If You Were Injured At Work, What Benefits Can You Claim?

Thursday, August 2, 2012

If You Were Injured At Work, What Benefits Can You Claim?

Written by Malman Law, reviewed by Steve J. Malman.

If you have been injured at work you may be searching for answers and wondering “what benefits can you claim to help you and your family get through this predicament. While there are a multitude of injuries that can occur in the workplace, there are a few services you may be eligible for if you have been injured at work.

So, what benefits can you claim? Check out the following list, which outlines typical benefits:

Medical Care – Injured employees are entitled to receive any necessary medical, medicinal, surgical, first aid, and hospital services required to treat the effects of your injury or disease. The employer’s responsibility is to pay for:

• All emergency services
• Up to two treating physicians, surgeons or hospitals of the employee’s choice
• Any additional medical care providers to whom the employee is referred by the two physicians, surgeons or hospitals

Additionally, an injured employee could also be entitled to receive physical, mental or vocational rehabilitation, when appropriate. An employee may choose any doctor or hospital at the employer’s expense.

Temporary Total Disability (TTD) Benefits – This is a benefit that covers the period of time frequently referred to as the “healing period”. Temporary Total Disability or TTD benefits are available to an injured employee who must lose time from work to recover from a work-related injury or disease. The employee is entitled to collect TTD benefits until they are able to return to work.

• Wage Rate: The benefit is two-thirds (66 2/3%) of the employee’s gross average weekly wage, subject to certain limits. The average is based on the employee’s wages during the year before the injury or exposure. The rate is fixed at the time of the injury, and does not change with changes in the employee’s salary or statewide average weekly wage.
• Two or More Jobs: If an employee was working for two or more different jobs, the TTD rate may be based on the combined gross income from all jobs. This will only apply if the employer for whom they were working at the time of the accident or disease had prior knowledge that the employee was working another job.
• Overtime: Overtime pay is generally not included in the calculation of the average weekly wage. It is included, however, under the Worker’s Occupational Diseases Act. If the employer stops or withholds payment of TTD benefits before the employee returns to work, the employer must give the employee a written explanation on the date of the last TTD payment. Furthermore, the employer may be subject to penalties for failure to provide the employee with written notice.

Permanent Partial Disability (PPD) Benefits – These benefits cover injuries that are not so serious as to leave a worker permanently, totally disabled, but may nevertheless result in some permanent impairment. A Permanent Partial Disability or PPD is technically the complete or partial loss of use of a part of the body, or the partial loss of use of the body as a whole. While the “loss of use’ is not specifically defined in the law, it generally means the employee is unable to do things with a body part or with the body as the whole that he or she was able to do before the injury.

• Permanent Loss: PPD benefits are paid only if the work-related injury or disease results in a permanent loss of use of a part of the body or the whole body. PPD benefits are paid only after the employee’s condition has reached a point where it will not improve any more. The Industrial Commission evaluates employee’s physical impairment and the effect of the disability on the injured worker’s life. Factors that may be considered include the individual’s age, skill, occupation, training, and inability to engage in certain kinds of work or activities, pain, stiffness or limitation of motion.

There are two ways in which PPD benefits may be determined.

1. In the first method, the amount depends on the part of the body injured and the extent of the loss. The law places a value on certain body parts, expressed as a number of weeks of compensation for each part.
2. In the second method, the employee may be entitled to a percentage of 500 weeks that the partial disability bears to total disability. This benefit is 60% of the employee’s gross average weekly wage, subject to certain limits.

Permanent Total Disability (PTD) Benefits – There are some injuries that are so serious that a worker is permanently, totally disabled. A Permanent Total Disability or PTD is defined as complete disability which renders the employee permanently unable to do any kind of work for which there is reasonable stable employment market or the loss of:

• both hands
• both arms
• both feet
• both legs
• both eyes
• or any two such parts

Employees who suffer permanent and total disabilities after being injured at work are entitled to benefits for life. Employees who received PTD benefits and then return to work or could return to work in the future may have their benefits modified or terminated. The benefit is two-thirds (66 2/3%) of the employee’s gross average weekly wage during the year before the injury or exposure, subject to certain limits.

Survivors Benefits – When a work-related injury or disease results in the death of the employee, his or her spouse and children are entitled to full benefits. Benefits are paid to children under the age of 18 or until age 25 if a full-time student or if physically or mentally handicapped for the duration of the incapacity.

This is the chain of survivor eligibility:

1. Spouse and children.
2. If there is no eligible spouse or child, benefits are paid to the deceased’s totally dependent parents.
3. If there is no eligible spouse, children, or totally dependent parents, the benefits may be paid to other survivors, including partially dependent children, parents, grandparents, grandchildren or any the other heirs who are at least 50% dependant on the employee.
4. If the spouse remarries, and there are no children at the time of the remarriage who are entitled to benefits, the spouse is entitled to a final lump sum payment equal to two years compensation. The benefit is two-thirds (66 2/3%) of the employee’s gross average weekly wage.

Settlement – Many workers don’t realize that a lump settlement may be possible after an injury at work. A settlement closes a claim in exchange for an agreed-upon amount of compensation and medical services. Cases in which the employer denies liability or disputes the amount of compensation are often settled by lump sum settlements.

In agreeing to a settlement, the employee avoids the risk of getting no compensation or less than is provided in the settlement. However, settlement agreements generally forfeit the employee’s rights to future medical benefits even if the employee’s condition worsens.

Workplace injuries are very common, especially in certain high-risk professions. In fact, workers compensation lawyers deal with thousands of workers compensation claims each year. If you have been injured at work or are wondering what benefits can you claim, contact a Chicago workers compensation lawyer today for a Free Case Evaluation.

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