Workers Compensation and Work Injury
1. What happens if I am injured on the job, or if I contract a job-related illness?
You are probably entitled to workers' compensation benefits.
2. What is workers' compensation?
Workers' compensation consists of a number of different kinds of benefits provided by state law to most workers who have suffered job-related injuries or illnesses under the Illinois Workers' Compensation Act. The Act is administered by the Illinois Workers' Compensation Commission, which is a state agency.
The Act was enacted by the Illinois General Assembly in 1911 to provide financial protection and security to almost any worker who sustains an injury or illness while on the job. Almost every employee in the state of Illinois is covered by the Act from the moment their employment begins with their employer, and benefits are paid to an injured worker regardless of who is at fault for the injury.
3. Who pays these benefits?
The employer pays workers' compensation benefits, either directly or through an insurance company.
4. What injuries, diseases or illnesses are covered by workers' compensation?
Workers' compensation benefits generally apply to injuries that are caused by the employee's work, and also apply when a previous injury or illness is aggravated by the employee's work. Injuries which are caused by repetitive stress, such as carpal tunnel syndrome, are covered, as are strokes, heart attacks and other physical problems that are directly caused by a worker's employment.
5. What kind of benefits are provided by workers' compensation?
Temporary total disability (TTD) compensation is paid in a percentage of the injured employee's gross average weekly earnings, including overtime, while the employee is off work by order of a physician as a result of a work-related injury or illness. If you hold a second job and the employer for whom you were working at the time you were injured is aware that you work this second job, your temporary disability payments are based on the gross income from both jobs. Reasonable and necessary medical, surgical and hospital expenses are 100% covered.
Physical, mental and vocational rehabilitation benefits, while subject to requirements and limitations, will be provided to an injured worker when such benefits are found to be appropriate. Permanent disability and dismemberment benefits may be compensated by way of a lump-sum payment or payments over time. If the injury causes the death of the worker, the worker's spouse and/or dependents are entitled to certain benefits as are specified by the Illinois Workers' Compensation Act.
6. What do I have to do to receive workers' compensation benefits?
You must notify your employer immediately of your work-related injury or illness. Any delay in notification may jeopardize your ability to receive benefits. Notice to your employer may be given orally or in writing.
In your own self-interest, DO NOT submit to a recorded statement and DO NOT sign any documents given to you by your employer or by your employer's insurance carrier until you are able to have them reviewed by a competent workers' compensation attorney. You should keep your employer informed of your medical condition.
7. When will my employer begin paying me TTD benefits?
Under the provisions of the Illinois Workers' Compensation Act, your employer or their insurance company is legally required to begin payment of TTD within fourteen (14) days of the date you informed your employer of your work injury.
8. Can I be fired from my employment for applying for workers' compensation?
Illinois law specifically prohibits an employer from firing injured employees for exercising their right to compensation under the Illinois Workers' Compensation Act. The firing of employees for exercising their rights under the Act may give rise to a separate legal action against the employer.
9. How do I know whether I have a viable workers' compensation claim?
Consult with an attorney who concentrates his practice in workers' compensation law. The Law Offices of Bradley S. Dworkin does not charge for consultation.
10. Can I choose my own doctor or hospital?
You may, within certain restrictions as are specified in the Illinois Workers' Compensation Act. The employer is responsible for 100% of all reasonable and necessary medical, surgical and hospital expenses.
In many cases you can see up to two doctors of your own choice, and your employer is also responsible for paying the charges made by any other doctors or hospitals to whom you are referred by either of your first two choices of doctors.
However, if your employer maintains a Preferred Provider list, you are required to select a treater from that list as your first choice of doctor, or else forfeit that first choice. In that case, you will be entitled to only one doctor of your own choice.
In our opinion, the doctors on an employer’s Preferred Provider list are biased in favor of the employer and should not be seen. Because declining to treat with your employer’s doctors will leave you with only one choice of doctor, it is important that you contact us before beginning treatment so that we can review with you your doctors and make the best use of your choice.
11. Is the employer responsible for payment if I wish to be seen by another doctor?
The employer is responsible for emergency services, physicians and hospital stays, and any additional medical care providers to whom the injured worker is referred by the above. Certain restrictions are specified in the Act. You should consult with an experienced workers' compensation lawyer in order to protect your rights regarding your employer's payment for your medical treatment.
12. Can my employer ask me to submit to an examination by its own physician?
Yes, but such an examination, which may be known as an "independent medical evaluation," must be done at the employer's expense and must also be performed at a time and place that is reasonable for the injured worker to attend. If applicable, the employer is responsible for payment of the employee's time lost from employment for the doctor's examination.
Be aware that your employer has sent you to their examining physician in order to obtain the injury history, diagnosis and prognosis they want, in order to minimize or even deny your claim. Therefore, you should be specific in advising your employer's physician or medical evaluator about the specifics of your injury and medical treatment, and that your injury was directly caused by your employment.
13. How do I pay for an attorney to represent me regarding my workers' compensation claim?
You will be charged a fee only when a recovery is made on your behalf. Details are provided in the written attorney/client agreement form that you will be asked to sign at such time as you retain legal counsel. Be certain to read the agreement carefully, and ask any questions you may have about the agreement at the time of signing.
14. When should I retain counsel to represent me regarding my workers' compensation claim?
The Law Offices of Bradley S. Dworkin recommends you retain competent counsel who focuses in workers' compensation law immediately. You will need a competent workers' compensation attorney to guide you through the claims process in order for you to obtain every benefit to which you are entitled to under the Illinois Workers' Compensation Act.
Your employer will not advise you of your rights under the Act, and although many employers are not unfair toward their injured employees, they may not feel that it is in their best interest to protect and assist you in the recovery of benefits as are provided by the Act. You should be aware that their motivation and objectives are entirely different from yours.
15. What should my workers' compensation lawyer do for me?
Your lawyer should assist you in the filing of your claim with the Industrial Commission, and should ensure that you receive all of the benefits you are entitled to under the Act. Your lawyer may have to petition for an immediate hearing so that you may receive the benefits you deserve from your employer in a timely manner.
Your work injury lawyer may have to take the evidence depositions of doctors involved in your medical care in order to ensure an equitable resolution to your claim. In the event that a hearing is necessary to resolve the issues surrounding your claim, your lawyer may need to review or appeal the decision made by the Arbitrator regarding your claim. Depending on the facts of the claim, your case may even go all the way to the Illinois Supreme Court.
16. What if someone other than my employer is responsible for my work-related injury or illness?
You may have a legal cause of action referred to as a "third party claim" against the party or parties responsible for your work injury. The most common forms of "third party claims" are vehicular accidents and product liability claims. In cases such as these a claim may be filed in State or federal court against the other driver and their insurance company, or the manufacturer that produced a defective product which led to your injury or disease.
If recovery of damages is made against a third party, your employer may be entitled to reimbursement of some or all of the benefits paid out in your workers' compensation claim. Such reimbursement should be made by the third party or their insurer.
17. What other benefits may I be entitled to?
You may be entitled to unemployment compensation, social security benefits, disability benefits and group health insurance benefits. Your workers' compensation lawyer should be able to advise you regarding whether these other benefits fit your particular circumstances.
18. What is the statute of limitations regarding the filing of a workers' compensation claim in Illinois?
Generally speaking, the statute of limitations for the filing of a workers' compensation claim is three years, although certain conditions are specified in the Illinois Workers' Compensation Act. You should act as promptly as is practical to ensure your rights under the Act.
19. Am I able pursue workers' compensation benefits even though I am no longer working for the employer I was working for at the time I was injured?
Yes, assuming you have complied with all of the other conditions specified by the Illinois Workers' Compensation Act.
20. What if my doctor returns me to full duty employment, but I feel that I am unable to perform that job anymore?
You should follow your doctor's recommendation and attempt to return to work. The more positive your attitude toward returning to work, the better it is for your workers' compensation claim in the long run. If you experience pain and discomfort upon your return to work you should report this to your supervisor and make an appointment with your doctor as soon as possible.
21. I have been handling my own workers' compensation case for two years, but am getting nowhere with it. Is it too late for me to get a lawyer?
No, as long as all notice requirements have been met.
22. Is it possible for me to receive a lump-sum settlement in the event I am found to be permanently and totally disabled from further gainful employment?
It is possible to receive a lump-sum settlement distribution rather than scheduled payments in such cases, provided such a distribution is approved by the Illinois Industrial Commission.
23. What happens when I settle my workers' compensation claim?
You may be closing out any further claim to workers' compensation benefits regarding your injury upon you acceptance of a settlement offer.
24. What happens if an offer of settlement is made to me by my employer and I choose not to accept it?
You may choose to go to an Arbitration hearing so that all of the evidence surrounding your claim may be heard by an Arbitrator. The Arbitrator's decision may be appealed by either party, and, depending on the facts regarding your injury, may go all the way to the Illinois Supreme Court.
25. Will I be entitled to receive any other benefits after I return to work at my regular job after being treated for my work-related injury?
You may be entitled to receive compensation for the partial permanent loss of use of the injured part of your body, or of yourself as a whole. Such compensation is called permanent partial disability compensation (PPD), and is received as the result of a settlement agreement between you and your employer, or as the result of the decision of the Arbitrator assigned to your claim.
26. Will I be entitled to receive any other benefits if I am unable to return to work at my regular job after being treated for my work-related injury?
If it is necessary for you to accept a lower-paying job because of your inability to perform the responsibilities of your usual and customary employment, you may be entitled to benefits equal to two-thirds (2/3) of the difference between your gross average weekly wage you were earning before you were injured on the job and the gross average weekly wage you are able to earn after your return to work.
27. Will I be entitled to any vocational rehabilitation benefits in order to retrain me for another occupation if I am unable to perform my former job duties as a result of my work-related injury?
If you are able to prove through medical evidence that you are unable to return to your usual and customary occupation as a result of your work-related injury, your employer may be responsible to pay for the vocational rehabilitation necessary to return you to a position consistent with your physical imitations. You may also be entitled to receive maintenance payments in the same amount as your TTD during your retraining period.
28. Under what conditions am I able to ensure that I will be able to receive future medical treatment for my work-related injury?
Having a hearing before an Arbitrator at the Illinois Industrial Commission is the only legal method for preserving your right to future medical treatment. When you settle your claim with your employer for a lump-sum payment of PPD, you forever close out your right to receive any future medical treatment for your work-related injury unless such a provision is specified in your settlement contract with your employer.
29. What happens if my condition worsens after the Arbitrator renders his decision regarding my claim?
If no lump-sum settlement of your claim has been made, under certain circumstances additional medical, surgical and hospital services and increased compensation may be allowed by the Illinois Industrial Commission.
30. Will I be able to receive social security benefits as a result of my work-related injury?
If you are disabled from working for a period of five (5) months, and it is anticipated by your physician that your disability will continue for a total of one year or longer, you may be eligible for social security benefits.
DISCLAIMER: All answers to the hypothetical questions contained herein are provided for informational purposes only and are not intended to be construed as legal advice. The Law Offices of Bradley S. Dworkin shall not be liable for any errors or inaccuracies contained herein, or any actions taken in reliance thereon.