Illinois Workers’ Comp Benefits: What You Need & When You Need It

Your guide to medical benefits, lost wages, and disability for a workers’ comp claim

If you were injured at work in Illinois, you might be worrying about how your medical costs will be covered and how you’ll stay afloat financially until you can return to work. 

These are reasonable concerns—but we’re going to walk you through the types of Illinois workers’ compensation benefits you might be able to expect for your injury.

Types of Illinois workers’ compensation benefits

In general, a recipient of Illinois workers’ compensation benefits can receive medical costs, vocational rehabilitation, survivor benefits for family members, and lost wages in the form of disability benefits.

Medical treatment

Illinois workers’ compensation covers all reasonable and necessary medical treatment for a workplace injury or illness. This includes doctor’s visits, hospitalizations, prescription medication, diagnostics like CT scan or MRI, surgery, physical therapy, chiropractic treatment, prosthetic devices, and prescribed medical appliances. It can also include home modifications like a wheelchair ramp if needed.

The injured worker can usually choose their own doctor. However, some employers have preferred provider plans that limit the choice to a doctor on their list. An employee is permitted to opt out of the preferred provider plan, but they must do so in writing. If you choose your own doctor, they must be trained in work-related conditions.

Vocational rehabilitation

That’s a fancy way of saying job training. If the injured worker can’t return to their pre-injury job because of their injury, recovery, or an ongoing disability, they can be entitled to receive job search counseling and retraining. This can include education at an accredited institution. A worker may choose their vocational program.

Death benefits for survivors

If a person who’s eligible for Illinois workers’ compensation dies as a result of a work-related injury or illness, their survivors might be able to claim death benefits. 

Eligible family members include:

• The worker’s spouse and/or children under 18 years old, along with children under 25 years old who are enrolled in an accredited educational institution. 
• Dependent parents of the worker could be eligible if there is no surviving spouse or children. 
• If there are no dependent parents, benefits may be claimed by a person who relied on the worker for at least 50% of their living expenses.

The survivors may receive maximum compensation of $500,000, or 25 years of weekly benefits (whichever is greater). The worker’s estate can recover medical expenses and temporary total disability benefits incurred before their death. The estate may also recover burial expenses up to $8,000.

Disability benefits

There are two types of Illinois workers’ compensation disability benefits.

1. Temporary total disability (TTD) benefits are equal to ⅔ or 66^⅔% of your average weekly wage. You may receive TTD after three days of missed work until 14 missed days. The first TTD payment should arrive in about 14 days, but delays are common. However, if the delay is unjustified, the worker could petition for penalties and attorney fees.
   
   A worker is entitled to TTD if:
   
   – Your doctor indicates that you are unable to return to work temporarily; and
   – Your doctor prescribes light-duty work but your employer does not have a job role that would suit your needs at that time.
   
   A worker receives temporary partial disability (TPD) if they are recovering from their injury and may work light-duty, part-time, or in a role that earns less than they did before the injury. The employer pays TPD until the worker can return to their regular job OR they’ve reached maximum medical improvement (MMI). MMI is when the person has healed to the fullest extent expected by their doctor.
   
   These benefits are calculated differently from TTD based on the date and extent of the injury and the ability to work. 
2. Permanent disability is available when the worker has reached MMI but is expected never to recover to the condition they were in prior to the injury or illness.
   
   This can happen based on these criteria:
   
   – The injury left you disfigured, like a scar without other injuries.
   – Permanent partial disability (PPD). Any body part that is permanently injured is assigned a number of weeks and the Illinois Workers Compensation Commission (IWCC) determines the percentage of loss for that body part. For instance, amputation would be a 100% loss. There’s also a classification for “person as a whole” which is injury to the back, neck, head, and internal organs.
   – Loss of earning capacity, which means you won’t be able to return to the job from before the injury and can only perform a job that earns less money.
   – Permanent total disability if you cannot return to work at all.

When do you need an Illinois workers’ compensation lawyer?

There are a couple of specific instances when it’s necessary to seek guidance from an Illinois workers’ comp lawyer.

1. If your employer stopped paying your benefits. Sometimes an employer will claim that you are able to return to work; although they are required to provide notice, sometimes this doesn’t happen and an employee is caught by surprise. If your benefits are suddenly terminated, you should contact an attorney for help.
2. If your disability has become more severe and you need additional benefits. You may petition to have benefits increased or reinstated within 30 months of the original decision. However, you likely cannot reopen the claim if you negotiated and signed a settlement agreement, unless the agreement provides that this is possible.
3. If you will need ongoing medical treatment or your condition could worsen, or your related needs could change, you should consult a lawyer before agreeing to a settlement. Generally, you can’t request more benefits once a settlement agreement is signed. Your lawyer has expertise in determining exactly how much you’ll need and for how long you’ll need it. They’re the best ones to negotiate with the insurer to ensure you’re receiving the full compensation you deserve.