SECTION ONE
GENERAL OVERVIEW
A. What is workers' compensation?
Workers' compensation is a system of benefits provided by Illinois law to most workers' who have been injured while at work. The amount of the benefits is subjected to limits as set form by the law.
B. Who is covered?
Almost every employee who is injured and whose employment is localized in the state of Illinois is covered by workers' compensation. Coverage begins from the moment the employee starts work.
C. Who provides the benefits?
The employer is responsible for providing benefits. The employer may be self-insured or have contracted with an insurance company to provide workers' compensation insurance for their employees.
D. Who administers the law?
The Illinois Industrial Commission is responsible for administering the law. It is responsible for resolving disputes regarding employees' enticement to benefits and the amount of benefits.
E. Can an employee be fired because he or she has filed a workers' compensation claim?
It is against the law for an employer to fire an employee because he or she filed a workers' compensation claim. Such conduct by an employer may give rise to a right to file a separate claim for damages in Circuit Court. The Illinois Industrial Commission does not have jurisdiction over such a claim.
F. Are workers ' compensation benefits subject to income tax?
No. Workers' compensation benefits are not subject to state or federal income tax and need not be reported on returns as income.
SECTION TWO
REPORTING AN INJURY
A. Who should the injured employee notify of his or her accident?
The employee must inform the employer immediately. Any delay in notification may result in the delay of benefits. A delay of more than 45 days may result in the complete denial of the entire claim. Notice to a non-management co-worker is not considered notice to the employer.
B. What should the notice include?
The law requires that the employee notify the employer of the date and place of the accident.
C. What is the best form of notice?
The best form of notice is a written and dated notification of the accident to the employer. A copy of the notification should be retained by the employee for his or her records.
D. What should the injured worker do after notice is given?
The injured worker should seek immediate medical attention if he or she has not done so already. The injured worker should also keep the employer informed of their medical status: i.e. whether they are under doctor’s care, and or whether the doctor is restricting them from work.
E. Is there any other notification that should be given to employer?
If the injured worker's doctor is restricting the employee from work, such information should be put in writing by the doctor and given to the employer and or the insurance carrier.
SECTION THREE
MEDICAL BENEFITS
A. Can the employee choose his or her own treating doctor or hospital?
Yes, an employee may choose his or her own treating doctor or hospital. It is recommended that the employee inform the employer in writing of the name and address of the doctor or hospital chosen. An employee may also obtain treatment from a doctor or hospital selected by the employer.
B. Is there a limit to the number of doctors an injured employee may choose?
Yes. The employer’s responsibility is to pay for all reasonable and necessary first aid and emergency services, two treating physicians, surgeons or hospitals and any additional medical card providers to whom the employee has been referred by the two physicians, surgeons or hospitals.
Emergency and first aid care will not be considered one of the employee’s two choices of doctors.
C. Is the employer required to pay all the medical bills?
If the treatment provided is reasonable and necessary to cure or relieve the employee from the effects of the injury, and the provider of the medical services has given the employer the information required by law, the employer is required to pay the reasonable charges.
D. Is the employer entitled to their own medical evaluation of the injured employee?
Yes. If an employee claims to be entitled to benefits, the employer can request that the injured employee submit to a medical examination by a doctor of the employer’s choosing. This is called an Independent Medical Examination.
Additionally, the employer is required to pay for the mileage incurred by the injured employee while attending the medical examination.
An employee’s refusal to submit to an Independent Medical Examination can result in the loss of benefits.
SECTION FOUR
COMPENSATION BENEFITS
A. What is Temporary Total Disability (TTD) Benefits?
Temporary Total Disability benefits are paid to the injured employee who must lose time from work to recover from a work-related injury. It is necessary for the injured worker to provide medical documentation, substantiating his or her inability to work.
B. When do TTD benefits begin?
TTD benefits are not paid for the first three work days lost after an injury, unless the disability continues for 14 or more calendar days.
C. How is the amount of TTD determined?
The benefit is two-thirds (66 2/3%) of the employee's gross average weekly wage, subject to certain limits. The average is based on the employee's wages during the year before the injury. The rate is fixed at the time of the injury, and does not change with changes in the employee's salary or the statewide average weekly wage.
D. What is permanent partial disability benefits?
Permanent partial disability benefits (PPD) are paid only if the job-related injury results in the permanent loss or loss of use of a part of the body or whole body.
PPD benefits will be only paid after the employee's condition had reached a point where it will not improve anymore.
SECTION FIVE
CLAIMS OVERVIEW
A. What are the time limits within which an employee must file a claim at the Industrial Commission?
A claim must be filed within three years after an injury, or within two years following the last workers' compensation payment, whichever is later.
Payment of medical bills is not considered payment of compensation for purposes of increasing the time within which an employee may file a claim.
Failure to file a claim within the time provided by the law generally results in a loss of benefits.
B. Who presides over workers' compensation claims?
An arbitrator appointed by the Industrial Commission acts as fact-finder and judge, conducts the hearing, and decides on the amount of benefits to which an employee is entitled.
C. Is it possible to appeal the arbitrator's decision?
Yes. The employee and employer both have the right to appeal a decision if dissatisfied with the arbitrator's decision. In most cases, a panel of three Commissioners will review the Arbitrator's decision.
Either party can then appeal the Commissioner's decision to the Circuit Court and, from there, to the industrial Commission Division of the Appellate Court. In some cases, further appeal may be taken to the Illinois Supreme Court.
D. Can the parties settle a claim for compensation benefits?
Yes, claims may be settled between the parties, provided the settlements are approved by the Industrial Commission. All settlements must have Industrial Commission approval.
*** This information is intended to serve only as a general overview of the rights of employees who have had work-related injuries. This information provides a brief overview of the rights of injured employees as set forth under the Illinois Workers' Compensation Act. This information does not constitute legal advice and does not represent all the rights as set forth under the Illinois Workers' Condensation Act.
It is not intended to explain all the benefits or conditions pertaining to specific cases. Each individual case has to be evaluated by applying the law to the facts of each case.
Portions of this information were excerpted from the Illinois Industrial Commission Handbook on Workers' Compensation. |
