Workers’ Compensation Claim Process

Workers’ Compensation Claim Process

In theory, the workers’ compensation process is relatively simple: you report your injury, get treatment, make a claim, and get paid. In practice, it can be very complicated, and if your employer is trying to dispute your claim or you have a dispute with the Illinois Workers’ Compensation Commission (IWCC), you may have significant difficulty in getting compensation for your injury.

If you are having trouble with the workers’ compensation process, you will likely benefit from talking to a lawyer in person. That’s why Willens Law Offices in Chicago offers free consultations. You can call us at 312-957-4166 or contact us today to schedule your consultation.

Reporting an Injury

If you suffer a workplace injury, you should report it as soon as possible to your employer If you are unable to report your injury immediately because you are unconscious or have to seek emergency medical care, or are simply unable to get in contact with them, you can report your injury to your employer within 45 days of the incident (or up to 90 days for radiological exposure). For occupational diseases, you should give notice as soon as possible after diagnosis.

Getting Treatment

In general, you have to get primary treatment for your workplace injuries at the care facility designated by your employer. The exception is if you need emergency care, in which case you are allowed to get it at the nearest facility or the one where you can get the most immediate care.

In Illinois, your employer cannot tell you which doctors to see. However, if your employer does have a Preferred Provider Program (PPP), you must choose a doctor from within the network or risk not getting workers’ compensation.

Filing a Claim

To file your claim, you must provide three copies of the Application for Adjustment of Claim and the Proof of Service. There are no fees to file the claim.

After your claim is filed, it will be assigned an arbitrator. Claims in Chicago are assigned to a different pool of arbitrators than those in the rest of Illinois. It remains your responsibility and that of your employer, to try to resolve the case.

Resolving Disputes

It is your responsibility to prove that you are entitled to workers’ compensation benefits. The most common disputes include:

  • Were you eligible for coverage at the time of the accident?
  • Were you an employee when injured?
  • Did you actually suffer an accident or exposure to occupational disease?
  • Did the accident or exposure cause your injury or illness?
  • Did you give notice to your employer about the injury or exposure?

We have experience helping workers overcome all these disputes.

Note: you can take payment for workers’ compensation benefits without limiting your rights to dispute findings. So can your employer. They may one day decide to deny a claim they’ve been paying and ask for repayment.

Every three months, you are given the option of moving your case to trial rather than continue negotiating with your employer over disputed benefits. Trials are conducted before an arbitrator, and decisions can be appealed if either party is unhappy with the outcome.

Getting Compensation

Your compensation will depend on the severity and type of your injury. In general, compensation is based on your average weekly wage before the injury and limited by the state’s average weekly wage figures.

An Attorney Can Help

Experienced workers’ compensation attorneys can help you at all stages of the process, from filing your original paperwork to appealing the decision of an arbitrator. At Willens Law Offices, we have helped many workers get the compensation they deserved after a workplace injury. Please contact Willens Law Offices today for a free consultation at either of our Chicago area offices.

Updated: April 16, 2015