Illinois Workers Compensation Benefits Book
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    Illinois Workers Compensation Benefits Book Illinois Workers Compensation Benefits Book Document Transcript

    • TABLE OF CONTENTSA. OVERVIEW 1. Who is covered by the Illinois Workers’ Compensation Act?.....................................# 2. Who provides the benefits?..........................................................................................# 3. What benefits am I entitled to under the law?..............................................................# 4. What injuries or diseases are covered?.........................................................................# 5. Are repetitive trauma injuries covered?........................................................................# 6. Can a reinjury of an old injury be covered under the Illinois Workers’ Compensation Act?.....................................................................# 7. Do I need to give notice?...............................................................................................# 8. Do I have to submit to treatment by a company doctor?...............................................#B. WEEKLY BENEFITS 1. What benefits should I receive while off work?............................................................# 2. What if I do not receive benefits to which I think I am entitled?..................................#C. PERMANENT PARTIAL DISABILITY 1. What compensation may I receive for permanent injury to my body?..........................# 2. What compensation is payable for bodily injuries not specifically listed in the Workers’ Compensation Act?..........................................#D. PERMANENT TOTAL DISABILITYE. WAGE LOSS OR DIFFERENTIAL What if my earnings are permanently reduced because of the injury?..........................#F. DISFIGUREMENTG. DEATH BENEFITSH. VOCATIONAL REHABILITATION 1. Do I have the right to be retrained in a new profession?...............................................# 2. Can I hire my own vocational counselor?.....................................................................#I. PROTECTION OF BENEFITS 1. Is there a statute of limitations for the filing of a Workers’ Compensation claim?....................................................................................# 2. Should I apply for group insurance benefits?................................................................# 3. Can I lose my job for filing a claim for compensation?................................................# 4. Should I give a recorded statement if the insurance company or employer requests one?..............................................................................# 5. Should I cooperate with a rehabilitation nurse hired by my employer or the insurance company?........................................................# 6. Do I need an attorney to assist me in the handling of a Workers’ Compensation Claim?.............................................................#J. BENEFITS IN ADDITION TO WORKERS’ COMPENSATION 1. Third Party Cases..........................................................................................................# 2. Social Security Disability benefits................................................................................#
    • THE LAW OFFICES OF DWORKIN & MACIARIELLO The law firm of DWORKIN & MACIARIELLO concentrates in Workers’ Compensationand personal injury. We have handled over 10,000 injury claims and are known throughout thestate as aggressive litigators. We are well known and respected by the unions and have writtenarticles and spoken at union halls concerning workers’ rights. We were listed in a past issue ofChicago Magazine among the top 5% of all work injury attorneys. Mr. Dworkin has also taughta Workers’ Compensation class at a local law school. We have handled injuries as large as deathcases and as small as a broken finger.Please read this booklet and then call us for a free consultation. (312) 857-7777 Please Visit Our Website At: www.illinoisworkinjury.com
    • A. OVERVIEW 1. Who Is Covered By The Illinois Workers’ Compensation Act? Virtually every worker who is injured in the State of Illinois is covered by Workers’Compensation. Even if you are injured in another state, you may be covered by the IllinoisWorkers’ Compensation Act if you can show you were hired in Illinois or the principal place ofyour employment was in Illinois. 2. Who Provides The Benefits? Employers usually pay premiums to an insurance company and once a worker is injuredit is then that insurance company’s responsibility to pay the benefits. The cost of Workers’Compensation benefits cannot be charged to a worker. 3. What Benefits Am I Entitled To Under The Law? Your employer is required to pay for all medical expenses incurred as a result of anywork-related disease or injury. These include first aid, emergency room service, ambulance,hospital service, doctor fees and prescriptions. You may also be entitled to receive appropriatephysical, mental or vocational rehabilitation. Your employer is also required by law to pay to you Temporary Total Disability (TTD)benefits during the period of time that you are off work recovering from the injury or disease,provided that a doctor has prescribed the absence from work. You are to be paid at acompensation rate equal to two-thirds (2/3) of your average weekly wage. In some instances thismay include overtime. Finally, your employer may be required to pay to you additional benefits should yousuffer Disfigurement, Permanent Partial Disability , Permanent Total Disability or Death onaccount of any worked-related injury or disease. In the case of death, members of the worker’sfamily are entitled to benefits. The method used to calculate the TTD rate can be extremely complicated and confusing.If you have questions concerning your TTD rate or whether you are entitled to additionalbenefits as a result of your accident, a lawyer from our office should be consulted immediately. 4. What Injuries Or Diseases Are Covered? Almost all job related injuries or diseases, with very few exceptions, are covered byWorkers’ Compensation. You may even be entitled to full benefits if the accident was your ownfault. 5. Are Repetitive Trauma Injuries Covered? Yes. Workers who do repetitive work often suffer injuries such as Carpal TunnelSyndrome, Cubital Tunnel Syndrome, Back injuries, etc. These injuries have been heldcompensable as long as they are reported properly and documented medically. These cases arevery complicated and often disputed.
    • 6. Can a Reinjury Of An Old Injury Be Covered Under The Illinois Workers’ Compensation Act? Yes. The fact that a work accident may have reinjured an old injury does not barrecovery under the Illinois Workers’ Compensation Act. Any new accident which aggravates apre-existing condition gives rise to the filing of a new case and may result in additional benefits. 7. Do I Need To Give Notice? Yes. The most important step toward getting benefits started after an accident is that yougive prompt notice to a supervisor. Failure to give notice required by law can result in a loss ofyour right to claim any Workers’ Compensation benefits. Although the law allows an injuredworker to give notice within forty-five (45) days from the date of the accident, many potentialproblems can be avoided if the notice is given immediately following an accident. 8. Do I Have To Submit To Treatment By A Company Doctor? No. In many cases an injured worker can see up to two doctors of his own choice, andthe employer is also responsible for paying the charges made by any other doctors or hospitals towhom the worker is referred by either of his or her first two choices of doctors. However, ifyour employer maintains a Preferred Provider list, you are required to select a treater from thatlist as your first choice of doctor, or else forfeit that first choice. In that case, you will be entitledto only one doctor of your own choice. In our opinion, the doctors on an employer’s PreferredProvider list are biased in favor of the employer and should not be seen. Because declining totreat with the employer’s doctors will leave the you with only one choice of doctor, it isimportant that you contact us before beginning treatment so that we can review with you yourdoctors and make the best use of your choice.B. WEEKLY BENEFITS 1. What Benefits Should I Receive While Off Work? You are entitled to Total Temporary Disability (TTD) benefits for the entire period oftime during which a doctor has ordered you to remain off work to recover from the effects ofyour injury. The weekly compensation rate is based upon your average weekly wage for the oneyear before the accident. Further, the TTD rate is subject to certain maximums and minimumsthat can be explained by a lawyer from our office. “Moonlighters” who hold two jobs shallreceive TTD based upon the combined wages of the two jobs, if the employer knows the workeris holding two jobs. 2. What If I Do Not Receive Benefits To Which I Think I Am Entitled? If you are under the active treatment of a doctor and are unable to work and not receivingWorkers’ Compensation benefits, you are entitled to have an emergency hearing before anArbitrator at the Illinois Workers’ Compensation Commission. You have a right to presentmedical evidence and witnesses at your hearing. You should have an attorney represent you at
    • this hearing before the Commission.C. PERMANENT PARTIAL DISABILITY 1. What Compensation May I Receive For Permanent Injury To My Body? Compensation is payable for Permanent Partial Disability (PPD) if the job-related injuryor disease results in the complete or partial loss, or loss of use of, a part of your body. Thecompensation rate for PPD is 60% of your average weekly wage, but is subject to minimum andmaximum limits. There is no fixed amount payable to any worker who is injured on the job. The methodsused to determine the value of a Workers’ Compensation case are extremely complex andconfusing. One of our attorneys at our office, experienced in the handling of Workers’Compensation claims, can protect your right and assist you in getting the maximum amount ofrecovery for your injury. 2. What Compensation Is Payable For Bodily Injuries Not Specifically Listed In The Workers’ Compensation Act? If you suffered a permanent injury to a part of your body not specifically listed in theWorkers’ Compensation Act you can receive up to 500 weeks of compensation for PPD to the“person as a whole.”D. PERMANENT TOTAL DISABILITY An injured worker is considered to be permanently and totally disabled if he or she has acomplete disability which renders him or her wholly and permanently unable to perform anykind of work for which there is a stable market. If permanently and totally disabled, you areentitled to benefits for life payable by the employer at your TTD rate.E. WAGE LOSS OR DIFFERENTIAL What If My Earnings Are Permanently Reduced Because Of The Injury? If, after you return to work, you can no longer earn as much as you did before theaccident, you may be entitled to receive weekly benefits equal to two-thirds (2/3) of thedifference between the average weekly salary you would be able to earn at the job you hurtyourself at prior to the accident and the amount you are able to earn after the accident.F. DISFIGUREMENT If you suffer serious and permanent disfigurement (such as scars) to the head, face, hand,neck, arms, legs (below the knee), or chest as a result of a job-related injury you may be entitledto compensation. Disfigurement cases cannot be tried or settled until after a six (6) monthwaiting period from the date of the injury. However, these cases should be filed with the IllinoisWorkers’ Compensation Commission immediately if the injury occurs; the same as any other
    • type of work-related injury case.G. DEATH BENEFITS A worker’s widow or widower, children or totally dependent parents who qualify fordeath benefits are entitled to weekly payments at the worker’s TTD rate. If the widow orwidower remarries and there are no children at the time of the remarriage, he or she is entitled toa lump sum payment equal to two (2) years of compensation and all rights to further benefits areextinguished. The maximum death benefit allowable is either twenty-five (25) years of weeklycompensation payments or $500,000.00, whichever is greater.H. VOCATIONAL REHABILITATION 1. Do I Have The Right To Be Retrained In A New Profession? Yes. If your doctor states that you cannot do the same job you were injured at you areentitled to be retrained in a new profession. This may include schooling, training or anapprenticeship program in some circumstances. 2. Can I Hire My Own Vocational Counselor? Yes. Often the insurance company will hire a vocational counselor to meet with aninjured worker. This vocational counselor will simply send the injured worker on a job searchfor a minimum wage job. You may hire your own counselor to formulate a rehabilitation planwhich will enable you to earn much more than minimum wage.I. PROTECTION OF BENEFITS 1. Is There A Statute Of Limitations For The Filing Of A Workers’ Compensation Claim? Yes. In a Workers’ Compensation case, the Statute of Limitations requires a claim befiled before the Illinois Workers’ Compensation Commission on the worker’s behalf within three(3) years of the date of the accident or within two (2) years of the last payment of compensation(whichever of these dates is later). If a claim is not filed on your behalf within this time period,all of your Workers’ Compensation benefits will be lost. If you have suffered an accident within the above time frame, and have not had a claimfiled on your behalf before the Workers’ Compensation Commission, your rights may be injeopardy. You should contact our office immediately to make sure that your rights are protected. It is important to note that the Statute of Limitations for a Third Party lawsuit is differentthan for a Workers’ Compensation case. 2. Should I Apply For Group Insurance Benefits? Your employer may encourage you to apply for group insurance or sickness and accident
    • benefits instead of Workers’ Compensation benefits to which you are entitled by law. Most ofthese alternatives do not provide for weekly benefits as great as those available under Workers’Compensation. In addition, these insurance benefits usually require you to pay a portion of your medicalexpenses. Also, benefits for Permanent Partial Disability and Disfigurement are usually notavailable under most group insurance plans. Most group insurance policies exclude the paymentof benefits for work-related injuries. Additionally, if you sign a group form indicating that youwere not hurt at work, it may prove difficult to later receive any Workers’ Compensationbenefits. 3. Can I Lose My Job For Filing A Claim For Compensation? The Illinois Workers’ Compensation Act provides that it is unlawful for any employer orinsurance company to interfere with, restrain, coerce or discriminate against any worker in anymanner whatsoever because of that worker’s exercise of the rights or remedies granted to him bythe Workers’ Compensation Act. Our office aggressively enforces this provision of the Act. 4. Should I Give A Recorded Statement If The Insurance Company Or Employer Requests One? No. If you submit to a recorded statement in person or even over the telephone, it can beused as evidence against you at a hearing before the Workers’ Compensation Commission. Astatement could also jeopardize any third party case you might have. If you are asked to give astatement, simply have the agent or adjuster call our office for any information he or she mayneed regarding the accident. 5. Should I Cooperate With A Rehabilitation Nurse Hired By My Employer Or Its Insurance Company? Yes, with caution. Under some situation a worker’s employer or its insurance companywill request that the worker consult with a rehabilitation nurse while the worker is unable toreturn to his or her usual employment. If you are contacted by an insurance companyrepresentative regarding a rehabilitation nurse, you should contact our office immediately tomake sure your rights will be protected. 6. Do I Need An Attorney To Assist Me In The Handling Of A Workers’ Compensation Claim? Yes. It is essential that you retain an attorney who concentrates in Workers’Compensation law to protect your rights and assure the maximum recovery under the law.Immediately after incurring an injury at work, you are involved in a legal claim under theWorkers’ Compensation Act. Every employer or its insurance company has a competent staff ofattorneys representing their interests. Your employer or its insurance company has no obligationto inform you of your rights under the Workers’ Compensation Act. A Workers’ Compensationclaim involves not only compensation for an injury, but also has provisions which can protectyou if you are unable to engage in your usual occupation as a result of the work-related injury.
    • J. BENEFITS IN ADDITION TO WORKERS’ COMPENSATION 1. Third Party Cases If a third party other than your employer is legally responsible for the accident, you havethe right to pursue a second case. This second case would typically be based on the third party’snegligence, manufacture of a dangerous product, or violation of the Illinois Structural Work Act.Financial recovery in a third party case is generally more than Workers’ Compensation benefitsfor the same injuries as there is no limitation on the amount of recovery. The damages to whichyou would be entitled in your “third party case” can include pain and suffering, disability, loss ofearnings, medical expenses, and more. You may not know whether you have a third party case. However, a lawyer from ouroffice will. The determination of whether a third party case exists often requires an analysis ofall applicable laws and potential theories of liability before the existence of a third party case canbe confirmed. It is important to call us to make this analysis on your behalf. A Complaint must be filed in the Circuit Court or Federal Court within the Statute ofLimitations, usually two (2) years following your accident. If a Complaint is not filed before thattime, you will have no right to recover damages from any third party. 2. Social Security Disability Benefits You may receive both Workers’ Compensation benefits and Social Security Disabilitypayments, but the amount you receive will be reduced while you are receiving Workers’Compensation benefits.Caution: The information contained in this booklet may change as cases further interpret andmodify the law and the law itself may change. You should always consult with us if you have aninjury or if you have any question.
    • [Front Cover] WORKERS’ COMPENSATION benefits guidebook Prepared by: THE LAW OFFICES OF DWORKIN & MACIARIELLO ADDRESS 134 N. LaSalle, Suite 1515 Chicago, IL 60602 WEBSITE www.illinoisworkinjury.com (312) 857-5555 (312) 264-5624 (FAX) INTRODUCTION The Illinois Workers’ Compensation Act provides the only legal remedy against theemployer for a worker injured in the job. This handy pocket guide of information on Workers’Compensation hopefully will answer questions you may have. Please be aware that this bookletcannot fully answer all your questions as the statute and thousands of court decisions interpretingthe statute are quite complicated. For complete information please call us.
    • [Back Cover] PLEASE CALL OUR OFFICE FOR A FREE CONSULTATION (312) 857-7777 www.illinoisworkinjury.com THE LAW OFFICES OFDWORKIN & MACIARIELLO