Process to File a Workers’ Compensation Claim in Chicago

Friday, February 23, 2024

Process to File a Workers’ Compensation Claim in Chicago

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

Have you suffered a work-related sickness or injury in Illinois? If so, you may be eligible for workers’ compensation benefits to cover your medical expenses and lost income.

Most employers in Illinois are obliged to carry workers’ compensation insurance for their employees. Therefore, most injured workers in Illinois can file a claim. The process is not simple, but you should start by seeking help from a workers’ comp attorney in Chicago.

What Workers’ Compensation Benefits Include

Worker’s compensation in Illinois includes:

• Medical care and rehabilitation
• Temporary total disability (when an employee is off work for the recovery of a work-related injury)
• Temporary partial disability (when an employee is working fewer hours to recover from a work-related incident)
• Permanent partial disability (for an employee who can work but become partially disabled)
• Permanent total disability (for an employee who was diagnosed as permanently disabled to work)
• Vocational rehabilitation
• Permanent partial or complete disability benefits, and
• Survivor benefits (for the survivors of a worker who died from injuries on the job –  an amount that is paid as two-thirds of the employee’s gross average wage 52 weeks before the illness or injury

Take note that workers’ comp only covers injuries related to your job, such as repetitive use, a stroke or heart attack due to work, or similar physical or psychological problems. The insurance also covers a pre-existing condition that worsened during your employment.

You must have been working at something, onsite or off-site, directly related to your employment. For example, you are not compensated if injured during a company softball game or picnic.

Workers’ compensation benefits are tax-free, so you don’t have to pay taxes on your compensation.

How Does Workers’ Comp Work in Illinois?

Illinois requires employers to acquire workers’ compensation insurance, even if it’s a small business with one employee. Workers’ compensation may include partial wage replacement when an employee misses work due their job-related illness or injury. The program also covers the costs of healthcare services and occupational therapy.

Most workers’ compensation programs in Illinois are paid by private insurance policies. In addition, Illinois has a Workers’ Compensation Commission, a state department that supervises the program and intervenes during disputes. When an employee is denied the benefits they think they deserve, a Chicago workers’ compensation attorney can bring an appeal before the Commission.

Receiving PTD and Death Disability Benefits

As of 2022, the maximum benefit per week for permanent partial disability or permanent total disability is $1,792.73, while the minimum benefit amount is $672.28. (The cap is revised every six months; a list of the maximums can be found on the Illinois Workers’ Compensation Commission website, which is responsible for enforcing the state’s workers’ compensation regulations.)

A recipient of PTD or death benefits is entitled to receive a cost-of-living adjustment periodically. Death benefits are paid over a span of 25 years or are paid in a sum of $500,000, whichever is greater.

Paying Out TTD Benefits

Total temporary disability (TTD) benefits are paid in minimums based on an employee’s average weekly wage or a scheduled rate, whichever is lower.

How to File a Claim for Workers’ Compensation in Illinois

When you are injured on the job, you must notify your employer promptly. You also need to receive medical treatment immediately so you have proof of your injury. Tell the medical provider that your injury is work-related so they know who pays for your medical care.

You’ll also need to provide your employer with information about your medical treatment and the address of the health care provider.

What to Include in Your Report

When reporting a work-related injury, you need to include the following details:

• The date of the injury
• The time the accident happened
• A description of the events that led to the injury
• Your contact details

Although the notice may be given orally or in writing, the Illinois Workers’ Compensation Commission prefers that you file it in writing. (Note – informing a non-management colleague does not constitute informing your employer.)

You must tell your employer of an injury within 45 days to protect your benefit rights. A delay of over 45 days may result in losing all workers’ compensation payments.

Only a few exceptions exist to this rule: If you have a slow-developing disease or injury, or a cumulative traumatic stress injury, you must report your condition to your employer as soon as you’re aware of the condition.

Submitting an Application for Claim Adjustment in Illinois

This form is unnecessary if your employer pays for your medical care and temporary or permanent disability compensation, as promised. However, you must file a claim if you need the State Commission to force your employer to pay you benefits.

Note – it is still a good idea to fill out the form and file it, especially if you run into a situation where you unexpectedly stop receiving your benefits. Alternatively, if you expect that your employer may need an incentive to pay you benefits in the future (such as compensation for back surgery), you should submit the documentation.

For most injuries, the Application for Adjustment of Claim must be filed within three years from the accident date or the discovery of the disability.

How to Submit an Application for Claim Adjustment

You must apply to the Illinois Workers’ Compensation Commission (IWCC) and your employer. Send the form by mail or deliver one copy of the filled-out application to your employer and three copies of the completed application to the IWCC’s address.

The IWCC is at 100 W. Randolph Street, #8-200, in Chicago, IL 60601.

Illinois Work Compensation Claims: Your Employer’s Obligation

Once you report a work-related injury to your employer, they must supply you with a list of approved medical providers and notify their insurer to begin the claims process.

If your injuries have prevented you from working for over three days, your employer must accept your claim or begin temporary disability benefits within 14 days.

Otherwise, they must offer you a written explanation of why your claim is being refused or delayed while an investigation is conducted (along with any information they may still require).

Within 30 days of being notified of your injuries, your employer must also submit a Form IC45 to the IWCC if your injury has limited your work time to three days.

Contesting a Denial of Workers’ Compensation in Illinois

Common reasons for denying a workers’ compensation claim include failing to notify your employer of an injury within 45 days or failing to prove that the injury or illness was caused by and occurred in the course of your employment.

You may petition the Workers’ Compensation Commission for a review if you notified your employer of your injury within 45 days but your company denied your claim. The Commission will perform an investigation and decide on your allegation.

How Does a Workers’ Compensation Attorney Help?

Victims who sustain work-related injuries can be under serious stress. The aftermath of an injury may be overwhelming, whether it is dealing with the pain and limitations of the injury, figuring out how to pay the medical bills, or managing your everyday expenses.

Instead of being stressed by the legal aftermath of a work-related injury, you should focus on your health and recovery, which is why handling the situation alone is not ideal. Instead, working with a worker’s compensation attorney enhances your chances of a positive outcome.

Here are a few benefits of working with a workers’ compensation attorney:

Compliance With Legal Guidelines

You must comply with the state legal requirements or conditions to file a successful worker’s compensation claim. An attorney will work with you to ensure your insurance claim has all the documents and meets all legal requirements.

These requirements can include:

• You must be an employee
• You reported the injury to your employer by a specific deadline
• Your employer carries workers’ compensation insurance
• You must have seen an approved physician or doctor recommended by the employer or insurer list
• You must demonstrate that you sustained a work-related injury or illness

Pursue Maximum Compensation

Once you’ve submitted a claim, an insurer may quickly table a settlement. If you’re dealing with an insurer without legal aid, they can pressure you to accept an insufficient offer. An attorney can evaluate the offer presented by the insurer.

An attorney can negotiate a fair settlement amount for your losses if necessary.

Prove the Extent of Your Injuries

Your chances of obtaining a fair settlement for your losses increase if you can demonstrate the extent of your losses.

An attorney can compile the following documents to prove the extent of your injury:

• Medical bills
• Specialist reports
• Initial doctor’s diagnosis report
• Witness statement
• Photos of the injury
• Images of the scene
• Police report

Represent You During Trial or Hearings

Most victims of work-related injuries obtain compensation from their employer’s insurer. Even so, you may need to go to court if you disagree. An attorney best suits the legal matter by presenting facts to the court.

An attorney will examine witnesses and may also defend you against contradicting statements issued by the opposing lawyer. More importantly, an attorney will identify any opportunity to settle before the full trial hearing date.

Contacting a Workers’ Compensation Lawyer in Illinois

The Workers’ Compensation Commission recommends that most employers and employees get legal counsel in contentious cases. A lawyer can facilitate settlement negotiations and/or request a formal hearing. A lawyer can also assist in preparing evidence for a claim’s trial or deliberations.

Whether you need a lawyer to file a dispute or represent your claim to expedite filing, scheduling a consultation is a good idea. In Illinois, contact Malman Law to learn more about your rights in Chicago when filing a workers’ compensation claim. Call (312) 629-0099 right away.