Injuries that Qualify for Workers’ Compensation
Getting injured is always a life-altering experience, especially if the injury affects your ability to work and provide for your family. If you’re familiar with the concept of “workers’ compensation,” you may think that your injury is compensable.
But are workers’ comp benefits available to everyone who has a job and sustains an injury? No, that's not that simple, as your injury must meet specific requirements to qualify for workers’ compensation. At Stiberth, Scarlati & Boudreau, LLC, our workers’ compensation attorneys in Chicago, Illinois, have over 100 years of combined experience helping people who suffered work-related injuries and illnesses pursue the compensation to which they are entitled.
Workers’ Compensation System in Illinois
Under the Workers’ Compensation Act in Illinois (820 ILCS 305), employers with at least one employee must carry workers’ comp insurance to provide benefits that cover:
Medical care costs
Temporary total disability
Temporary partial disability
Permanent total disability
Permanent partial disability
Survivor benefits (in the event of work-related death)
However, to be eligible for workers’ compensation in Illinois, injured employers must notify their employer of the injury within 45 days of its occurrence. While oral notice is acceptable, it’s best to provide it in writing to have documented proof.
What Injuries Qualify for Workers’ Compensation?
An injury is covered by workers’ compensation insurance if it occurs in the course and scope of employment. Thus, any injury or illness that is related to work qualifies for workers’ compensation regardless of its type and severity. Common examples of injuries that may be compensable under the workers’ comp system include:
Back injuries
Sprains and strains
Internal injuries
Traumatic brain injuries
Contusions
Broken bones
Fractures
Nerve injuries
Burns
Psychological injuries may also qualify for compensation if such injuries are related to and caused by a work-related physical injury.
What About Pre-Existing Injuries?
Contrary to popular belief, workers may also seek benefits under the employer’s workers’ compensation insurance if they had a condition that predates a work-related accident as long as workplace conditions made the condition worse. For example, if an individual suffered a back injury in a car accident years ago and then their workplace conditions made the injury worse somehow, they would be able to seek workers’ compensation for any expenses arising from the aggravation of the injury.
What Workers’ Compensation Doesn’t Cover
While workers’ compensation generally covers any work-related injury or illness, regardless of how it occurred or whose fault it was, there are certain exceptions. As a general rule, workers’ compensation won’t cover:
Self-inflicted injuries
Injuries that result from horseplay or fighting
Injuries that occur during the participation in an off-duty recreational activity
Injuries that happen while the worker was violating company policies
Injuries that occur while the worker was committing a crime
Injuries that happen while the worker was under the influence of alcohol or drugs
However, just because your employer or their insurance company says your injury doesn’t qualify for workers’ compensation because it falls under any of the above-mentioned categories, doesn’t mean you shouldn’t file your claim. It’s worth looking into the facts of your case to determine whether or not your circumstances disqualify you from seeking workers' compensation. That’s why you might want to have your case reviewed by a workers’ compensation attorney.
What About Cumulative Work Injuries and Illnesses?
Generally, injuries or illnesses sustained over-time—like carpal tunnel syndrome—qualify for workers’ compensation, but many workers get their claim denied because they miss the notification deadline, which, under Illinois law, is 45 days from the date of the occurrence of the injury or illness. As a rule of thumb, in the case of a cumulative injury, the clock starts ticking on the date when:
The worker took time off work due to the injury/illness; or
The worker discovered or should have reasonably discovered that the injury/illness was related to work.
Even if you notify the employer within the 45-day period, you should still be able to demonstrate that the cumulative injury or illness is related to work.
What if Your Injury Qualifies for Workers’ Compensation, But Your Claim Is Denied?
If your injury or illness meets the eligibility requirements for workers’ compensation benefits, the insurance company may still deny your claim. Yes, that happens. Unfortunately, insurance companies may find a multitude of reasons to deny a workers’ comp claim. This could be due to a lack of evidence to show that the injury is related to work or because there are inconsistencies in the claim.
If you believe that your workers’ compensation claim was denied unfairly, do not hesitate to contact an attorney. Our attorneys at Stiberth, Scarlati & Boudreau, LLC, help those whose claims are denied fight back and obtain the compensation to which they are entitled under the law.
Not Sure if Your Injury Qualifies for Workers’ Compensation? Seek Legal Help
Sometimes, figuring out whether or not you have grounds to file a workers’ compensation claim is tough. If that’s how you feel, you might want to discuss the circumstances surrounding your case with our attorneys. We—here at Stiberth, Scarlati & Boudreau, LLC—provide personalized guidance to those who wish to explore their options for compensation. We can advise you on whether your injuries qualify for workers’ compensation, and, if they do, help you secure the maximum compensation you deserve. Reach out to our office today to set up a free consultation.