FAQs

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General Questions

How do I Pick Winning Lottery Tickets?
We have no idea. We just wanted to make sure you answer every question carefully. In workers compensation, you can tell the truth and do the right thing, yet still make innocent mistakes that foul up your claim. You can protect yourself and your family if you:

  • Start a diary, keep a file. Record all conversations and appointments with doctors, company representatives, witnesses, etc., and keep track of all time you lose from your job. Put all appointment cards, letters, receipts, and bills in one place. Keep them organized. Do not throw anything away!
  • Get an off work, light-duty, or return to work slip from your doctor, every time! You are entitled to temporary disability pay under the Illinois Workers Compensation Act only if your doctor certifies that your injury prevents you from working.
  • Unless you have a written doctor’s excuse for all the time you miss, the Company will not pay disability benefits. Your doctor must cover every single day you miss from work with a written excuse for as long as you are off.
  • Always make sure the Company has a current off-work slip, signed by your doctor excusing your absence. This is the only way to keep yourself paid while you are off work! We recommend that you get a fresh off-work slip from your doctor at least every four weeks.
  • File your claim with the Workers’ Compensation Commission within three years of your injury date, or you may lose your rights forever! Three years + one day = you lose!
  • Keep careful track of all of your medical bills, charges and payments from the first day of your case to the last.
Who pays for my medical treatment if I am injured on the job?
The Workers Compensation Act requires your employer must pay for all the first aid, medical, surgical and hospital services necessary to cure or relieve the effects of an accidental injury.You must prove your medical expenses relate to you injury before your employer is obligated to pay for it. There are no deductibles or co-pays in Workers’ Compensation. Even if your employer has paid a medical bill related to your injury, your employer is not necessarily obligated to pay any other bills in the future.Take all your work-related medical bills straight to your employer.If your claim is disputed, denied, or contested, turn all the medical bills in to your regular insurance. Be sure to tell your regular insurance the bills are for work-related medical care, but that workers compensation claim refuses to pay them.
What should I do if I get hurt at work?
Always report any injury immediately (same day) to your supervisor or other person in charge. Report your injury even if the injury does not appear serious at first. Fill out a written accident report immediately. Give the accident report to a manager or supervisor the same day. Try to keep a copy.For repetitive trauma injuries [tennis elbow, carpal tunnel, etc.], say overuse at my regular job caused pain. If you do not report your accident to the Company right away, you can lose all your rights.Insurance companies love it when injured workers do not report their accidents promptly. This innocent mistake (I’ll just wait and see how I feel tomorrow . . .) saves insurance companies millions of dollars every year.Even if you do not consider yourself seriously hurt, play it safe. Report every injury immediately. Literally, every hour counts. Delayed reporting seriously endangers your wage protection and medical care benefits.You cannot go wrong if you report all injuries and accidents immediately!
Can I be fired because I reported an accident?
It is strictly against the law for your employer to harass, discharge, and refuse to rehire or in any way discriminate against you for exercising your rights under the Workers Compensation or Occupational Diseases Acts.Such employer misconduct may give rise to separate lawsuit for damages in the Circuit Court. Though, an employer’s workers’ compensation insurance may not cover costs and damages arising from retaliation lawsuits.On the other hand, having a workers compensation claim pending does not automatically protect you from discipline or discharge because of misconduct.If you have questions or concerns about discipline and retaliation, you ought to consult with a legal representative.
What does my employer have to prove?
Your employer does not have to prove anything, but can deny or contest any one or all of the elements of your claim [employment, accident, causal connection, earnings, lost time, medical care, permanent effects, etc].If you have questions or concerns about qualifying for benefits, you ought to consult with a legal representative.
What injuries or diseases are covered?
The Illinois Workers Compensation Act covers most job-related injuries or diseases. You are generally entitled to benefits even if the accident was your own fault. In any dispute, however, workers must prove their entitlement to benefits. This is called the workers burden of proof. If you get injured during employer-sponsored athletic events, parties, picnics, etc. you will not be covered unless your employer ordered you to participate. In addition, if you sustain accidental injuries while participating in a drug or alcohol rehabilitation program you will not be covered.
What are workers’ compensation benefits?
Unless your employer disputes, denies or contests your claim, when you get injured at work you are entitled to receive:

  • All necessary medical, first aid and hospital care for the injury at no cost;
  • If excused from all work by a doctor, disability pay equal to two-thirds of your average weeks wage during the 52 weeks preceding your accident, tax free (TTD); and
  • If approved for “light duty” by a doctor, disability pay equal to two-thirds of the difference between your regular full pay and your after-tax light duty pay, tax free (TPD); and
  • If entitled to vocational rehabilitation, pay equal to two-thirds of your average weeks wage during the 52 weeks preceding your accident, tax free (Maintenance);
  • An arbitration award or settlement to compensate you for the permanent physical impairment or permanent lost earning capacity resulting from your injury (PPD, Wage Loss, or PTD).
What is workers’ compensation?
Workers’ compensation is a generic term. It refers to a privately funded system of wage loss and medical care benefits provided, under certain circumstances, to workers injured or poisoned at work. The term also refers, however, to a state-run legal arbitration agency that resolves factual, medical, and legal disputes between workers and their employers over such benefits.

Legal Questions

What if my employer refuses to pay the medical bills for my injury or disease?
Any medical debts incurred after February 01, 2006 are subject to special laws designed to protect injured workers with medical bill problems. How much protection you get under the law depends on whether your employer accepts or disputes your claim.If your employer accepts your claim, your employer must pay your doctor within 60 days. You must provide your employer with all information required before they are obligated to pay. Your doctor must accept the payment your employer makes under the Workers Compensation Medical Fee Schedule as full payment. Doctors and hospitals cannot make you pay the difference between their charges and what your employer paid.If your employer disputes your claim, however, unless you have filed your legal claim at the Workers Compensation Commission your doctor or hospital may seek payment of the actual charges from you directly. On the other hand, once you tell a doctor or hospital you filed a claim at the Workers Compensation Commission, the law bars them from seeking payment from you until your case is over. If you are having problems with medical bills or collections, this is another very good reason to file your claim.After you file your claim and all collection efforts stop, should you resolve by settlement or by arbitration then doctors and hospitals may resume ordinary collection efforts. Any medical expenses left unpaid at the end of your case are your legal responsibility.It is, therefore, critically important to keep careful track of all of your medical bills, charges and payments from the first day of your case to the last.
What information must I give to my employer?
You employer must be given sufficient medical information to determine whether benefits are due.
Do I need a lawyer?
In Illinois, both the employer and the worker can retain legal counsel, and frequently do. Law fixes the amount lawyers charge for legal services related to a workers compensation claim. You pay nothing for legal services until the end of your case. The amount that your lawyer is paid depends on how much money your lawyer gets for you.In general, if you wonder whether you need a lawyer you probably do.
What if my employer lies about my injury, or destroys evidence?
Anyone (employer, employee, company, corporation, insurance carrier, doctor, etc) who makes false or intentionally misleading statements in order to obtain or withhold benefits has committed a serious crime.If you suspect this has happened, you should contact your legal representative immediately.
How are disputes resolved?
We encourage you to try to resolve your differences with your employer informally, in the spirit of fairness and compromise. If that fails, you should know that the vast majority of disputes in Illinois workers compensation are resolved on a compromise basis between lawyers and insurance adjusters.However, if all the parties cannot resolve disputes between themselves then they must submit the questions and problems to the Workers Compensation Commission for arbitration, a legal hearing.The Workers Compensation Commission is responsible for:

  • Administering applicable Illinois laws,
  • Providing information and assistance to workers and employers, and
  • Resolving disputes regarding the workers’ compensation benefits.

Medical Questions

What if I am Released by My Doctor to go Back to Work?
If your doctor releases you back to work, be sure to get a “trial” full-duty release so you can come right back to them if you start having problems again.Never completely stop seeing your doctor until you are 200% sure you are healed or as good as you are going to get. If you stop treatment to see how you feel, the law presumes you have recovered fully. Once you stop treating, it is very difficult to re-start. Make monthly or weekly follow-up appointments with your doctor until you are 100% certain you are going to be okay. Cancel the appointment if you are doing well.
What if My Doctor Says I Need Surgery but the Company’s Doctor says I do not?
This is very common. If your doctor thinks you need a medical procedure, get your doctor to put their reasons in writing. Take your doctor’s reasons to the company doctor and your employer. If this dispute between your doctor and the company’s doctor cannot be resolved, you can use your regular employee insurance to get the medical care you need. Just be very careful and make sure you tell your regular insurance that you need care for a disputed work injury.During this dispute, your employer can refuse to pay for your medical procedure until ordered to do so by the Workers Compensation Commission.You cannot go to arbitration and get an order requiring your employer to pay medical benefits unless you file your claim. Once you sense that a dispute like this might be brewing, you should probably see your legal representative right away.
What if My Doctor Says I Cannot Work, but the Company Doctor Says I Can?
This is very common. If your doctor thinks you need a medical procedure, get your doctor to put their reasons in writing. Take your doctor’s reasons to the company doctor and your employer. If this dispute between your doctor and the company’s doctor cannot be resolved, you can use your regular employee insurance to get the medical care you need. Just be very careful and make sure you tell your regular insurance that you need care for a disputed work injury.During this dispute, your employer can refuse to pay for your medical procedure until ordered to do so by the Workers Compensation Commission.You cannot go to arbitration and get an order requiring your employer to pay medical benefits unless you file your claim. Once you sense that a dispute like this might be brewing, you should probably see your legal representative right away.
What if I Have a Heart Attack at Work, can I Recover Compensation?
Maybe. Under the Act, if you prove that a specific work activity or condition probably contributed to your heart attack, or that your heart condition was probably aggravated, or accelerated, by your job, you can recover benefits.Even if you have pre-existing heart disease, you may still be eligible for workers’ compensation benefits if the medical evidence shows that your work was probably a factor in your heart attack. Important: there is an important difference in the law between “what is possible” and “what is probable”. This often requires the assistance of medical experts. “Job stress” heart attacks claims are rarely successful under current law.
What if My Injury Causes Permanent Damage to a Part of My Body?
The law entitles you to compensation for permanent partial loss of use, or permanent partial impairment, of all your body parts. This benefit is called Permanent Partial Disability (PPD).Not all injuries and diseases result in permanent partial disability. In general, you are only eligible for PPD benefits after your condition will not improve any more.The amount of PPD compensation you might get depends on three things:

  • Your average weekly wage (How much you were earning before the injury?)
  • The degree of permanent impairment or disability (How bad is the damage?)
  • The part of your body affected (What is damaged?)

If your employer disputes the extent of your injuries, the Workers Compensation Commission evaluates the degree of physical impairment and the effect of the disability on your life at arbitration. Factors that may be considered include your age, skill, occupation, training, inability to engage in certain kinds of work or activities, pain, stiffness or limitation of motion.

Can my employer make me see their doctor?
Yes. If you claim you are entitled to Workers’ Compensation, your employer can force you to attend an examination by a doctor of its choice. Do not let company doctors treat your injury. Remember: whoever pays the piper calls the tune. Never forget who signs the company doctor’s paycheck.Obviously, if you are bleeding to death, break a bone, etc. and need emergency medical attention, accept it from the first doctor you see no matter what.Think of any visit to a company doctor as a “touch and go landing” on your way to your own doctor. Let the company doctor examine you. Tell them exactly how you got hurt at work.Avoid letting any company doctor give you a prescription, order physical therapy, refer you to a “specialist”, etc. Once you accept treatment from a company doctor, you must use your precious “second opinion” to see your own “first” doctor!To keep your claim valid, however, you must cooperate with your employer’s medical examination, provided your employer picks a reasonable time and place. If you refuse to let your employer’s doctor examine you, you can lose your benefits.The employer pays for this exam, and must pay you mileage to and from, plus meals and lost wages. Remember: the law only lets the company doctor examine you. You have an absolute right to refuse treatment from their doctor.

How much can my doctor charge me?
Effective February 1, 2006, Illinois law established a medical fee schedule that controls the charges for all medical treatment and procedures covered under the Workers Compensation Act. These charges are the maximums allowed by law. The Workers Compensation Commission adjusts the medical fees schedule annually for the rate of inflation.
Should my doctor send medical reports to my employer?
Yes. If your doctor does not send medical reports to your employer or its insurance company, benefits may be delayed. Make sure you tell your doctor not to speak directly to your employer or its insurance representatives, however.Your doctor’s report should include enough information to allow your employer to determine:

  • Whether weekly benefit payments should be started, continued or stopped; and
  • Whether treatment is necessary to cure or relieve the effects of your injury or disease.
Can I select my own doctor or hospital?
Yes. If your injury or condition is work-related, you may select any doctor, surgeon, or hospital service you choose, at your employer’s expense, even if the doctor is outside your regular insurance plan or network.Your employer cannot refuse to pay for medical treatment simply because they did not select or approve it in advance. Go to a hospital emergency room, or see your own family doctor, immediately. Make sure the first thing you tell every doctor you see, every time, is that your injuries arose out of an accident on the job. Whenever you explain to anyone how you got hurt at work, make sure you say exactly what you told the Company when you first reported the accident. Be consistent. Be specific.Make sure your doctors write down what you say in your medical records.The Worker’s Compensation Act allows injured workers to obtain a second medical opinion at their employer’s expense. This second opinion does not include any doctors or specialists your treating doctor refers you to: those providers are part of your “first opinion.

Workers Compensation Benefits

Are any Workers’ Compensation Benefits Subject to Income Tax?
No. Workers’ Compensation payments are not subject to state and federal income tax. Do not report it on your tax returns as income.
What benefits Are My Family Entitled To if I Die Because of a Job-Related Accident?
Under the Act, your spouse and minor children would be entitled to a death benefit equal to two-thirds (2/3) of your average weekly wage up to a maximum which changes annually. These payments continue for a maximum of 25 years or $500,000.00, whichever is greater. Benefits will be paid to your children until age 18 or to 25 if a full-time student. If your child is physically or mentally incapacitated, than they receive benefits for the duration of the incapacity. If you leave no eligible spouse or child, the benefits can be paid to totally dependent parents, or perhaps to other survivors.There is also a burial expense benefit equal to $8,000.00.
What happens if I have a career-ending injury?
If your injury ends your career but you can still work in another job, permanently reducing your earning capacity, you are entitled what is known as “Wage Loss” or “Loss of Trade” compensation.The amount of compensation you receive for permanent Wage Loss is equal to two-thirds of the difference between the average weekly wage you would be earning in your regular job and the amount you are actually able to earn after the accident, for life.
What if I can never return to any kind of work because of my injury?
You may be eligible for Permanent Total Disability (PTD) if you can pass a three-part test:

  • A permanent medical condition which causes you to be
  • Medically incapable of returning to any type of work, which
  • Resulted from a job-related disease or injury.

The amount of PTD compensation you get depends on your average weekly wage [AWW] at the time of your injury.

If the Workers Compensation Commission judges you to be permanently and totally disabled, then for the rest of your life you will receive two-thirds of your AWW, tax-free, subject to a maximum cap fixed by state law. The maximum weekly total permanent disability benefit changes annually, so contact us for current maximum rate information.

In addition, if you are eligible for PTD you have the right to free medical care for the specific injury or condition for life.

What Benefits Am I entitled to if my Injury Causes Permanent Damage to a Part of My Body?
The law entitles you to compensation for permanent partial loss of use, or permanent partial impairment, of all your body parts. This benefit is called Permanent Partial Disability (PPD).Not all injuries and diseases result in permanent partial disability. In general, you are only eligible for PPD benefits after your condition will not improve any more.The amount of PPD compensation you might get depends on three things:

  • Your average weekly wage (How much you were earning before the injury?)
  • The degree of permanent impairment or disability (How bad is the damage?)
  • The part of your body affected (What is damaged?)

If your employer disputes the extent of your injuries, the Workers Compensation Commission evaluates the degree of physical impairment and the effect of the disability on your life at arbitration. Factors that may be considered include your age, skill, occupation, training, inability to engage in certain kinds of work or activities, pain, stiffness or limitation of motion.

What income benefits should I receive while I am unable to work?
In Illinois, there are three basic kinds of temporary disability benefits

What is Maintenance Compensation (maintenance)?
You are entitled to Maintenance when you require no more medical treatment but can never return to your usual and customary occupation because of the injury.You are entitled to the Maintenance benefit while you search for a new job or participate in a vocational rehabilitation program.Weekly Maintenance rates are equal to your TTD rate, tax-free.
What is Temporary Partial Disability Compensation (TPD)?
You are entitled to TPD compensation when you are temporarily unable to perform full duty because of an injury sustained on the job, but still to work light- or modified-duty.Weekly TPD benefits EQUAL two-thirds of the difference between your regular full duty pay and your after-tax light duty pay, tax-free.There is no time limit on the amount of time that you can collect TPD payments, provided a doctor excuses all your light duty.
What is temporary total disability compensation (TTD)?
You are entitled by law to TTD compensation while temporarily unable to perform any work because of an injury sustained on the job. Typically, a doctor must excuse you in writing for every day of work lost because of the work-related injury or disease.Weekly TTD rates are equal to two-thirds of your average weekly wage during the 52 weeks preceding your accident, tax-free. The maximum amount of weekly TTD benefits changes annually. Contact your legal representative for current maximum rate information.No TTD compensation is due for the first three working days lost, unless the lost time continues for 14 or more calendar days from the date of injury.If your employer does not pay temporary total disability benefits within 14 days, and cannot justify the delay in payment, your employer may be required to pay a penalty.If you are able to work light- or modified-duty, the law requires you to do so.
What if my employer pays me workers compensation benefits voluntarily?
Just because you accept payment of workers’ compensation benefits and medical benefits, you have not waived or given up any rights under the Workers’ Compensation Act. Merely signing receipts or other reports requested by your employer does not waive your rights either.The fact that your employer voluntarily pays you compensation benefits does not represent an admission of liability. Even if you file your claim with the Workers Compensation Commission after a voluntary payment, your employer can still deny its obligation to pay you any compensation at all.After an injury, in order to fully and finally close out your rights, a legal settlement must be written on a form provided by the Workers Compensation Commission. The Workers Compensation Commission must formally approve all settlements.If there is a dispute regarding the amount of compensation you are owed, you should immediately file a claim with the Workers Compensation Commission and contact your legal representative.
How Do I File A Workers Compensation Claim?
Completing an accident report or signing your employer’s injury forms is not the same as filing an enforceable legal claim that protects your rights. Do not delay and do not be fooled. You can file a claim yourself but remember: your employer will no doubt get legal representation.Unless you file your claim with the Workers’ Compensation Commission on time, you lose your rights forever! You must file all the proper claim forms with the Illinois Workers Compensation Commission. Call 312-814-6500 to locate the office nearest you.
Who must actually pay for workers’ compensation insurance and benefits?
The Workers Compensation Commission does not pay benefits. All benefits due to qualified injured workers are the sole responsibility of the employer or their insurance carrier.It is illegal for employers to charge workers for any part of a workers’ compensation insurance premium or for any workers compensation benefits, even by passing it through on a payroll check.
Who provides workers compensation benefits?
If the worker can prove that they were injured or poisoned at work, the employer is responsible for providing specific wage loss and medical care benefits.Many employers buy workers compensation insurance. Others insure themselves under the supervision of the State of Illinois. In either case, all Illinois employers must post a notice in the work place explaining to its workers who to contact concerning work-related injuries, diseases and conditions.

Workers Compensation Eligibility

Is hearing loss due to noise at work compensable?
Your hearing loss claim may be compensable, but it may be difficult to prove the required details. To make a successful hearing loss claim, you must prove a specified degree of exposure (loudness) for a specified period of time (duration).
What if I contract an illness or disease because of my employment – can I receive compensation?
Any illness or disease scientifically proved to be caused, aggravated, or accelerated by your employment is compensable under the Occupational Disease Act. The benefits provided by the Occupational Disease Act are nearly identical with those provided by the Workers’ Compensation Act.Among those illnesses found to be compensable include illnesses involving dust inhalation, silicosis, asbestosis, diseases associated with the inhalation of toxic gases, vapors or fumes, dermatitis, radiation poisoning, occupational deafness, bronchitis, asthma, and many other diseases not specifically listed.If you fail to file and occupational disease claim within the time limits provided by law you may lose all benefits forever. Unless an occupational disease disables you within two years of the date of last exposure to the hazards of the disease, in most cases, no compensation is payable.Under the Occupational Disease Act, you may be entitled to compensation if your pre-existing illness or disease was aggravated or disabling because of the exposure of the employment.
What if an injury leaves me a disfigured?
If you suffer a serious and permanent disfigurement to your hand, head, face, neck, arms, legs below the knee, or chest above the armpits because of a job-related injury you may be entitled to PPD benefits.The law requires you to wait at least six months from the day of injury to determine if a disfigurement resulting from the accident is legally serious and permanent.
How do I know if I am qualified for benefits?
In order to qualify for benefits under the Illinois Workers Compensation Act, you must be able to prove each of the following elements:

  • That on the date of accident your employer was subject to the Illinois Workers’ Compensation or Occupational Diseases Act.
  • That you employed by the company on the date of the accident
  • That on the date of accident, you sustained injuries [or acquired a disease] from usual and customary work activity
  • That your medical condition was either caused, aggravated or accelerated by the injury or exposure alleged on the date of accident.
  • That you gave the employer notice of the accident or exposure within 45 days of the date of accident
  • Your earnings during the fifty-two weeks before the accident.

After you have established your eligibility, and all of your medical care is complete, you may still have to prove:

  • That the medical care received was necessary to cure or relieve the effects of your injury or illness.
  • The total amount spent on your related medical care
  • The dates of all lost time caused by your illness or injury.
  • You were inability to perform light duty, or its unavailability.
  • The nature and extent of your injury [permanent, disfigurement, career ending wage loss, total disability, death, etc.]
  • The merits of rehabilitation and retraining.
Who can apply for worker compensation?
Under the provisions of the Illinois Act, almost all workers are entitled to receive compensation for an injury received on the job. You may file a claim for Workers’ Compensation Benefits in Illinois if:

  • You are injured in Illinois, or
  • Were hired in Illinois, even though the accident occurred in another state, or
  • Most of your work is in Illinois, even though you may have been hired or injured out of state [for example, Indiana or Wisconsin] or,
  • You were hired in Illinois and were sent to work in another state.
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