Rights Under Worker's Compensation
If you are injured at work
you have the right to obtain various benefits under
the Illinois Worker's Compensation Act, which is described
Total Disability: - If you miss more than three
(3) days of work as a result of a work-related injury,
you have the right to receive a weekly payment of two-thirds
(2/3) of your average weekly wage, computed on the basis
of the last 52 weeks of work for that employer before
the accident if offered on a regular basis. Overtime
is used in calculating your temporary total disability,
but not at full values. Wages from a second job will
impair you too. This is known as "temporary total
disability" or "TTD." Most people simply
refer to this as their "worker's compensation",
but it is not the only benefit available under the law.
Services and Treatment: - Your employer, or
the worker compensation insurance carrier, must pay
all medical bills for your treatment, which are "reasonable
and necessary." You have the right to select your
own doctor, plus one other doctor. Any referrals these
two (2) doctors make do not count as additional doctors.
There is no limit to the claim of referrals for medical
treatment, as long as the treatment is reasonable and
necessary and a result of your injury at work.
What happens if my
bills are not paid?
The worker's compensation
carrier may decide not to pay for your medical treatment.
The reasons are many: a dispute that your injuries are
work-related; that the treatment you selected is not
reasonable or necessary as connected to the injuries
from the accident. If this happens, there are alternatives:
1) Pay the expenses yourself
and try to get worker's compensation to reimburse you
2) Try to get your health
insurance carrier to pay for them. They may not be willing
to do this at all or in the alternative you would sign
a statement saying that the treatment is not work-related.
This statement would be untruthful and presents problems,
and should be avoided. If neither of these alternatives
is available, then with your permission to guarantee
bills, the doctor, if he agrees, may wait for payment.
What if my temporary
benefits are cut off?
At some point during your
treatment, the worker's compensation carrier will probably
send you one of their doctors to examine you and decide
if you can return to work. This is called an Independent
Medical Examination. Since these doctors are hired by
the insurance companies, they often have a tendency
to ignore your complaints and release you for work before
your treating doctor does.
The Industrial Commission
has procedures available for situations such as these.
Unfortunately, it can take anywhere from four (4) months
to four (4) years to obtain a final decision from these
'immediate hearings," depending on how many appeals
are taken by the losing side. A petition for an immediate
hearing may be filed to enforce your rights to reasonable
and necessary medical treatment, your right to temporary
total disability payments or other rights.
Obviously, this is not
very helpful to you if you need your benefits. We will
try and convince the insurance company that
you are entitled to benefits. This is done through obtaining
medical reports and records (unfortunately the cost
of these reports and records is an expense you ultimately
must bear). If the insurance company does not respond
favorably, then we will file the petition for an immediate
Partial Disability: - If your injury is serious
enough to leave you with some type of permanent restriction
or limitation of some kind; you are entitled to receive
additional compensation. This is called "permanent
partial disability" or "PPD."
The amount of money you
receive for permanent disability depends upon many factors,
such as, wages before the accident, the part of the
body that was injured, the severity of the injury, the
ability to return to work, and the wages you made when
you return to gainful employment.
What if my injury
was caused by the fault of my employer?
The Worker's Compensation
Act is a "no-fault" law. It does not matter
whether the accident was the fault of your employer,
your fault, or no one's fault. The only thing that matters
is that your job "increased the risk of injury"
occurring. For example, if you have to do lifting at
work, the risk is increased that you will injure your
back doing so. If your job requires you to make deliveries
in a motor vehicle, you are increasing the risk of being
involved in a motor vehicle accident. It does not matter
whether or not your plant is "unsafe," or
whether or not there are a lot of accidents there. Virtually
all types of jobs increase the risk of injury
due to some degree and, therefore, most injuries, which
occur at work are compensable.
Can I sue my employer?
Even if the accident was
caused by gross negligence on the part of your employer,
you cannot sue fellow employees or employer. Under the
Worker's Compensation Act, all employers are immune
from suits by their employees for work-related injuries
or occupationally caused disease. Your only remedy is
under the Worker's Compensation Act.
If however, your injury
was caused by fault of some "third party",
other than your employer, you can sue
that "third party" for your injuries in court.
This is something to discuss thoroughly with our firm.
Can I be fired for
filing a Worker's Compensation claim?
Section 4(h) of the Worker's
Compensation ACT states:
It shall be unlawful
for any employer, insurance company or service or
adjustment company to interfere with, restrain or
coerce an employee in any manner whatsoever in the
exercise of the rights or remedies granted to him
or her by this Act or to discriminate, attempt to
discriminate, or threaten to discriminate against
an employee in any way because of his or her exercise
of the rights or remedies granted to him or her by
It shall be unlawful
for any employer, individually or through any insurance
company or service or adjustment company, to discharge
or to threaten to discharge, or to refuse to rehire
or recall to active service in a suitable capacity
an employee because of the
exercise of his or her rights or remedies granted
to him or her by this Act.
Numerous employers have
been successfully sued for violating Section 4(h) of
the Workers' Compensation Act. There have been verdicts
in the millions of dollars in civil suits against certain
employers for violating this part of the Act. This part
of the Act is one of the few times you can sue an employer
if your rights are violated under Section 4(h).
Processing a claim
The first thing our office
will do if you retain our services is to file an Application
for Adjustment of Claim with the Industrial Commission,
which starts the claim process and offers you protection
for past, present, and future rights and benefits under
the Illinois Worker's compensation Act. Your employer
will receive a notice of the claim.
After your medical treatment
is completed, you will return to work. After you have
been working at your regular job for a few months, we
will contact you and verify any bills for unpaid medical
treatment and to insure all of your temporary benefits
have been paid. Finally, we may or may not send you
to a physician for an independent medical evaluation.
We will usually advance the funds for this examination.
(The cost for this will ultimately be charged to you
at the time of the settlement for your case.)
The worker's compensation
insurance carrier will probably send you to one of their
doctors for a similar examination. (When going to the
insurance company doctor it is very important that you
be accurate in explaining the extent of your injuries.)
Once the reports from both
sets of doctors are in, the process of evaluating your
claim begins. If an agreeable settlement can not be
reached, we will take your case before an Arbitrator
at the Industrial Commission. You will be notified and
will have to come to court to testify. (Sometimes it
may be necessary for your doctor to testify.) The expense
of providing testimony of your doctor will be charged
against the proceeds of the case. After hearing all
of the testimony and presentation of evidence, the Arbitrator
will issue an opinion.
If your case goes to arbitration,
your rights to future medical care and additional benefits,
if your condition gets worse, are preserved. These rights
are usually given up in any settlement.
After arbitration both
sides have the right to appeal to the Industrial Commission.
Due to the extreme backlog, it is now taking 2-3
years for these appeals to be decided after
the arbitration decision has been entered. Your employer
does not have to pay the arbitration award while the
case is on appeal.
Under certain circumstances
the decision of the Industrial Commission may be appealed
to the Circuit Court and then to a special Industrial
Court of Appeals. It is not unusual for this process
to take one or two years.
How long will my
As you can see by the above
discussion, there are many variables to determine the
length of time your case may take. The most important
thing to remember is the legal process will not begin
until you have reached maximum medical improvement.
We cannot, however, even begin to discuss settlement
of your claim until you have returned to work and completed
all of your treatment. In addition, since any settlement
will almost always close out your rights to future medical
care and any additional compensation for any worsening
of your condition, we must be sure that your condition
has completely stabilized before commencing any settlement
discussions with the insurance carrier.
If it is appropriate, and
we have received a settlement offer that you accept,
the terms of settlement and a complete breakdown of
our fees, costs and the amount you will receive will
be sent to you in the form of a settlement contract.
Always read the term of a settlement contract carefully.
Your rights to future benefits will be given up and
as well as the the right of reimbursement for medical
bills incurred, and left unpaid or agreed upon. All
settlement proceeds are completely TAX-FREE.
The insurance company may
at anytime after you file a claim, send an investigator
to video tape your activities. This evidence can be
used at your hearing before the Arbitrator to dispute
any issues with your case.
Contact us for a free
consultation of your specific needs at (847)
244-0690 24 hours a day.
is the Workers' Compensation Act?