In Illinois, when a person is injured while performing his or her job, he or she is entitled to receive certain benefits provided by the employer, typically through its workers’ compensation insurance carrier. There are many provisions of the Illinois Workers’ Compensation Act, and this page is not intended to provide a comprehensive discussion of the entire Act, but simply to provide a brief overview of some of the basic benefits provided under the Act.
If the employer either accepts that the employee was injured while performing his or her job, or if it is established through litigation that the employee was injured while performing his or her job, the employer is required to provide the injured employee with the following:
- The employer must pay all medical expenses for treatment associated with the injury. The employer cannot make the employee use his or her health insurance and the employee shall pay no deductibles or co-pays. Furthermore, with certain limitations, the employee is entitled to be treated by a physician, which he or she chooses and cannot be required to treat with a doctor chosen by the employer or the insurance company.
- If the employee is off work due to his or her injury for more than 72 hours, then the employer shall pay the employee for his or her time off work beginning on the 73rd hour, but if the employee is off for more than 14 days, then the employer must compensate the employee for lost income going all the way back to the last day worked. This compensation for lost time is called Temporary Total Disability Benefits (TTD) and is paid at the rate of 2/3 of the employee’s Average Weekly Wage (AWW). Fringe benefits, unfortunately, are not included and are not provided for under the Workers’ Compensation Act. Therefore, the employer is not required to make the employee’s contributions for group health insurance, pension contributions, 401(k) contributions, accrued vacation time, etc.
- When an injured worker has reached what is called Maximum Medical Improvement (MMI) as determined by his or her treating physician (typically), the worker is entitled to be compensated for the fact that her or his body is not the same as it was before the work injury. This element of benefits under the Illinois Workers’ Compensation Act is called Permanent Partial Disability (PPD). In most cases, where the worker is able to return to her or his regular job after recovering from the injury, PPD is determined based on a percentage loss of use of the injured body part. Major body parts are assigned a value based on a number of weeks of compensation. For instance, a leg is assigned 215 weeks of compensation. So if the Commission were to award the injured worker compensation for 40% loss of use of a leg, that would equate to payment of 86 weeks (40% of 215) at the worker’s PPD rate, which is 60% of the worker’s Average Weekly Wage (up to a maximum weekly rate, which tends to increase every year or so).
- If the worker is unable to return to his or her regular job after reaching Maximum Medical Improvement, then the Act provides for other types of compensation such as Wage Differential Benefits, which are intended to compensate the injured worker for the difference between what she or he could earn in the pre-injury job and what she or he can earn in a job that is within his or her post-injury physical restrictions. These restrictions are typically established by the treating physician after the worker undergoes a lengthy physical test called a Functional Capacity Evaluation (FCE). If the worker cannot return to any type of gainful employment due to the severity of the injuries (or based on a combination of factors including the severity of the injuries), the Act provides for Permanent Total Disability Benefits (PTD).
- The Workers’ Compensation Act also provides Death Benefits to the dependents of workers who die as a result of injuries suffered on the job.
- In certain circumstances an injured worker can recover for disfigurement caused by a work related injury, but there is no recovery under the Workers’ Compensation Act for things like pain and suffering or lost enjoyment of a normal life. This is the trade off with workers’ compensation, you don’t have to prove that your employer was at fault for causing your injury, but the benefits that you can recover under the Act are limited, and not the same as if you were able to sue your employer for negligence in the judicial court system.
Although workers’ compensation is an administrative law proceeding, there are a great many issues that can arise while the worker is recovering from his or her injuries. Workers who suffer any type of injury at work (except very minor injuries for which there is no time lost from work and no ongoing medical treatment) would benefit from hiring an experienced workers’ compensation attorney to represent him or her in pursuing the full measure of workers’ compensation benefits.
The reason for this is simple. If the employer’s insurance company knows that you are unrepresented in the proceeding, it knows that there is very little, if anything, you can do to enforce your rights under the Act. Very few non-attorneys would be capable of successfully litigating a contested issue before the Workers’ Compensation Commission. (For that matter, most attorneys who are not experienced in practicing before the Workers’ Compensation Commission, would be equally unable to do so). Therefore, what is the injured employee to do if the insurance adjuster decides to cut-off his or her benefits without justification for doing so? Certainly you can hire attorney at that point, but you would have been much better off to have the attorney involved from the outset.
There is no additional cost involved in hiring an attorney earlier in the proceeding. Workers’ Compensation attorneys are paid a contingent fee, which means that the attorney does not earn a fee unless he recovers for the client. The fee is capped by the Workers’ Compensation Act at 20% of any amount that is contested, meaning that the attorney takes no fee on any benefit that the employer/insurer voluntarily provides. Typically, the attorney earns his or her fee as a percentage of the recovery for Permanent Partial Disability and as a percentage of the recovery for Temporary Total Disability benefits that should have been paid but were not. On occasion, the attorney fee will also be based on his or her recovery of unpaid medical expenses.
Evan Hughes has practiced before the Illinois Workers’ Compensation Commission for almost his entire 20-year career. He has tried many workers’ compensation cases of all types and has handled all levels of workers’ compensation appeals. Mr. Hughes has recovered millions of dollars in workers’ compensation benefits for his clients through trial and settlement.
If you were injured at work, call me today for a free, no-obligation initial consultation: (312) 236-7650. I will fully explain your rights under the Act and determine if you would be best served by hiring an attorney to represent you.