Do You Need Help Obtaining Workers' Compensation Benefits?
Let an experienced injury attorney navigate the minefield of the Illinois Workers Compensation System for you
In principle, workers' compensation should be simple. If you get hurt on the job, your employer pays for your medical bills, lost wages, an award based on the level of your permanent disability, and other benefits. In practice, it can be much more complicated and dealing with insurance companies can be difficult. An experienced workers' compensation lawyer can help you cut through the confusion.
- What counts as an "on-the-job" injury?
- If I'm hurt at work in Illinois, what are my legal rights?
- What do I need to do after an accident at work?
- I have a repetitive use injury (like carpal tunnel). Do I need a workers' compensation lawyer?
- Do I really need to go through workers' compensation? Why can't I just use my health insurance?
- My employer is denying or cut off my benefits. What can I do?
- Can I file a lawsuit against my employer in civil court after a work injury?
- My boss says I can't get workers' compensation because the injury was my fault. Is that true?
These questions and answers should give you an idea of what you need to do after an on-the-job injury. However, every case is unique. If you need help with your individual claim, reach out to Schweickert & Ganassin, LLP today. Call (866) 604-9075 .
Broadly speaking, any injury you sustain while working is considered an on-the-job injury. For instance, if you slip and fall at work or cut yourself on broken glass in your workplace, you have sustained an occupational injury. The accident need not happen on your employer's premises; if you are hurt at a client's office or while driving to an appointment, that is also considered an on-the-job injury.
Usually, your commute to and from work is not covered by workers' compensation. However, there are exceptions. If your employer gave you specific instructions regarding your commute and you are injured while following those instructions, your injury should be covered. For instance, if your employer instructs you to park in a particular off-site parking lot and then walk to the office, and you are injured while walking from your car to the office, that is an on-the-job injury.
Workplace injuries in Illinois are covered by the Illinois Workers' Compensation Act (IWCA). The IWCA requires your employer to provide you with all of the following benefits after your on-the-job injury:
- Medical expenses: Your employer is responsible for all reasonable and necessary medical expenses related to the injury. There is no deductible or co-payment.
- Choice of doctors: The IWCA gives you the right to choose two doctors to treat your work injury. Workers' compensation will also pay for your treatment with any doctors to whom you are referred by your original two.
- Lost wages/Temporary Total Disability (TTD): If you are unable to work temporarily while recovering from your injuries, workers' compensation will pay weekly benefits equal to two thirds of your average gross weekly wage.
- Temporary Partial Disability (TPD): If you are earning less than you normally would be because you are working in a light-duty position while recovering from a work-related injury, you may be entitled to TPD benefits until you reach maximum medical improvement (MMI).
- Permanent Total Disability (PTD): After a work injury that leaves you permanently unable to work, or after loss of two of the same body parts (e.g. both hands, both feet), you are entitled to lifetime benefits, again equal to two-thirds of your average gross weekly wage.
- Permanent Partial Disability (PPD): If your injury leaves you with permanent partial loss of use of a body part, you are entitled to a lump sum benefit. The value of the lump sum depends on the injured part and the degree to which your impairment will affect your life.
- Loss of Trade/Wage Loss Differential: After a work injury, you may be unable to do your original job and need to take a lower-paying position that accommodates your injury. This benefit pays two-thirds of the difference between your former average gross weekly wage and your new average gross weekly wage.
- Vocational Rehabilitation/Maintenance: If your injury prevents you from returning to your original job, this benefit may pay for retraining so that you can obtain a different job within your medical restrictions.
- Survivor Benefits: When workers are killed on the job, their dependent heirs can collect workers' compensation benefits.
Your employer is required by law to carry insurance that provides all of these benefits. Moreover, your employer must pay the entire premium to carry workers' compensation insurance - it is illegal for an employer to pass any of that cost along to the employees. It is also illegal for an employer to retaliate against you in any way for exercising your rights under the IWCA.
Many injured workers end up leaving money on the table because they aren't aware of all the benefits they can receive - and the insurance company has little incentive to tell them. That's why it's in your interest to meet with us for a free consultation. We can often help obtain thousands of dollars in additional benefits that you would not have otherwise received.
As with any injury, you need to seek medical help right away. Depending on the extent of your injuries, you may need to go to the emergency room, or you may be able to visit a local clinic that specializes in occupational health. Be sure to document every medical appointment - including mileage to and from the appointment - so that you have a clear and detailed record of all of your medical expenses.
You need to report the accident to your employer in a timely manner. Illinois law gives you up to 45 days, but we don't recommend waiting that long - the sooner the better. Remember, you need to notify a manager or supervisor, not a co-worker. It's best to make your notification in writing and get a copy of the accident report so that your employer can't later argue that they were not aware of the injury.
In the parlance of workers' compensation, injuries due to repetitive use such as carpal tunnel, tendinosis, thoracic outlet syndrome, edema and many others are considered repetitive trauma injuries. Unlike industrial accidents, such as falls, that happen at a specific time and place, these injuries happen over time due to performing the same motion for months or years.
Obtaining workers' compensation benefits for an repetitive trauma injury can be very difficult because there is no specific, documented incident that you can use to prove that the injury was sustained on the job. The Illinois Workers' Compensation Commission routinely denies these claims, so it is crucial you are represented by a lawyer that knows the ins and out of the IWCA and appeals process. In order to get through that process and get the benefits you deserve, you need an experienced injury lawyer on your side.
There are a few reasons why going through your health insurance after an on-the-job injury is less than ideal:
- Your health insurance likely has co-payments and deductibles that you are responsible for. With workers' compensation, all of your medical bills related to the work injury are 100 percent covered with no out-of-pocket expense for you.
- Health insurance only pays for medical treatment, not lost wages or disability benefits. Even within the medical realm, there may be procedures that your health insurance will not cover.
- If your health insurance carrier finds out that your injury was work-related, they may deny your claim because the injury should have been covered by workers' compensation.
In short, while your health insurance is a good backup plan in the event that your workers' compensation claim is denied, you are much better off going through workers' compensation if you are able to do so. Getting a workers' compensation attorney on your side can protect your right to compensation and make sure you don't leave money on the table.
Don't panic! It is very common that an employer is not accommodating, or entirely truthful, about your workman's compensation benefits. They may refuse to pay your medical treatment or time off work, or even fail to mention significant compensation is available to you in the form of other benefits. Understandably, this can be a confusing process during a difficult time for the injured employee that just wants to get better and return to work. However, to protect your legal rights and get the compensation you deserve, we recommend that you contact the experienced workers' compensation lawyers at Schweickert & Ganassin, LLP right away.
The tradeoff involved with the no-fault workers' compensation system is that you cannot sue your employer for damages in civil court after a workplace injury. Even if your employer's negligence was the cause of your injury, you must first pursue your claim through the Illinois Workers' Compensation system.
However, if your accident involved a negligent third party, you have the right to file a personal injury lawsuit against that third party. For example, if you were hurt in a car accident caused by another motorist while driving for work, you can file a workers' compensation claim with your employer and a personal injury claim against the at-fault driver in the civil circuit court system. Or, if your injury involved an outside contractor or defective product, you could also pursue those claims simultaneously in circuit court. It is essential you obtain an attorney who understands the complex interplay of these third-party claims, as it could mean the difference between thousands and millions in available compensation.
Your boss either doesn't understand how workers' compensation works or is deliberately misleading you. Workers' compensation is a no-fault system, which means that even if your own carelessness caused the accident, you are still entitled to benefits. There are only a few situations in which your on-the-job injury may not be covered, such as:
- You inflicted your own injuries deliberately. (This includes injuries sustained after you started a fight.)
- You were committing a serious crime when you sustained the injury.
- Your conduct that led to the injury violated company policy.
In most instances, fault is irrelevant when it comes to workers' compensation. You only need to prove that you sustained the injury while on the job. However, if your boss is trying to tell you that you can't get benefits, you're facing an uphill battle to get the compensation you need. That's why it's so important to contact us and get an experienced injury lawyer on your side.