Workers’ compensation is an insurance program carried by every employer in Illinois, mandated by law. It provides benefits for employees injured in the workplace or illnesses that arise out of employment.
Some states don’t require employers to have workers’ comp insurance if they employ fewer than a minimum number of employees. In Illinois, however, anyone who has even one employee must take part in the workers’ compensation insurance program.
All employees who are injured on the job, contracted an illness while on the job or had a pre-existing condition made worse by work-related conditions are entitled to receive medical care related to their illness or injury. The employer, or the employer’s workers’ comp insurance company, will cover the cost of all medical treatment. An employee is also entitled to receive a portion of their wages if they miss time on the job due to a work-related illness or injury.
The Illinois workers’ compensation program is no fault. You can’t sue your employer for an injury or illness that you suffer because of your job. On the other hand, you do not have to prove negligence on the part of the employer. Even if the worker is injured because of their own actions, they are still covered. Workers’ comp provides benefits that cover medical costs and lost wages because of a work-related injury or illness.
Under the Illinois workers’ compensation insurance plan, there are several different categories of benefits available to workers injured on the job. Which one is available to you depends on the severity of the injury, the amount of time needed for recovery and which part of the body was injured. These benefits deal with lost wages and medical costs.
Other benefits are available including vocational rehabilitation benefits if you need to look for new employment after you’ve been injured and survivors’ benefits which will provide benefits to your dependents if you are killed on the job or die of a work-related illness. All benefits in the Illinois workers’ compensation program are adjusted for the cost of living.
You can receive TPD benefits if you are injured on the job and are unable to work. The idea behind TPD benefits is to partially replace what you earn every week until you can return to work. How much TPD you will receive depends on your income.
There is a short waiting period before you can receive TPD benefits. In some situations, you may be ineligible for benefits. You can receive these benefits even if you don’t live in Illinois. If you are hired by a company in Illinois or if your company is based here, you can still file a claim even if you live or work in another state.
Your TPD benefits will be based on two-thirds of your average gross weekly wage. That wage total is based on how much you have earned in the 52 weeks before you were injured. It includes overtime if it was mandated. It also includes your earnings from a second job if your employer knew about it.
To receive TPD benefits, you must have a statement from your doctor saying you are unable to work at your current job because of your injury. It is critical that you get this in writing from your doctor. Your doctor may also decide that you can turn to work with some restrictions. These benefits are available to you while you are still undergoing medical treatment and your doctor says that you are not at your Maximum Medical Improvement (MMI) level. You reach Maximum Medical Improvement when your doctor says you are healed or that you have recovered as much as you’re going to recover.
If you work on a part-time basis or in a less demanding job that pays less than you were previously earning, you will receive TPD wage benefits by calculating two-thirds of the difference between what you received before your injury and what you are receiving currently.
For example, if you were receiving $500 a week before your injury and now you are receiving only $300 a week while working part-time during your recovery, you would receive two-thirds of the difference between $300 and $500. That’s two-thirds of $200, or $133.33.
If you have been injured on the job, and your doctor says you are unable to work or places work restrictions on you that your employer is unable to fulfill and so you are unable to return to your job for a certain period of time, then you may be eligible for TTD benefits.
TTD benefits are calculated by taking two-thirds of your average weekly wage and then adding 10 percent for your spouse and 10 percent for each of your children if you have any. As with TPD, overtime is included when calculating this figure, as well as any income from a second job.
You are eligible for TTD benefits from your first day on the job. Don’t expect, however, you will receive TTD benefits if your injury means you are unable to work for a couple of days. Benefits do not start until the fourth day after you have been injured. If you know you are going to be out of work for more than two weeks, the benefits will include those first three days.
If you are injured on your job, or you have become ill because of work conditions, but you have not recovered entirely, you may be eligible for PPD benefits. These benefits are designed to help an injured employee who has lost the use or the partial use of a part of their body which prevents them from performing the tasks required by their job.
Before your right to PPD benefits can be determined, however, you need to reach your MMI. When your doctor says you have reached MMI, the Illinois Workers’ Compensation Commission (IWCC) and your employer will determine the benefits to which you are entitled. The IWCC uses four different ways to calculate PPD benefits:
If your injury means that you had to change jobs and the new job has a lower wage than your pre-injury job, you are eligible to receive wage differential benefits. The IWCC calculates these benefits by taking two-thirds of the difference between your pre-injury average weekly wage and post-injury wages. The maximum you can receive in wage differential benefits in Illinois is currently $1,110 a week. This is also known as the statewide average weekly wage (SAWW). You can receive wage differential benefits for five years or until you turn 67. You can check the most current benefit rates by visiting the IWCC website’s benefits rate page.
A schedule is used to determine the length of time you will receive compensation for injured body parts. The schedule awards a certain number of weeks of compensation based on the body part injured. The total loss of the use of the body part is also taken into consideration. For example, let’s say your leg was injured on the job, and it was determined that you lost 50 percent of its use. A leg injury is eligible for up to 215 weeks of compensation.
So to determine your benefit, you would take the 215 weeks and divided by 50 percent which would give you roughly 108 weeks. You would then multiply 108 weeks by two-thirds of your average weekly wage. If your average weekly wage was $900, this would mean that two-thirds of your average weekly wage is $600. Multiply 108 weeks by $600. The total benefits to which you would be entitled are $64,800.
A breakdown of the schedule that includes all the weeks of possible compensation for each body part is available.
You are eligible for a nonscheduled benefit if the injury you suffered at work does not fall on the regular schedule of body parts. This could be for an injury such as a repetitive stress injury that has created permanent limitations to the use of your hands or your fingers.
When determining a nonscheduled award, the IWCC takes several factors into consideration including your occupation, your skill level, how old you are, how much the injury has limited your motion, how much pain you are feeling and how the injury has affected your life. These factors are then used to determine the percentage that calculates your “loss of a person as a whole.” You multiply this figure by the 500 weeks of compensation for which you are eligible. You take this number and then multiply it by 60 percent of your average weekly wage.
So let’s say you are earning $800 a week and you are diagnosed with a severe repetitive stress injury. The IWCC determines that 40 percent of your whole person has been diminished or lost. Multiply 500 by 40 percent which equals 200 weeks. Sixty percent of $800 a week equals $480. Then multiply 200 by $480. This means that you would be entitled to a benefit of $96,000.
If you suffer serious or permanent disfigurement to visible areas such as your head, neck, face, hands or lower legs, you are entitled to disfigurement benefits. Disfigurement benefits can last up to 162 weeks. You need to determine a value for your disfigurement calculated by a number of weeks. You then multiply the number of weeks by 60 percent of your average weekly wage. You cannot, however, “double-dip” – you cannot be compensated under the scheduled award category and the disfigurement category at the same time.
If an injury on the job or a work-related illness has left you totally unable to work the rest of your life or if you have lost both of your eyes, hands, feet, arms or legs, for workers’ compensation purposes you are considered permanently disabled and eligible for PTD benefits. These benefits come into play when there is no reasonable job market to be expected for you or your injuries have left you unable to travel or care for yourself.
To qualify for PTD benefits, you must have severe permanent job restrictions or documentation by your doctor that you are unable to work under any condition. You must submit this report from your doctor to your employer’s insurance company.
Under PTD benefits, you will receive a weekly benefit for the rest of your life consisting of two-thirds of your average weekly wage. PTD benefits are subject to a minimum and maximum levels. The current minimum level is $555 a week, while the current maximum level is $1480.12. Remember, you should check the most current benefits rate.
If you have suffered permanent or long-term injuries which mean that you cannot return to your previous job, you may be eligible for vocational rehabilitation benefits. The idea behind these benefits is to help you rebuild previous skills and develop new ones.
Some of the services to which you may be entitled include:
You will continue to receive workers’ compensation wage and medical benefits while you are undergoing vocational rehabilitation. This is known as “maintenance.”
If you are receiving vocational rehabilitation benefits, it is essential that you actively take part in any training services and vocational plan. During vocational rehabilitation, make sure you document each step along the way. If your employer can show that you have not participated or cooperated, they will seek to suspend or terminate your vocational rehabilitation benefits and your maintenance benefits as well.
If you are killed in an accident on the job or die of the work-related illness, your family members may be eligible for workers’ compensation survivor benefits. These benefits are designed to help your family with funeral costs and living expenses in the future. The benefits depend on which of your family members are eligible to receive them.
Eligible family members can receive as much as two-thirds of your average weekly wage. There are minimum and maximum levels for these benefits. Again, you can check current rates at the IWCC’s website’s benefits rate page.
Workers’ compensation will also cover the cost of your funeral up to a maximum of$8,000.
Your spouse and dependent children are eligible for benefits. Children are considered dependent if they are under 18 years old, under 25 and enrolled in school full-time or are physically or mentally disabled. These benefits continue until your spouse dies, until the 18th birthday of your youngest child or their 25th birthday if they are enrolled in school. If the child is mentally or physically disabled, the benefits continue while they are incapacitated. If your spouse remarries and you have no children, your spouse receives a lump sum payment worth two years of benefits. After this, no more death benefits will be paid.
If you are unmarried, or if your spouse has died and you have no children, death benefits will be paid to your parents if they were dependent upon you financially. They will receive this benefit for the rest of their lifetime.
If no family member is eligible in the first two categories, survivor’s benefits can go to your adult children if they were dependent on you financially. They may also go to your parents if they were partially dependent financially on your wages. These benefits can continue for up to eight years.
If you have no family members who are eligible under the above categories, grandparents, grandchildren or family members related through sibling situations, such as a brother, a sister, a cousin, an aunt or uncle may be eligible for survivor benefits. These family members, however, must be at least 50 percent dependent upon you financially. They may receive these benefits for up to five years.
Filing a workers’ compensation claim in Illinois is never easy. It can seem even more difficult when you must deal with the stress of knowing that your family is dependent on you financially. Trying to do it on your own can be hard, especially if you’re still suffering from the effects of your injury. That’s why it makes so much sense to work with Chicago workers’ compensation attorneys, like the attorneys at Argionis and Associates.
We want to use our experience in workers’ compensation law to help our clients feel whole again and receive the benefits to which they are legally entitled. When you work with us, your case will be handled by an experienced workers’ compensation attorney. No one will work harder for you than we will. We also work on a contingency basis, so you only pay legal costs if we recover all the benefits you deserve.
If you’d like to know more about our workers’ compensation experience, call us for a free consultation at 1-312-626-6294 or contact us online and a member of our team will get back to you as soon as possible.