Workers' Compensation

DO YOU NEED AN ATTORNEY TO HANDLE YOUR WORKER'S COMPENSATION CLAIM?
 

Every employer and its insurance company have lawyers representing their interests. Not surprisingly, your employer and its insurance company have no responsibility to tell you your rights under the Worker's Compensation Law. So it is important that you have a lawyer to protect your rights and maximize your recovery. Remember, insurance companies stay in business by paying nothing or as little as they can get away with!

A worker compensation claim supplies compensation for an injury. It also has aspects which protect the worker if he is unable to continue his usual employment because of the injury.

Important - an injured worker is making a claim with the insurance company, and is not suing his employer if he pursues a worker's compensation case.

With all this in mind, here are the most common questions that we get in the workers compensation area. If any of this is unclear or you need more information, call us.

I           THE BASICS 
1.         Who is covered under Workers' Compensation?
2.         Who pays the benefits?
3.         What benefits are required to be paid?
4.         What about repetitive work injuries, like Carpal Tunnel?
5.         What about pre-existing medical conditions?

 

II         REPORTING & BENEFITS 
1.         What initial steps should be taken to protect the claim?
2.         Must the injured worker submit to treatment from the company doctor?
3.         What benefits is an injured worker entitled to receive?
4.         What if the injured worker is unable to return to any type of work?
5.         What if the worker's earnings are permanently reduced because of the injury?
6.         What benefits are payable if a worker is killed on the job?

 

III        PERMANENT PARTIAL DISABILITY
1.         What compensation is payable to an injured worker for a permanent injury?
2.         What about disfigurement?
3.         What compensation is payable for bodily injuries that do not involve a specific body part?

 

IV        PROTECTION OF BENEFITS
1.         Must a worker notify his employer if he has been injured?
2.         Is there a time limit for filing of a workers compensation claim?
3.         Can an injured worker lose his job for filing a workers' compensation claim?
4.         Should an injured worker provide a recorded statement if requested by the insurance company?
5.         Should an injured worker sign any documents for his employer or the insurance company?
6.         Should an injured worker cooperate with a rehabilitation nurse hired by his employer or its' insurance company?
7.         If I retain an attorney to represent me on my workers' compensation claim, how much does it cost?

 

V         OTHER CLAIMS FOR WORK RELATED INJURIES
1.         Can I sue other persons or companies who may be responsible for my injury while working?
2.         How does a worker know if any third-party may be legally responsible for his injuries? 

 

I           THE BASICS  

1.         Who is covered under Worker's Compensation?     

Any worker who is injured or hired in Illinois is covered by Worker's Compensation.  If the worker is injured while working in another state he or she may be covered under Illinois law, if it can be shown that he was hired in Illinois or the principal state of his employment was Illinois.

 

2.         Who pays for the benefits?
Usually an insurance company.  If there is no insurance the state has a special fund which sometimes provides benefits.  The costs of workers compensation benefits cannot be charged to a worker.

 

3.         What benefits is the injured worker entitled to receive? 

First, the employer is required to pay for all medical expenses incurred as a result of any work-related diseases or injury.  

Second, the employer is also required to pay Temporary Total Disability (TTD) benefits during the period of time that the employee is off work and recovering from the injury or disease.  The worker is paid at a compensation rate equal to Two-thirds (2/3) of his average weekly wage. 

Finally the employer may be required to pay the worker additional benefits should the worker suffer disfigurement, permanent partial disability, permanent total disability or death on account of the work-related injury. In case of death, members of the worker's family receive the benefits.

 

4.         What about repetitive work injuries, like Carpal Tunnel? 

There are some situations where a worker may be entitled to benefits without a specific accident having occurred.  These types of cases usually involve repetitive physical movement in the work environment, such as developing Carpal Tunnel Syndrome in the wrist. Special medical evidence is required to support these claims.

 

5.         What about pre-existing medical conditions? 

The fact that a work accident may aggravate an old injury does not bar recovery under the Illinois Workers' Compensation Act.  Any new accident which aggravates a preexisting condition gives rise to a new case and may result in additional benefits, even if the initial condition was not work related. 

 

II         REPORTING & BENEFITS 

1.         What initial steps should be taken to protect the claim? 

The most important step toward getting benefits started after an accident is for the worker to give prompt notice to his employer. Notice can be given orally or in writing.  Even if a worker sustains an injury which does not at first appear serious, he should immediately report the injury to his supervisor or other person in charge and request to fill our an accident report, if one is available, especially if the injury arises before a weekend, holiday, or vacation period.  Failure to give the notice required by law can result in a loss of the worker's right to claim any Workers' Compensation benefits.  Although the law allows an injured worker to give notice within forty-five (45) days from the date of accident, many potential problems can be avoided if notice is given immediately after an accident.  Another important step an injured worker can do to protect their access to Workers' Compensation benefits is to give an accurate history of the injury to any doctor, hospital, or nurse.  If the injury arose during employment, make sure you mention that to the health care provider.

 

2.         Must the injured worker receive treatment from the company doctor? 

While the injured worker may accept treatment form the company doctor, the worker also has the right to choose his own doctor or hospital at the company's expense.  However, the worker is limited to choosing two (2) different doctors. But, the employer is also responsible for paying for the charges made by any doctors or hospitals to whom the worker is referred to by either of his first two doctors (the "chain of referral").  If a worker wants to see a third doctor of his own choosing, he must pay for these services.   A worker should always be certain to advise any additional hospital or doctor treating him that his injuries arose out of an accident on the job. The employer does have the right to have the employee examined by a physician chosen by the employer.

 

3.         What benefits should an injured worker receive while unable to work? 

The worker is entitled to Temporary Total Disability benefits (TTD) for the entire period of time during which a doctor has ordered him to remain off work to recover from the effects of the injury.  The weekly compensation rate is based upon the worker's average weekly wage for the one year period before the accident.  The TTD rate is subject to certain maximums and minimums. Often, those who hold two jobs can receive TTD based upon the combined wages of the two jobs, if the employer knew the worker was holding two jobs. There is no limit to the length of time that a worker may collect TTD payments. TTD can be collected until the worker's treating physician says the employee can return to work.

 
4.         What if the injured worker is unable to return to any type of work? 

An injured worker is considered to be totally and permanently disabled if he has a disability which renders him wholly and permanently unable to do any kind of work for which there is a reasonably stable market.  If totally and permanently disabled, the worker is entitled to benefits for life, payable by the employer at the worker's TTD rate.

 
5.         What if the worker's earnings are permanently reduced because of the injury? 

If, after his return to work, the injured worker can no longer earn as much as he did before the accident, he may be entitled to receive weekly compensation benefits equal to two-thirds (2/3) of the difference between the average weekly wage he earned before the accident and the amount he is able to earn after the accident.

 

6.         What benefits are payable if a worker is killed on the job? 

A worker's spouse and children are entitled to weekly payments at the worker's TTD rate. If the spouse remarries, and there are no children at the time of the remarriage, the spouse is entitled to a lump sum payment equal to two (2) years of compensation. All rights to further benefits will be extinguished.

If the injury or death occurred on or after February 1, 2006, the maximum death benefit allowable is either twenty (25) years of weekly compensation payments or $500,000, whichever is greater.

 

III        PERMANENT PARTIAL DISABILITY

1.         What compensation is payable to an injured worker for a permanent injury?

Compensation is payable for permanent partial disability if the job-related injury results in the complete or partial permanent loss, or loss of use, of a part of the worker's body. The compensation rate for permanent partial disability is 60% of the average weekly wage, but is also subject to minimum and maximum limits.

There is no fixed amount payable to a worker who is injured on the job. The methods used to determine the value of a Workers Compensation case are complex and can be confusing. One of our attorneys can make sure the worker gets the maximum amount allowable for his injury.

 

2.         What about disfigurement?

 A worker who suffers serious and permanent disfigurement (such as scars) to the head, face, hand, neck, arms, legs (below the knee), or the chest as a result of a job-related injury may be entitled to compensation. Disfigurement cases cannot be resolved until at least six (6) months following the date of the injury. The amount of compensation depends upon the degree of disfigurement.

 

3.         What compensation is payable for injuries that do not involve a specific body part?

 A worker who has suffered a permanent injury to a part of his body not specifically listed in the Worker's Compensation Act can receive up to 500 weeks of compensation for permanent partial disability to the "man as a whole." This often applies to injuries involving the neck, and the middle or lower back.

 

 

 IV        PROTECTING YOUR BENEFITS

 1.         Must a worker notify his employer if he has been injured?

 Yes. The injured worker is required to report all accidents to his employer within forty-five (45) days from the date of the accident. It must be reported to someone in the company who has a position of authority, such as a supervisor, foreman or personnel manager.

 

2.         Is there a time limit for filing a worker's compensation claim?

 Yes. Generally, a claim must be filed with the Illinois Worker's Compensation Commission within three (3) years of the date of the accident. If a claim is not filed on the worker's behalf within this time period, all of his worker's compensation benefits will be lost. There are a few instances which allow this period to be extended, but they are rare.

 If you have suffered an injury and have not had a claim filed on your behalf with the workers compensation commission, your rights may be in jeopardy. You should contact our office immediately to make sure that your rights are protected.

 

3.         Can an injured worker lose his job for filing a claim for compensation?

It is unlawful for any employer or insurance company to discharge a worker because of the exercise of his rights or remedies under the Worker's Compensation Act.

 It is also unlawful for any employer or insurance company to interfere with, restrain, coerce or discriminate against any worker who exercises the rights granted to him by the Worker's Compensation Act.

 

4.         Should an injured worker give a recorded statement if requested by his   employer or its insurance company?

 No. A recorded statement can be used as evidence against the worker at a hearing before the Commission. A statement could also jeopardize a third-party case. If a worker is asked to give a statement, simply have the agent or adjuster call our office for any information they might need regarding the accident.

 

5.         Should an injured worker sign any documents for their employer or its     insurance company?

  No. Any documents or forms that a worker signs could adversely affect the claim, especially if the worker's claim is contested at a later date.

 

 6.         Should an injured worker cooperate with a rehabilitation nurse hired by the        employer or its insurance company?

 Yes, with caution. Under some situations a worker's employer, or its insurance company, will require that the worker consult with a rehabilitation nurse while the worker is unable to return to his usual employment. In some cases, this may be an important benefit provided for the worker.

 However, unless handled properly, this relationship may compromise certain rights and benefits. If a worker is contacted by an insurance company representative regarding a rehabilitation nurse, the worker should contact our office to make sure that his rights will be protected.

 

7.         If I retain an attorney to represent me on my worker's compensation claim,        how much does it cost?

 First, there is no cost for filing a worker's compensation claim. Generally, attorney's fees are limited to 20% of any benefits recovered which are contested by the employer. If an employer or insurance company does not contest an aspect of a claim, there generally is no fee. For instance, if the employer or insurance company agrees to pay TTD benefits, and no hearing on that issue is required, there is no attorney's fee for receiving those benefits.

 


V         OTHER CLAIMS FOR WORK RELATED INJURIES

 1.         Can I sue other persons or companies who may be responsible for my injury                               while working
Yes, if a third party, other than a worker's co-employee, contributed to causing the injury for the worker, the worker has the right to pursue a separate lawsuit. This lawsuit is often based on the third party's negligence. Damages in this second case are usually more than worker's compensation benefits for the same injuries. The damages to which a worker would be entitled in a third party case include pain and suffering, disability, loss of earnings, medical expenses and possible others. These can be recovered in addition to the worker's compensation benefits.

 

 2.         How does a worker know if a third party may be legally responsible for his         injuries?         

 A worker may not know, which is why it is important that you contact our office immediately if you think there may be a third-party claim. To see if you have a third party case requires us to check the law and look carefully into what happened, how it happened and why it happened. It is important to do this analysis as soon as possible, because the time period for filing these claims is usually shorter than 3 years.               


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Richard F. Mallen & Associates, Ltd
228 South Wabash Avenue, Suite 420
Chicago, IL 60604
Phone: 312-346-0500
Fax: 312-346-5778
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