WORKERS' COMPENSATION ATTORNEYS SERVING CHICAGO, ILLINOIS
Workers’ compensation is an insurance-based system that pays for employees’ medical expenses and lost wages if they are injured or fall ill because of a workplace condition or accident. The system actually was inaugurated in Germany under Chancellor Otto von Bismarck in 1871. It took a while, but the first state in the U.S. to adopt workers’ compensation was Wisconsin in 1911. Mississippi was the last state to enact legislation in 1948.
Today, all 50 states have mandatory workers’ compensation laws in the book except for Texas, which makes it optional. In Illinois, if you’re in business and have at least one employee, full- or part-time, then you must purchase workers’ compensation insurance. The Illinois Workers’ Compensation Commission (IWCC) oversees the program in the state.
If you’re having trouble getting your workers’ compensation claim approved in or around Chicago, Illinois, contact the legal team at Stiberth, Scarlati & Boudreau, LLC. We proudly serve clients throughout the counties of Cook and Collar.
Even though workers’ compensation insurance is mandatory in all Illinois workplaces, navigating the system is not always a straight path. The insurer can request additional information while you are running up medical expenses and losing time from the job. They might even find a reason to deny you your benefits. If you face delays or denial, let our workers’ compensation attorneys fight for your benefits.
Overview of Workers’ Compensation in Illinois
Workers’ compensation is a no-fault system of insurance. If you’re injured or fall ill due to a workplace condition or accident, the system is designed to cover your medical expenses and lost wages if you miss time from work because of your injury or illness. No fault means you cannot sue your employer for the injury or illness, and they cannot sue you.
Slips and falls are fairly common workplace accidents. Say you trip on a slippery surface, fall backward, and injure your neck or spine. Workers’ compensation should cover your treatment and lost wages if you are forced to miss work to recover. Another example: your place of business uses toxic chemicals as cleaning agents. You inhale some toxic fumes and become ill. Workers’ compensation should cover that too.
Repetitive stress injuries are also covered. These injuries can result from lifting boxes, typing on a keyboard, sitting for long hours, or working in a production line. Repetitive stress injuries include tendonitis, carpal tunnel syndrome, and bursitis.
Filing a Claim
By law, you have 45 days to report a claim to your employer, but you probably want to initiate medical examination and treatment well before then. There is also a three-workday waiting period for lost-wage benefits to kick in. If you are still injured or sick on the fourth workday and unable to work, you are eligible to receive two-thirds of your average weekly wage rate prorated by days missed. You don’t get paid for the first three days until you’ve missed 14 days of work.
The Illinois Department of Employment Security every six months also establishes a minimum and maximum rate based on the statewide average weekly wage (SAWW), which through July 14, 2023, stands at $1,386.15.
You must inform your physician that your injury or illness resulted from a workplace incident or from a chemical or other exposure. Your physician will need to supply medical records explaining your condition to the workers’ compensation insurance company hired by your employer. (The employer can also self-insure.)
Reasons You May Be Turned Down
Workers’ compensation insurers are for-profit institutions, and it is in their interest to challenge claims to make sure they’re both real and not exaggerated. In the process, they may turn down many legitimate claims, forcing the claimant to seek legal counsel and representation. Generally speaking, here are the most cited reasons for denying a claim:
Your injury was unwitnessed.
You failed to promptly report your illness or injury.
There’s a discrepancy between what you reported and what shows on your medical record.
Your medical exam turned up evidence of illegal drugs in your system.
You filed your claim after you were laid off or fired.
You refused to give the insurer a recorded statement or refused to sign a medical authorization form.
It’s important to note that if an injury at work results from horseplay or because you are drunk or high on a drug, workers’ compensation will not cover it. If you file a claim after you’ve been let go, the insurer automatically assumes it’s a “revenge” claim.
Also, there is no law requiring you to make a recorded statement recounting the accident or incident that resulted in your condition. Though you are required to provide medical evidence justifying your claim, there is no legal requirement for you to sign an authorization.
Appealing a Decision
If your claim is denied, you need to request a hearing before an arbitrator assigned by the Illinois Workers’ Compensation Commission (IWCC). To do so, you have to file an Application for Adjustment of Claim, along with a Proof of Service showing that you had notified your employer of your injury or illness. These forms are available on the IWCC website.
Note that your employer will no doubt be represented by legal counsel during the hearing, so it is in your best interest to have a knowledgeable workers’ compensation attorney representing you.
WORKERS' COMPENSATION ATTORNEYS SERVING CHICAGO, ILLINOIS
If you run into an insurer making excessive demands on you, such as signing an authorization or making a recording – reach out to us immediately. We know how to deal with insurance company claim adjusters and will fight for your just benefits and compensation. Contact us at Stiberth, Scarlati & Boudreau, LLC. We proudly serve clients in Chicago and the counties of Cook and Collar, Illinois.