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I am always looking to write about topics that I think injured workers would benefit from knowing. I also try to determine what injured workers want to know, especially if they are new to the process. So I thought it would be beneficial to write a post on how Illinois workers compensation works. This isn’t everything, but a nice overview.
First thing to know applies to even before an accident. All employees are covered from the moment they are hired. It doesn’t matter if you are part time or on probation or at a small company. You are eligible for Illinois work comp benefits. And it’s a felony for your employer to not have work comp insurance.
So if you are hurt on the job, what happens next? There’s no particular order, but here are things you should know:
- You have to notify your employer of a work accident within 45 days of it happening. If your boss witnesses a forklift run over your foot, they are on notice. If you have carpal tunnel from repetitive activity, you should let them know as soon as you have reason to believe it’s work related. The best way to give notice is in writing. An email can prove when you sent it.
- If it’s more than superficial pain, you should get to a doctor ASAP. When you see them, let them know how you hurt yourself. For example: I was at work, I lifted a box that weighed around 50 pounds and I felt a pop in my back. One of the biggest mistakes workers make is waiting too long to get medical care. If you are hurt in March, but don’t see a doctor until June, it will be hard to prove your need for medical care is related to a work injury.
- Do not worry about not having health insurance. If your medical treatment is for a work related injury, 100% of your medical care is covered. No co pays. Nothing out of pocket.
- If your doctor says you can’t work due to your injury, you are entitled to 2/3 of your average weekly wages, tax free, until you are able to work again. This is called temporary total disability or TTD. So if you make $1500 a week before tax, you’d get $1,000, tax free, from work comp. This happens also if you have restrictions that your employer can’t accommodate. So if you are a nurse with a 20 pound lifting restriction and can’t do your job, you will get TTD until your restrictions go away or they have a job for you within your limits.
After that, what happens next depends on the facts of your case.
You will likely get a call from an insurance adjuster. We highly recommend that you don’t speak with them. They often will try to have you give a recorded statement. That is an insurance company tactic where they may try to twist your words and deny your case.
The insurance company has a right to your medical records as relates to this injury, but they don’t have a right to all of your medical records. Don’t sign a general medical release form. You can sign a limited one. So if you have a work related back injury, they have a right to your medical records related to your back. They don’t have a right to information about mental health care, or problems with your shoulder, or cancer treatment or anything else.
The insurance company might deny your case for invalid reasons. It happens all the time. If they don’t, they are looking for a reason to do that and limit what they pay. This includes assigning a nurse case manager to your case. You don’t have to talk to that person. They might try to talk to your doctor to influence your care. That’s illegal. All they can legally do is ask for copies of medical records and bills.
Another insurance company tactic is to send you to a doctor of their choosing. This is called an independent medical exam or IME. It’s often a hired gun doctor who will state that your injuries aren’t work related or that you don’t need to be off work or have surgery. These “exams” usually last less than five minutes and they try to substitute their opinion for that of your treating doctor who knows you well.
If it sounds like the insurance company isn’t on your side, it’s because they aren’t.
The good news is that an experienced Illinois workers’ compensation lawyer can protect you and push back. It costs nothing to hire a lawyer or file a case. If your benefits are delayed or denied, we can file a trial motion to get you in front of an Arbitrator and get an order for them to pay your benefits.
When you are all better and back to work or as good as you can get medically, we will be able to get you a settlement. How much your case is worth depends on how bad the injury was, what treatment you had and might need in the future, how much you earned, your age and your ultimate recovery. Almost every case has value. It can be as little as a couple thousand dollars to many hundreds of thousands of dollars.
Attorneys get paid 20% of whatever settlement you get. Aside from a lawyer protecting you as the case goes on, you will almost always get more in a settlement because you have a lawyer. If the case is lost you owe nothing.
And those are the basics. There are more things that can happen based on the case. If you have any questions about Illinois workers comp law, please get in touch with us any time.