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Workers’ Compensation Questions

Illinois Workers’ Compensation Questions

Find Answers to your Illinois Work Comp Questions Here.

Below is general information based upon our experience and Illinois law. Because every case is different, you should always consult an experienced and skilled Illinois workers’ compensation attorney for legal and practical advice on these issues.

1. Who is responsible for providing benefits under the Illinois Workers’ Compensation Act?

The employer is, by law, completely responsible for providing benefits. The employer usually provides benefits through a Workers’ Compensation insurance company or sometimes, provides benefits directly. A worker cannot be charged for benefits provided by the Illinois Workers’ Compensation Act or any portion of their employer’s Workers’ Compensation insurance premium.
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2. What workers are covered by the Illinois Workers’ Compensation Act?

Every worker injured in Illinois, hired in Illinois but injured while working in another state or injured while working in another state for an employer whose principle place of business in Illinois, is covered by the Workers’ Compensation Act. So long as the worker did not intentionally cause an accident, he/she is still entitled to workers’ compensation benefits. It does not matter if the injured worker caused the accident, was careless or negligent.
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3. What injuries are covered by the Illinois Workers’ Compensation Act?

Any worker who has sustained an injury “arising out of and in the course of their employment” has a potential claim under the Illinois Workers’ Compensation Act.
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4. What medical benefits does the Act provide to a worker after they have sustained an on-the-job injury?

An injured worker is entitled to receive 100% of “all necessary and reasonable medical expenses incurred as a result of a job-related accident.” The employer’s liability to pay for medical services is limited to (a) all medical, surgical and hospital services provided by the physician, surgeon, or hospital initially chosen by the employee or any subsequent medical provider(s) in the chain of referrals from the original provider and (b) any such services provided by an employee’s second choice of such a medical provider or any subsequent medical provider(s) in the chain of referrals from the second choice medical provider. Thereafter, the employer shall select the provider. Therefore, if you wish to see a different doctor, ask for a referral from your treating doctor so the new doctor is within the chain of referral.
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5. What should I do immediately after a workplace accident?

If you are hurt, do not just try to work off the pain. As soon as possible, go to either the hospital or to your primary care physician and get all of your symptoms documented.

Always report accidents as soon as possible after they happen, and if possible, fill out an accident report. When you are filling out the report, try to be broad and general in describing the accident rather than specific. The more specific the report, the more likely the injured worker will forget something that may be material. Notification, oral or written, must be within forty-five (45) days from the date of the accident.

Call an experienced Illinois Workers’ Compensation lawyer. Calling a lawyer does not cost anything. Proceeding without legal counsel may cost you your right to receive workers’ compensation benefits and jeopardize your livelihood. Don’t sign anything until your lawyer reviews it.
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6. What do I need to inform my employer of while I am off of work?

Be sure to keep your employer informed as to your return to work status. Give your employer a copy of all work status reports from your doctor. If you fail to do so, your employer may attempt to discipline you, including possible termination.
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7. Is a worker entitled to benefits under the Act for injuries that result from performing repetitive motions in the course of their job?

Yes. A worker who has sustained an injury, commonly referred to as a repetitive trauma injury, is entitled to benefits under the Illinois Workers’ Compensation Act. Repetitive trauma injuries are not necessarily due to a specific incident. These injuries generally occur over time. Unfortunately, when a worker is injured through repetitive trauma, the worker might not associate the injury as being work-related.
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8. Does a worker have a viable Workers’ Compensation claim if they re-injure a previously injured part of their body or aggravates a pre-existing physical condition?

If a worker sustains a work-related injury to a previously injured part of their body, regardless of whether the previous injury was work-related, they are not barred from recovery under the Illinois Workers’ Compensation Act. Similarly, if they sustain an accident which aggravates or accelerates a pre-existing physical condition, they are still entitled to all the rights and benefits provided by the Illinois Workers’ Compensation Act.
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9. Is a worker who sustains an on-the-job injury entitled to compensation if the injury causes disfigurement?

Yes. A worker who suffers a serious and permanent disfigurement to the head, face, neck, arms or legs as a result of a work-related injury, is entitled to benefits under the Illinois Workers’ Compensation Act.
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10. What benefits is an injured worker entitled to while off work?

The Illinois Workers’ Compensation Act provides that a worker receive compensation (Temporary Total Disability benefits or T.T.D. benefits) for the entire time the worker’s treating doctor requires them to remain off work to receive treatment and recuperate from their injuries.

T.T.D. benefits are required to be paid within fourteen (14) calendar days from the date the employer or one of his agents receives notice of the accident from the injured worker, unless the Workers’ Compensation insurance company indicates, in writing, the reason for its refusal to pay T.T.D. benefits to the injured worker.

T.T.D. benefits are calculated as two-thirds (2/3) of a worker’s average, gross, weekly wage for the year preceding the accident (excluding overtime and bonuses). In addition to numerous variations and complications in calculating the worker’s average, gross, weekly wage, the T.T.D. rate is subject to various minimums and maximums prescribed by the Act.
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11. What benefits are provided by the Act if the injuries sustained by the worker are permanent in nature?

Even though an injured worker may return to their usual profession or trade after sustaining an on-the-job injury, they could be entitled to compensation for any complete or partial permanent loss of use of any part of their body. This compensation is called Partial Permanent Disability benefits or P.P.D.

The amount of Partial Permanent Disability benefits a worker is entitled to is based on their P.P.D. rate and the level of permanency of their injury. A worker’s P.P.D. rate is calculated as sixty percent (60%) of the worker’s average, gross, weekly wage for the year preceding the accident (subject to specific statutory minimums or maximums). There is no predetermined or fixed amount (level of permanent disability) that is applicable to a worker’s injury. There are numerous factors which must be taken into consideration to determine the approximate monetary value of an injured worker’s entitlement to P.P.D. benefits under the Act. It is essential to understand that every injury sustained by a worker is unique, therefore, requiring the knowledge of an experienced Illinois Workers’ Compensation attorney to assist the injured worker in recovering the maximum amount of P.P.D. benefits to which they are entitled under the Act.
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12. What if an injured worker is unable to return to their usual trade or profession after their treating doctor has exhausted all forms of treatment?

If an injured worker can no longer perform their usual trade or profession and must, therefore, accept a lower paying position, the worker could be entitled to benefits equal to two-thirds (2/3) of the difference between the average, gross, weekly, wage earned before the accident and the wage they are earning after the accident.
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13. What if the injured employee, after their recovery, is unable to return to any type of work?

If the injured worker is unable to return to “any type gainful employment” they would be considered totally and permanently disabled and would be entitled to weekly benefits at the worker’s T.T.D. rate for life or until such time as they are capable of returning to some type of gainful employment.
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14. Is an injured employee entitled to vocational rehabilitation?

If a worker sustains an injury serious enough that they are unable to return to the type of work they were doing at the time of the accident, the Workers’ Compensation insurance company or employer could be responsible to pay for vocational rehabilitation to retrain the worker for a new job, trade or profession consistent with their physical limitations. The employer’s Workers’ Compensation insurance company or employer itself may also be required to continue paying the worker’s weekly T.T.D. benefits for the entire rehabilitation period. Whether an individual is eligible for vocational rehabilitation depends on several factors specific to each worker.
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15. What benefits are payable to survivors of a worker whose death is caused by a work-related accident?

The maximum death benefit provided by the Illinois Workers’ Compensation Act is twenty (20) years of the deceased worker’s T.T.D. rate or $250,000, whichever is greater. Death benefits are payable to the widow(er) and or the worker’s dependent children under eighteen (18) years of age. Under certain circumstances, monies could be paid to other dependent relatives of the deceased worker if there is no surviving widow(er) or dependent children.
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16. How long does an injured worker have to file their Workers’ Compensation claim?

A worker, who is injured as a result of a work-related accident, must file a claim with the Illinois Industrial Commission within three (3) years of the date of their accident or within two (2) years of the latest payment of compensation, whichever of these dates is later. This provision is referred to as the Statute of Limitations. With regard to the Statute of Limitations, it is important that every worker remember the following:

  1. Completion of an accident report form (or any other type of form relative to an accident), for the employer or its Workers’ Compensation insurance company, is not considered “filing” of a claim under the Act. Either the worker or their attorney must file a specific form entitled “Application for Adjustment of Claim” with the Illinois Industrial Commission.
  2. If an Application for Adjustment of Claim form is not filed with the Illinois Industrial Commission within the Statute of Limitations, the worker would lose their rights and benefits provided by the Act.

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17. Should an injured worker give a recorded statement to his/her employer or its Workers’ Compensation insurance company?

No. In order for an injured worker to be entitled to benefits under the Act, the employer or its Workers’ Compensation insurance company must simply receive proper notice of the accident, and the name and address of the doctor(s) from which the worker is receiving treatment. There is no requirement in the Illinois Workers’ Compensation Act that this or any other information be transmitted to the employer by a recorded statement. Furthermore, a recorded statement is generally not taken to the benefit of the injured worker. The injured worker’s statement could be used as evidence against the worker at a subsequent hearing before the Illinois Industrial Commission. A recorded statement may also negatively affect the worker’s rights relative to a potential Third Party case resulting from the accident.
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18. What is a Third Party case?

An injured worker could have the right to receive additional monetary damages in the form of a “Third Party” lawsuit if the facts and circumstances of the accident establish that a Third Party other than their employer or a co-worker is responsible for the accident.
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19. Can I have a Workers’ Compensation case and a Third Party case at the same time?

Yes. If a worker is injured on the job as a result of someone else’s negligence or fault other than their employer or a co-worker, they can have both types of cases.
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20. Should an injured worker sign any documents for their employer or the Workers’ Compensation insurance company?

The only document an injured worker should sign is an accurately completed accident report. Any other documents signed by the worker, no matter how insignificant they may appear, could adversely affect the worker’s rights and benefits under the Illinois Workers’ Compensation Act. Furthermore, said documents could adversely affect the worker’s rights relative to a potential Third Party case resulting from the workplace accident.
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21. Is an injured worker required to submit to an examination from a doctor selected by the Workers’ Compensation insurance company or the employer?

Yes. If an injured worker claims they are entitled to receive or are receiving benefits under the Illinois Workers’ Compensation Act, the Workers’ Compensation insurance company or employer is entitled to have the worker examined by a doctor of its own choosing at a reasonable time and place. The Workers’ Compensation insurance company or employer must pay for the exam. Failure to attend the examination could result in an interruption of benefits to the injured worker.
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22. Is an injured worker required to cooperate with a rehabilitation nurse retained by the Workers’ Compensation insurance company?

Yes. The Act provides that any injured worker who fails to cooperate with the rehabilitation process can have their benefits terminated by the Workers’ Compensation insurance carrier. However, remember that the nurse case manager, no matter how pleasant, is not your friend. This person works for the employer and his/her job is to get you back to work as fast as possible while minimizing the employer’s cost.
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23. What rights does an injured worker have if they are not receiving the benefits they are entitled to under the Act?

If an injured worker, under active medical treatment and off work pursuant to their doctor’s instructions, is not receiving their benefits, they have the right to a hearing before an Arbitrator of the Illinois Industrial Commission. At this hearing, the worker would have the opportunity to present medical evidence and witnesses in support of their claim for Workers’ Compensation benefits.

Most likely, an attorney will be defending the claim on behalf of the Workers’ Compensation insurance company or employer. Therefore, in order to level the playing field, it is strongly advised that the injured worker retain an experienced and competent Illinois Workers’ Compensation attorney.
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24. Should an injured worker apply for group health insurance benefits instead of Workers’ Compensation benefits?

No. Often an employer will encourage their injured workers to apply for group health insurance benefits instead of Workers’ Compensation benefits. However, it is advisable not to apply for group insurance benefits for the following reasons:

  1. Most group health insurance policies do not provide for lost time or Temporary Total Disability benefits (T.T.D.).
  2. Most group health insurance policies usually require that the injured worker pay a portion of the medical expenses, whereas, Workers’ Compensation pays 100% of any injured worker’s reasonable and necessary medical expenses.
  3. The extensive rights and benefits an injured worker is entitled under the Act (T.T.D., P.P.D., rehabilitation, etc.) are not provided by group health insurance plans.
  4. Finally, and most importantly, group health insurance policies frequently exclude the payment of any benefits for work-related injuries and therefore, might require the injured worker to indicate, in writing, that the benefits being provided are not a result of a work-related injury. Such an admission could jeopardize their Workers’ Compensation claim.

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25. Can an injured worker be fired for filing a claim for Workers’ Compensation benefits?

No. The Act provides that it is unlawful for any employer or its Workers’ Compensation insurance company to interfere with, coerce or discriminate against any injured worker, in any manner, whatsoever, for exercising their rights to obtain any or all of the benefits provided for by the Act.
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26. When is a Workers’ Compensation claim considered done?

A Workers’ Compensation claim is considered done, i.e., settled and/or permanently closed, only after “Lump Sum” settlement contracts are prepared and signed by the appropriate parties and approved by the Illinois Industrial Commission. After the above process is concluded, the worker’s claim is closed and they are no longer entitled to Workers’ Compensation benefits for their injuries. In the event of a subsequent accident, the worker would need to file a new claim for Workers’ Compensation benefits.

It is important to know that if an injured worker has received various Workers’ Compensation benefits from his employer but never signed Lump Sum Settlement contracts, he may still have a viable Workers’ Compensation claim if the Statute of Limitations has not expired.
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27. Can a worker file a lawsuit against his employer for the injuries he sustained for a work-related accident?

Generally no. In Illinois, the remedy a worker has against their employer is a Workers’ Compensation claim filed with the Illinois Industrial Commission.
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28. Is an injured worker entitled to money for the payment of union dues, health insurance, or other similar benefits?

No. Unfortunately, the Act does not provide compensation to the worker for any of these benefits.

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