This post is written as an introduction to a person’s basic rights under the Illinois Workers’ Compensation Act (the “Act”). The State of Illinois has also enacted connected legislation referred to as the Workers’ Occupational Diseases Act, which has many overlapping features but deals mainly with workplace exposure to occupational diseases or hearing loss that may occur as a result of job activities. This post will focus on examining the core benefits that an injured worker may be able to receive under the Act’s protections.
In Illinois, a worker who is injured on the job may be entitled to medical treatment, temporary total disability (also known as “TTD” or “comp”) and permanent partial disability (also known as “PPD”) payments, depending on the facts and circumstances surrounding his or her injury. The payment of these benefits will be the responsibility of the employer if it is demonstrated that an accident occurred under Illinois law. It is important to note that the injured worker may be entitled to additional benefits and the above is not an exclusive list. These benefits will be discussed in greater detail below.
What to do after an injury first occurs
If a person is injured at work, the first thing they should do is obtain emergency medical treatment, if necessary. The second thing they should do is give notice to their employer of their injury. The law states that the employee must give notice to their employer within 45 days of the accident’s occurrence. Notice to the employer must be given to a supervisor or someone in management. Giving notice to a fellow employee is notsufficient and will not satisfy an employee’s duties under the Act. The law requires that the injured employee inform the employer of the date and place of the accident. The law does not require that the notice be in writing. It may be oral or written.
The employer is responsible for all necessary first aid, emergency medical and surgical services, as well as those medical, surgical and hospital services that are proven to relate to the workplace injury. After the 2005 Amendments, medical treatment has become subject to the Medical Fee Schedule. Under the Medical Fee Schedule, the Illinois Workers’ Compensation Commission is required to establish a fee schedule for medical services, which is adjusted on a yearly basis.
In regard to billing, the Act states that when an employee notifies a medical provider that the treatment is for a work-related injury, the provider shall bill the employer directly. If the employer does not then dispute payment of these medical bills, then the employer is required to make payment directly to the provider on behalf of the employee. The employer is required to then pay the bill within 60 days of receipt of the bill as long as the proper claim information is provided to them.
However, if the employer does dispute payment for the bill or bills by telling the provider they do not believe the injury or illness is work-related, the provider may seek payment of the bill directly from the employee. At that point, the employee may then tell the provider to cease all collection activities if they have already filed a claim for benefits at the Illinois Workers’ Compensation Commission. The provider may then only resume collection efforts after a final award or settlement occurs on the claim. The employee will then be responsible for payment of any outstanding bills plus interest awarded.
Temporary Total Disability and Temporary Partial Disability Benefits
If a person becomes injured as the result of a workplace accident, and remains off work for three or more consecutive days because of a current doctor’s recommendation, he or she may be entitled to TTD. However, no compensation is payable regarding the first three days off unless a person remains off work, per a doctor’s orders, for fourteen days or more. In any event TTD should be paid starting the fourth day after the accident occurred if a doctor has an injured worker completely restricted from work.
When an employee receives treatment from a medical provider they need to make sure that they receive an “off-duty” or “restricted duty” slip from them. This slip will tell them if they can do light-duty work or if they are to be completely off work. The employee should then make a copy for their own records and then give a copy to their supervisor immediately. If light-duty work is not available at their workplace, the employer will be responsible for paying them TTD.
Generally speaking, TTD payments are calculated by taking 66 2/3% of your average weekly wage (“AWW”) earned before the accident occurred, subject to certain statutory minimums and maximums and Illinois case law. In addition, the July 2005 amendments enacted the creation of Temporary Partial Disability (“TPD”) benefits for workers who are working light-duty on a part-time basis after being injured. When an employee is working light duty, on a part-time basis or full-time basis, and earns less than he or she would have earned if employed full-time, the employee may be entitled to TPD benefits.
If the employee is entitled, TPD shall be paid at two-thirds of the difference between the average amount that the employee would be able to earn in the full performance of his or her duties in the occupation in which he or she was engaged at the time of the accident and the net amount which he or she is earning in the modified job for the employer or in any other job that the employee is working.
Permanent Partial Disability Benefits
After an injured employee has returned to work a doctor will make a determination at some point that they are at Maximum Medical Improvement, or MMI. This is the point in a person’s treatment where the injured employee has essentially rehabilitated their injury as best they can through medical treatment. At this time the injured worker, depending on the case, may be entitled to Permanent Partial Disability (“PPD”) benefits.
Each injured employee is entitled to what is legally referred to as loss of the use of the part of the body they injured, or if a non-specific injury, they are entitled to loss of the use of their body as a whole. Just as TTD benefits are based on 66 2/3% of an injured employee’s wage, PPD is calculated based on 60% of a person’s wage. For example, say your average weekly wage was determined to be $600 per week, based on Illinois statute and case law. Your PPD rate would be 60% of $600, or $360. If an Illinois Workers’ Compensation Commission arbitrator awarded you ten weeks of PPD for a thumb injury, you would receive $3600 or $360 multiplied by ten weeks.
It is against the law for an employer to fire an injured employee for filing a claim for benefits
It is a common fear of injured employees that they will be fired the moment they file a claim with the Illinois Workers’ Compensation Commission to enforce their legal rights under the Act. It is important to note that this is a direct violation of the Act for an employer to do so. A fired worker may have a civil claim for retaliatory discharge if they can prove that the firing was related to the filing of their claim or the exercising of their rights under the Act. If you are terminated and have a work comp claim you should contact an attorney such as myself immediately.
There are three basic things you should remember if you have an injury at work. First, do immediately obtain the proper emergency medical treatment you need after the accident. You can speak to your employer at a later date. Second, give notice (oral or written) of the accident to your employer within 45 days of the occurrence. Third, remember that there are statutes of limitation in effect that require you to file a claim within a specific period of time or you will barred from obtaining any benefits you are entitled. If you have a legal question regarding the relevant statute of limitations period, consult an attorney experienced in workers’ compensation soon after your accident.
This post is not intended as a complete guide to the benefits an employee may have a right to or the obligations he or she may be subject to under the Illinois Workers’ Compensation Act. Each individual case has its own set of facts and circumstances. In addition, there are statute of limitations which provide a specific time period for filing claims under the Illinois Workers’ Compensation Act and the Illinois Occupational Disease Act. You must file a claim within a certain period of time or your right to benefits will be forever barred. The author strongly advises that any person who feels they may have a claim to consult an experienced attorney who handles workers’ compensation cases.