, an assessment of the period after which a person should rejoin work will depend on the merits of individual cases.
The decision is to be arrived at by the doctor and the injured employee. The insurance company and the employer have no role to play in this matter. No injured employee should be forced to resume unless physically fit to carry on the duties.
Physical Fitness: An Important Criteria
It goes without saying that the insurance companies and the employers have a financial stake in getting an injured employee to start work as soon as possible. The payment of workers’ compensation benefits ceases as soon as the worker is back on duty. There are cases where injured employees are pressurized to rejoin the work though they do not feel physically fit to do the work. The employee should return to the job only under the advice of the doctor to do so.He is legally right to rest and ensure full recovery before resuming work.
14. CAN I SUE MY EMPLOYER FOR DENYING WORKERS COMP?
Employer negligence at workplaces can result in accidents and injury to workers. If the workplace conditions are unsafe, it is an invitation to accidents. “Can an employer be sued for accident due to negligence on his part?” In a majority of cases the answer is “no”. But there are circumstances under which the employers can be sued for negligence.
As the employees are covered under the workers compensation scheme, the employers are protected from workers dragging them to court by filing a suit. There are exceptions to this rule and an injured employee can sue the employer when the injury occurs due to extreme negligence by the employer. Look at these examples. A worker is made to work without a breathing mask in a place of harmful gases and dust. Sometimes injury may take place because of third parties like manufacturers of chemicals or equipment, contractor, vendors etc. working at your job place. You can file a suit against an employer or a third party depending upon the facts of the case.
When you file a lawsuit, you can get full compensation for material and non-material losses, if your case succeeds. Non-material losses like pain and suffering often constitute the largest part of an injury claim. Some lawyers offer a free consultation to assess the case.
15. CAN I SUE WORKERS COMP INSURANCE COMPANY?
As an employee, you have a right to sue the insurance company. When you are injured at the workplace and want to make a claim, it is against your employer and the workers’ compensation insurance company engaged by them. In your claim, you can sue both for medical bills and lost wages(when you were not at work). However, your claim needs to be backed by a valid and strong medical opinion and your medical practitioner has a very crucial role to play in this matter.
You can file a claim for penalties against the workers’ compensation insurance carrier. But remember that this claim will be outside the workers’ compensation act. The circumstances that enable you to file such a claim are restrictive or limited and hard to prove. It is also challenging to prove that additional damages claimed by you are entirely attributable to their actions and hence liable for compensation payment due to you.
If you have your own lawyer, you should discuss the pros and cons of your case with them. You would definitely benefit by consulting an expert lawyer who is experienced in successfully handling similar workers’ compensation claim cases.
16. CAN I SUE MY EMPLOYER FOR PAIN AND SUFFERING?
An injury invariably results in pain and suffering. But workers’ compensation insurance does not cover pain and suffering due to an injury. However, if the pain caused by a physical injury results in a mental injury, you may receive additional benefits. A personal injury lawsuit covers damages for pain and suffering due to an injury.
Workers’ compensation insurance aims at setting in place a system to settle workers’ claims for injuries sustained while working. Employers have to make the compensation payments. Employees do not need to prove that the injuries are attributable to employers and this makes it easy for them to get the benefits. But there is a catch. The benefits are limited to reimbursement of medical bills and loss of wages.
However, if the physical injury results in mental or emotional disorder, a worker may become eligible to get additional compensation. Look at a case where an injury at a workplace causes insomnia or depression requiring treatment. Such a case is treated as “compensable consequence” of the work-related injury and entitles a worker to the treatment and benefits for the mental-emotional condition as a part of workers’ compensation case.
17. CAN YOU GET PAIN AND SUFFERING WITH WORKERS COMPENSATION?
Workers’ compensation claim plans are designed to provide benefits to injured workers for an injury that takes place at work. If the claims are filed properly, the injured worker gets benefits like medical bills and lost wages. It is not necessary to prove that it was the employer’s fault that caused an injury. It does not matter if the worker was somehow at fault for the injury. In a way, liability is not an issue for the worker.
The flipside is that damages for pain and suffering due to the injury are not covered under the plan. If an employee’s life-long or serious injury results in debilitating pain, fluctuating moods and other emotional disturbances, there is no provision for benefits in workers’ compensation law. In such a situation, the worker has the option to file a civil law suit against the concerned party for gross negligence that caused an accident.
These civil law settlements or verdicts cover “nominal damages” i.e. damages due to pain and suffering.There are cases of undervalued claims too, where the worker is not granted full compensation to pay medical bills, and compensation for pain and suffering is unheard of. The aggrieved worker can take legal action against the employer and insurance company to claim the benefits based on the details of the case.
18. CAN YOU WORK WHILE ON WORKMANS COMP?
Injuries suffered at work vary in nature. Some injuries are so severe that workers become incapable of working for very long periods. The injured workers are often partially disabled and unable to resume their pre-injury duties. In such cases, the workers work only part-time or accept work that carries lower wages and light duties.Those facing this situation become eligible for continued workers’ compensation benefits but must follow certain limitations.
In fact, when the injury that has taken place at work compels you to accept partial work, you should consult a lawyer experienced in handling work injury compensation cases. They can ensure that you get just compensation suited to the details of your case.Many wonder whether they can work at a second job and not at the place they have been injured at. The clear answer to this query is “no”.
Compensation benefits are available to the injured workers to cover their inability to work. If you can work at a second job, it means that you can resume your current duties or can seek a job elsewhere. The long answer is that this issue is complex and its best to consult a workers compensation lawyer for detailed information about what is permissible by law.
19. CAN YOU LOSE YOUR JOB WHILE ON WORKERS COMP?
Every injured worker may not file claims for workers’ compensation. This typically happens because they are afraid of losing their jobs on account of filing a claim. This is why many adopt different methods such as using their health insurance to cover the costs of their doctor’s visits. Some end up using sick leave or even short term disability leave if they are unable to attend work due to injury.
Doctors are aware of these practices and screen for injuries. If it is a work-related injury and you have not filed a claim under workers’ compensation, the doctors either refuse to look at your case or bill your employer’s workers compensation insurance provider.
An injured worker has generally little option but to file a claim for compensation. As a matter of fact, your employer cannot fire you just for filing a claim. However, an employer will not also openly tell an employee on workers’ compensation that his services are terminated for filing a benefit claim.
Can an employer fire you when on an open compensation claim? The employer will have to establish definite reasons for firing you that are not related to your filing a compensation claim. You are within your rights to file a lawsuit for discrimination or retaliatory termination of service.
20. DO YOU GET PAID WHILE ON WORKMAN'S COMP?
Injured workers are eligible for weekly benefits under workers’ compensation claims. But in order to be eligible for these, they need to be temporarily or permanently unable to resume work due to severe injuries.These benefits are not the same in all states. But there are some common features that can give you an idea of the amount and kind of weekly workers’ compensation benefits you may get.
Compensation claims regularly when claim is open or active- This entirely depends on your ability to resume work in whichever position the employer offers and it may include even light duty work. There is also a provision for regular “time loss” compensation benefits when you are incapable of working on account of industrial injuries.
This depends on the law of your state.Then there are “loss of earning power” benefits which are offered when an injured worker returns to the job temporarily, in a lower paying job than they did prior to the injury. Some states offer these benefits.
Workers also want to know whether their medical bills will be paid. If and when get medical treatment, your doctor will directly bill your employer or their workers’ compensation insurance company for the treatment provides. The bills will be paid if the treatment relates to an industrial injury and is covered under the workers’ compensation in your specific state.
21. DOES WORKMAN’S COMP PAY FOR LIGHT DUTY?
It is in the interests of both the employees and employers that former get back to work as soon as possible after an injury. This entitles them to certain incentives under the workers’ compensation act. If an employee, on his return to duty, is given light duty or shorter hours of work due to partial disability, he gets Temporary Partial Disability (TPD) compensation.
TDP is meant to cover the difference between a worker’s present wages and pre-injury wages (Ind. Code §22-3-3-9). It is paid only if the present wages are lower than the statutory maximum average weekly wage.
Whether an injured worker is getting TTD (Temporary Total Disability) or TPD benefits, they are non-taxable. But it is important to note that any light duty wage is a wage and therefore is subject to various types of deductions by the employer, such as withholding and payroll tax, union fees, health insurance etc.
There is an exception which comes into force when the light duty wage exceeds the statutory maximum average weekly wage ($1040 for injuries incurred on or after July 1, 2014). In this case, the injured worker receives the light duty wage and is not entitled to any additional benefit.
22. WILL WORKERS COMP OFFER ME A SETTLEMENT?
If you have suffered an injury while at work, you get workers’ compensation benefits. You need to understand the settlement process because these are voluntary in nature. It means that your employer or its workers’ compensation insurance company are not bound to settle your claim. Similarly, you are under no obligation to accept the settlement offer proposed by them.
As an injured worker, you may be considering accepting a settlement or understanding some matters related to your compensation claim. This will help you get an idea about what you can get in the settlement. First and foremost, you need to know your entitlement under the workers’ compensation benefits, and the rights you give up as a quid pro quo in the settlement. There is coverage for the following:
- Permanent partial disability
- Temporary total disability or time loss compensation
- Unpaid medical bills
Kinds of settlement
Injured workers may be eligible for two primary kinds of settlements. They can get a:
- Lump sum settlement
- Structured settlement
In the first arrangement with the employer or its insurance company, you receive a lump sum (once only), in exchange for giving up certain rights. In the second type of settlement, you receive smaller payments over a year or a longer period such as ten years or more.
23. IS THERE A WAITING PERIOD FOR WORKERS COMP?
When a worker becomes injured or ill at work, they may be eligible to get benefits under The Workers Compensation Act. The payment of these benefits is managed under the employer’s insurance policy, to safeguard his and the workers interests. The injured workers can receive compensation for medical bills and a part of lost wages by agreeing not to file a lawsuit against the employer.
A favorable aspect of the Workers’ Compensation Act is that most work-related injuries and illnesses are covered.Workers find the waiting period and retroactive period to be the most confusing aspects of the compensation benefits. They include:
- Waiting Period-This indicates the missed work period in the number of days before an injured worker starts getting indemnity payments. The waiting period is generally five days (can differ in different states). If permitted by the employer, the injured worker can use sick leave or vacation days to cover the waiting period
- Retroactive Period– The injured worker has the facility of meeting the conditions of the retroactive period. If they agree to the conditions, the injured worker will get the benefits for work days missed during the waiting period. The retroactive period could be 21 days or more depending on the State.
A claim can become a complex and long-drawn-out process. A minor mistake in filing a claim can delay or reduce the benefits. This is why it’s best to hire the services of a good workers compensation lawyer.
24. CAN YOU COLLECT WORKERS COMP AFTER BEING FIRED?
If a company lays you off, there are certain benefits you get such as severance pay, unemployment benefits or some other compensation.Companies do go bankrupt but it does not necessarily put an end to the compensation benefits you should get. There are differences in corporate bankruptcy cases. Some companies remain operational by arranging to reorganize their debts under Chapter 11 bankruptcy.
Even under Chapter 7 when a company files for liquidation of all assets and closes the business, workers’ compensation benefits may remain unaffected. Your employer’s insurance provider pays the workers’ compensation benefits and the employer pays the insurance premium to the company. So as long as the employer has not missed the premium, an injured worker will continue to receive their payments. In case the employer falters on making the premium payment, you may be still able to get the benefits from other sources. The employer will be subjected to paying fines and may face criminal charges too.
In case, you have resumed work and are on work limitations, your benefits do not go away even in case of a layoff. In case you have continued to receive workers compensation benefits even after resuming work, the insurance company has to pay you reasonable and necessary medical bills post-layoff.