Frequently Asked Questions

Navigating the world of workers' compensation claims can be overwhelming, particularly when you're dealing with the aftermath of an injury. Whether you're a seasoned worker or new to the workforce, understanding how the process works in Illinois is crucial to ensuring you receive the benefits you're entitled to. This guide will break down the key aspects of workers' compensation, providing you with the knowledge to protect your rights and make informed decisions.

Workers' compensation is a system designed to provide financial and medical benefits to employees who suffer work-related injuries or illnesses. In Illinois, this program is mandatory for most employers, ensuring that employees have access to coverage without the need for lengthy legal battles. The Illinois Workers' Compensation Act governs the process, outlining the rights and responsibilities of both employers and employees.

One common question is, "Am I eligible for workers' compensation?" In Illinois, any employee injured or who becomes ill due to their job is generally covered. This includes:

• Full-time, part-time, and seasonal workers.
• Temporary employees.
• Undocumented workers, as long as they are legally employed.

The key requirement is proving that the injury or illness is directly related to the job.

If you're injured at work, taking the right steps can significantly impact your claim's outcome. Here's what you should do:

1. Report the Injury Immediately: Notify your employer as soon as possible, ideally within 45 days of the incident. Delays can jeopardize your claim.
2. Seek Medical Attention: Visit a healthcare provider to document your injuries and receive treatment.
3. File a Claim: Complete the necessary forms and submit them to the Illinois Workers' Compensation Commission (IWCC).

There are generally five types of workers’ compensation that an injured worker may be entitled to receive, including:

• Medical Benefits: Coverage for all necessary medical treatments related to the injury.
• Temporary Total Disability (TTD): Wage replacement if you're unable to work temporarily.
• Permanent Partial Disability (PPD): Compensation for lasting impairments.
• Vocational Rehabilitation: Assistance in returning to work or finding new employment if you're unable to perform your previous job.
• Death benefits for a surviving family member.

While the system is designed to be straightforward, many workers face challenges, such as:

• Claim Denials: Employers or insurance companies may dispute the claim.
• Benefit Delays: Administrative hurdles can slow down the process.
• Insufficient Compensation: The benefits offered may not fully cover your needs.

If your claim is denied, don't lose hope. In Illinois, you have the right to appeal the decision. Here's how:

1. Request a Hearing: File a petition with the IWCC to schedule a hearing.
2. Gather Evidence: Collect medical records, witness statements, and other documentation to support your case.
3. Seek Legal Assistance: Consider hiring a workers' compensation attorney to navigate the appeals process.

Yes, in Illinois, you can select your primary doctor and one additional healthcare provider. However, any referrals must come from these chosen providers.

Employers in Illinois are required by law to carry workers' compensation insurance. If they don't, you can file a claim through the state's Injured Workers' Benefit Fund.

Generally, up to three years from the date of the injury or two years from the last payment of benefits, whichever comes later.

Yes, Illinois operates on a no-fault system, meaning you can receive benefits regardless of who caused the injury.

While not mandatory, having an attorney can be beneficial, especially if your case is complex or disputed.

Understanding the intricacies of workers' compensation claims in Illinois can empower you to take control of your situation. Whether you're navigating the process alone or seeking professional assistance, being informed is your first step toward securing the benefits you deserve.

In a compensable workers' compensation claims, the employer (or their insurer) is required to pay for all medical care that is necessary to cure illness or relieve its injured employee from the effects of the injury. This includes, but is not limited, the following:

• First aid
• Emergency care
• Doctor visits
• Hospital care
• Surgery
• Physical therapy
• Pharmaceuticals
• Prosthetic devices
• Prescribed medical appliances/devices

In a compensable workers' compensation claim, the employer (or their insurer) is required to pay the injured employee two-thirds (2/3) of his/her Average Weekly Wage in the following scenarios:

1. The injured employee's physician(s) has determined that he/she is temporarily unable to return to any work; and
2. The injured employee's physician(s) has determined that he/she can only return to work with restrictions, but the employer is either unable or unwilling to accommodate said restrictions. 

An injured employee may be entitled to Temporary Partial Disability benefits if they are still healing and are working light duty, part-time, or earning less than they would before injury or illness. 

An injured employee who has reached maximum medical improvement is entitled to compensation for the permanent damage caused to his/her body as a result of their work accident:

• Disfigurement – for example, a scar with no other residual injury
• Permanent Partial Disability (PPD)
  • Every body part is assigned a number of weeks.  The Commission determines what percentage of loss you suffered for that body part
  • If you suffer an amputation, you would recover 100% loss of that body part
  • In addition to body parts, there is a classification for “person as a whole.”  This represents injuries to the back, neck, head, internal organs, etc.
• Loss of earning capacity for someone who is unable to return to their occupation at the time of injury and can only perform a job earning less money
• Permanent Total Disability for someone who is not capable of ever returning to any type of work