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This brief outline of the
Act applies to injuries and exposures which
happened on or before January 31, 2006. Click here for the law relating to
accidental injuries and exposures on or after February 1, 2006.
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The Illinois Workers' Compensation
Act provides the only legal remedy against
the employer for a worker injured on the job.
This outline is not a substitute for legal
advice and should not be relied on without
consultation with an attorney from our office.
This is a brief outline of the Act. The Workers'
Compensation Statute and thousands of court
and Illinois Workers' Compensation Commission
decisions interpreting it, are quite complicated.
The facts in every case make each claim unique.
For complete information, contact
us.
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A
SUMMARY OF THE ILLINOIS WORKERS' COMPENSATION
ACT
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If you are injured in the course
of your work, you are entitled, at your employers'
expense, to receive all necessary medical
and hospital services. Your employer is responsible
for paying 100% of all reasonable and necessary
medical expenses. You may select any physician
and go to any doctor or hospital you are referred
to through that physician. You may also select
one more such line of doctors. After that
you must go to doctors selected by the employer,
or else pay your own bills. You are not required
to treat with the doctor to whom you were
referred by the insurance company or your
employer.
In addition to medical treatment, you may
be entitled to various kinds of compensation
payments as follows:
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| YOUR
COMPENSATION RATES |
Your weekly compensation rates
are the basis for figuring benefits under
the Act. You have two compensation rates,
both fixed as of the date of your accident.
Both rates are a percentage of your average
weekly earnings for the year before your accident,
but are subject to certain maximum limits
and also to minimums for low-paid workers.
Overtime earnings may be included in the calculation
of your weekly earnings. In addition, shift
differential, COLA and production bonus /
piecework is included in the average weekly
wage.
One rate applies to three kinds of payments
- TT, death and total disability. This rate
is two-thirds of your average weekly earnings,
limited by a maximum which is changed every
January 15th and July 15th, according to fluctuations
in the Statewide average wage. For example,
for accidents from January 15, 2005 through
July 14, 2005, this maximum rate is $1,051.99.
The second rate applies to permanent partial
disabilities, such as specific loss, and is
set at 60 percent of your average wage. The
maximum for this rate was fixed at $567.87
per week for accidents from July 1, 2004 through
June 30, 2005. |
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KINDS
OF PAYMENTS |
Temporary Total Compensation
("TT")
If, because of an injury on the job, you are
unable to work for more than three working
days, you are entitled to weekly payments
in the above amounts. Payment for the first
three days are due if your period of total
disability extends for more than 14 calendar
days from the date of injury. These dates
need not be consecutive days of lost time.
Temporary total compensation continues as
long as you are totally disabled and under
treatment. You may also be entitled to receive
"maintenance" benefits if your injury limits
your work ability and your employer cannot
accommodate your restrictions. "Maintenance"
is usually paid at the temporary total disability
rate.
You may be entitled to additional compensation
if you can qualify for any one of the following:
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- I. Specific Loss Compensation
A "specific loss"
is a permanent disability to certain specific
"members" of parts of the body. The number
of weeks of compensation allowed by the
statute for total loss of each such member
is set forth below:
Thumb 70 Weeks
Index finger (forefinger) 40 Weeks
Middle finger 35 Weeks
Ring finger 25 Weeks
Little finger 20 Weeks
Great toe 35 Weeks
Other toes (each) 12 Weeks
Hand 190 Weeks
Arm* 235 Weeks
Leg* 200 Weeks
Foot 155 Weeks
Eye sight (1 eye) 150 Weeks
Hearing (one ear, complete)** 50 Weeks
Hearing (two ears, complete)** 200 Weeks
One testicle 50 Weeks
Two testicles 150 Weeks
Fracture to a vertebrae at least 6 Weeks
Skull fracture (cranial vault) at least
6 Weeks
Facial bone fracture at least 2 weeks
*Additional compensation is provided for
amputations above the knee or elbow and
for enucleation of an eye.
**The statute sets out a complicated formula
for determining the degree of hearing
loss.
Where the injury results in permanent
or partial loss of use of any of the listed
"members" of the body, compensation is
based on the percentage of loss of use
of the member. Recovery is allowed for
partial loss of hearing due to industrial
noise.
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- II Disfigurement Compensation
An employee who suffers permanent scars
on the hand, head, face, neck, arm, upper
chest or the leg below the knee, may recover
for disfigurement. The amount payable
varies in each case, depending on the
seriousness of the disfigurement, but
it can in no case exceed 150 weeks of
permanent partial disability payments.
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- III. Fatal Injury Compensation
Where an employee dies as a result of
accidental injuries on the job, leaving
a widow (or widower), children or other
dependent heirs, compensation is payable.
A widow (or widower) receives the compensation
rate each week until he or she dies, up
to a maximum of 20 years or until he or
she has received $250,000, whichever is
greater. However, if the widow (or widower)
remarries at a time when there are no
dependent children he or she receives
only a lump sum of 2 years compensation.
Children may receive benefits up to age
25 if they are students. Under some circumstances
the employer may deduct amounts paid under
group life insurance policies.
IV. Person as a Whole
A worker who is disabled may receive up
to 500 weeks of compensation for partial
disability to the whole body. Injuries
to the low back, neck and other areas
of the body which are not on the schedule
are compensated under this provision.
A partial loss of a specific body part
may be compensated under this provision
if the loss affects the ability to earn
your full wages, such as the ability to
work overtime.
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- V. Permanent Earnings Loss
A permanent reduction in earnings capability
is also compensable. The wage loss is
subject to a cap. With this award, the
insurance company or your employer has
an obligation to provide you with vocational
assistance. Permanent earnings loss is
payable as long as the disability lasts.
This is paid as 66 2/3% of the difference
between the post-injury earnings and what
you could expect to make in the full performance
of your regular job. This payment, like
all workers' compensation payments is
tax-free.
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- VI. Permanent Total Disability
- 1. Inability to Work. If an injury results
in complete disability so that the employee
is wholly and permanently incapable of
work, compensation is payable weekly until
death or until the employee is able to
return to work.
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- 2. Disability Based on Specific Loss.
The loss of use of both hands, or both
arms, or both feet, or both legs, or both
eyes, or any two of them - as for example,
one arm and one leg - suffered in an accident
constitutes permanent total disability
and entitles the employee to weekly compensation
payments until death, even if the employee
can do some work.
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| HOW
TO QUALIFY FOR BENEFITS |
- Report any accident to the employer
within 45 days. This can be done orally
or in writing to the foreman or the plant
nurse, or any other management representative
of the company. If notice of the accident
is not given in time, the claim may be
barred.
- Have a claim filed with the Illinois
Workers' Compensation Commission, 100
W. Randolph St., Chicago 60601 within
three years after the accident, or, where
weekly compensation ("TT") was paid, within
two years from the date of the last payment,
whichever is later. Payment of medical
expenses through workers' compensation
may extend the statute of limitations.
Payment of non-occupational benefits for
a work-related injury tolls the date required
for giving notice and filing your claim.
Unless the application is filed within
the required time, the Statute of Limitations
will forever bar the claim.
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| CAUTION
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WARNING: Do not rely
on the advice of insurance adjusters or company
doctors concerning the settlement value of
your claim. Contact an attorney who limits
his/her practice to workers' compensation.
If an offer is made, ask for it in writing.
Usually family doctors do not understand how
the Commission evaluates permanent disability.
Sometimes, in order to save the company money,
a personnel manager will urge an employee
to say that the accident did not happen at
work and to claim group insurance or sickness
and accident benefits instead of Workers'
Compensation. Once a worker states that he
was not injured at work, it may be impossible
to collect compensation benefits. Compensation
is more generous than group insurance for
the injured worker because it pays all medical
costs, not just some, pays higher weekly benefits
in almost all cases, and makes substantial
payments for disfigurement and disability
which are generally non-existent in group
insurance. A lump sum settlement, approved
by the Commission, closes a case and ends
a worker's right to further medical treatment
for that accident. In contrast, an award of
benefits after trial at the Illinois Workers'
Compensation Commission entitles the worker
not only to compensation payments for the
permanent disability suffered, but also to
the right to reopen the case within 30 months
if the disability materially increases and
in addition, provides payment for all medical,
surgical and hospital treatment needed at
any time in the future as a result of the
accident in question.
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| HELPFUL
FACTS |
- Keep in mind that some "natural" illnesses,
such as heart attacks or strokes may be
brought on by work stresses. If so, valuable
benefits are available under this Act.
- If the accident is caused by the negligence
of someone other than the employer, the
worker can file a civil suit for damages
against the negligent third party, in
addition to a compensation claim against
the employer.
- Illinois law specifically protects
the right of injured employees to file
claims under this law. Employers and insurance
companies are prohibited from discriminating
in any way against an employee for filing
a claim. Illinois courts enforce these
protections.
- Recovery as outlined above is also
allowed for disability due to occupational
diseases such as hearing loss, dermatitis,
asbestosis and other lung diseases, carpal
tunnel syndrome, etc.
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This brief outline of the
Act applies to injuries and exposures which
happened on or before January 31, 2006. Click here for the law relating to
injuries and exposures on or after February 1, 2006.
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to top |
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