The first comprehensive workers’ compensation laws in Illinois were passed on March 23, 1911. The laws have undergone countless changes since then, but the basic premise remains the same: Workers’ compensation insurance provides financial benefits to workers who are injured on the job.
Let’s take a look at Illinois’ workers’ compensation laws, including the steps you need to take to file a workers’ compensation claim in The Prairie State.
The basics of workers’ compensation
Workers' compensation is a form of insurance that provides benefits to employees who are injured on the job.
Workers’ compensation is a no-fault insurance system, which means workers injured in Illinois can receive benefits regardless of who's at fault for their injury.
Workers' compensation is also an exclusive remedy, which means that an injured worker almost always has to file a workers’ compensation claim in lieu of a personal injury lawsuit.
Does my Illinois employer have workers’ compensation insurance?
With very few exceptions, Illinois employers with at least one employee (full or part-time) must obtain workers’ compensation insurance.
To find out whether your employer carries workers’ compensation insurance, you can use the free workers’ compensation verification tool. Just type in the state, the coverage date, and the name of your employer.
When choosing a coverage date, it may be helpful to know that there is no waiting period for workers’ compensation coverage. The Illinois Workers’ Compensation Act requires that workers’ compensation coverage begin the moment you’re hired.
What is considered a workers’ compensation injury in Illinois?
In Illinois, injured workers have the burden of proving by a preponderance of the evidence that:
- Their injury arose out of their employment, and
- Their injury was sustained in the course of their employment
An injury is NOT considered to have arisen out of an employee’s employment if it occurred at work but would have occurred anywhere.
For example, if you have a heart attack at work due to high cholesterol, you probably won't receive workers' compensation benefits because your heart attack didn’t arise strictly out of your employment. Your heart attack could have just as easily occurred while driving to the supermarket.
Workers' compensation covers both traumatic work injuries and occupational work injuries:
- Traumatic work injuries are those that result from a one-time accident at work (e.g., getting electrocuted while working on a construction site).
- Occupational injuries occur over a period of time (e.g., repetitive movement injuries).
Unlike many other states, Illinois allows workers to receive workers’ compensation benefits if they sustain psychological injuries due to their employment.
A person may suffer psychological problems as a result of a traumatic work experience (e.g., a police officer who witnesses a shooting) or may become depressed as a result of a physical injury sustained at the workplace (e.g., a construction worker who falls off a ladder, becomes bed-ridden, and falls into a depression).
Maria worked as a packager and assembler for the Pathfinder Company in Cook County, Illinois.
One morning, Maria instructed another worker, Veronica, on how to operate a punch press. Veronica assured Maria that she knew how to use the press. As Maria was walking away from the punch press, she heard screams. Veronica had gotten her hand stuck in the press.
Maria rushed to Veronica’s aid and quickly realized that Veronica’s hand had been severed. Maria fainted at the sight of the severed hand.
A short time after the incident, Maria began experiencing numbness, headaches, blurred vision, nervousness, anxiety, and other psychological complaints.
Maria filed a workers’ compensation claim alleging that she had sustained an injury “arising out of” and “in the course of" her employment. In other words, Maria claimed that she suffered a severe emotional shock as a result of the work incident, and that shock caused her ongoing psychological problems. Maria’s employer disputed the claim.
The Illinois court that heard the case held that there was clear evidence that Maria underwent a traumatic injury and therefore, the subsequent mental problems were compensable.
How do I file a workers’ compensation claim in Illinois?
Injured workers are responsible for filing their own workers’ compensation claims in Illinois.
As an injured worker, you have 45 days to notify your employer of your injury in writing and 3 years to file your claim with the Illinois Workers’ Compensation Commission.
To file a workers’ compensation claim with the Illinois Workers’ Compensation Commission, you must mail your employer an Application for Adjustment of Claim (along with a proof of service stating that you mailed the form).
It’s important to answer ALL of the questions on the Application for Adjustment of Claim. Additionally, you need to mail three copies of the form to the Illinois Workers’ Compensation Commission at:
Illinois Workers’ Compensation Commission
100 W. Randolph Street, #8-200
Chicago, IL 60601
It’s a good idea to keep a copy of the signed application for your records as well.
Once you’ve notified your employer of your work injury, your employer is obligated to provide you with a list of approved medical providers and inform their insurer to begin the claims process.
What benefits does workers’ compensation provide to injured employees in Illinois?
• Medical expenses. Injured workers can receive “reasonable and necessary medical expenses.” These expenses include things like ambulance expenses, doctor’s visits, surgeries, X-rays, prescriptions, and psychological counseling sessions.
Be sure to tell your treating physician to send all medical reports and bills to your employer’s workers’ compensation insurer. The physician should call the employer to get the contact information of the insurance carrier.
• Wage loss benefits. You can receive wage loss benefits if you’re unable to return to work or if you’re unable to return to the same type of work.
Wage loss benefits are calculated according to the nature of the injury, with injuries falling into one of the following categories:
Temporary partial disability (TPD). If you're able to return to part-time or light-duty work while you're recovering but earn less than your normal wages, you may be eligible for temporary partial disability benefits. Temporary partial disability benefits are calculated as ⅔ of the difference between your pre-injury average weekly wages and your post-injury weekly wages (subject to the statutory maximum)
Temporary total disability (TTD). If you're temporarily unable to work, you may be eligible for temporary total disability benefits. TTD benefits are calculated as ⅔ of your average weekly wage prior to your injury (subject to the statutory maximum).
Permanent partial disability (PPD). If you suffer a permanent injury but are still able to work in some capacity, you may be eligible for permanent partial disability benefits in addition to temporary disability benefits. Your PPD award depends on the severity of your injury and the parts of your body affected.
Permanent total disability (PTD). If you're totally and permanently disabled (i.e., unable to return to ANY type of work), you will receive wage loss benefits at the same rate as your TTD benefits, but for life.
• Death benefits. In the event of a fatal work injury, the surviving spouse and dependent minor children may be entitled to weekly benefits at ⅔ of the worker's average weekly wage. In addition, families may receive funeral expenses up to $8,000.
If your initial workers’ compensation claim is denied, all hope is not lost. You have several opportunities to appeal an unfavorable decision.
You can appeal your first denial to the Illinois Workers’ Compensation Commission. Appeals filed with the Commission will go to an arbitrator. The arbitrator will preside over a hearing at which you and your employer will present arguments and evidence. The arbitrator will then issue a decision.
If the arbitrator upholds the denial, you can file a second appeal with the Illinois Workers’ Compensation Commission. A second hearing will be set in which three members of the Commission will listen to both sides and make a decision.
If the second hearing is unfavorable, you can file an appeal with your local Illinois circuit court. Finally, if you’re unhappy with the circuit court’s decision, you can appeal to the Illinois Supreme Court.
An experienced workers’ compensation attorney can help you navigate the complicated appeals process.
Illinois workers’ compensation appeals process
Workers’ Compensation Commission (first appeal) →
Workers’ Compensation Commission (second appeal) →
Illinois circuit court (third appeal) →
Illinois Supreme Court (fourth and final appeal)
Should I hire a workers’ compensation attorney to handle my Illinois workers’ compensation claim?
You’re allowed to hire an attorney at any point in the workers’ compensation claims process. An attorney can present your claim and handle all of the necessary appeals if your claim is denied.
To find an experienced workers’ compensation attorney in Illinois, visit our free online directory.
The basis for personal injury law is fairly straightforward:
If you're injured because of someone's negligence, then you're entitled to recover for your financial losses related to the injury.
The premise for the workers' compensation system is similar:
Your employer is required to have specific insurance that provides benefits if you're injured at work.