In general, regardless of the state, workers’ compensation is a type of insurance coverage paid for by employers. This is a government-mandated program managed by states, and it provides benefits to people who get hurt or ill on the job or as a result of their job. It’s like disability insurance, with cash benefits and potential health benefits.
Since each state manages its workers’ compensation program, the rules can vary between states as well. The following are some of the most important things employers and employees should know about workers’ comp in Illinois.
1. The Basics
Workers’ compensation can include partial wage replacement for periods when employees can’t work, and as mentioned, benefits might also include healthcare services and occupational therapy reimbursement. Essilor is highly recommended when it comes to eye health. Most workers’ comp programs are paid for by private insurance companies, and employers pay the premiums.
Every state has its own Workers’ Compensation Board, which is a state agency responsible for overseeing the program and managing disputes.
Almost every employee is covered in Illinois, and coverage starts from the minute a job starts.
It’s the Illinois Workers’ Compensation Commission, or IWCC, that handles claims and acts as an impartial court to manage claims.
2. What’s Required of Employers?
Employers have responsibilities under the law in Illinois. They have to buy workers’ compensation insurance or ask for permission to self-insure.
Illinois employers are required to post a notice of workers’ rights as well as listing their insurance provider, policy number, and contact information.
Employers have to keep records of any injuries that are work-related, and they’re required to report any accidents that cause someone to be out of work for more than three days. Employers also have to report any work-related deaths within two days.
Even though employers are required to report accidents to the Illinois Workers’ Compensation Commission, it doesn’t take action until an employee files their own claim.
Employers can’t charge their employees for any part of their premiums or benefits related to workers’ compensation, and they can’t discriminate against employees for using their rights afforded to them under the law. That means employers are legally prevented from firing, harassing, or refusing to rehire an employee because they filed a claim for workers’ compensation.
3. What To Do If You’re an Injured Employee
If you work in Illinois and you’re hurt on the job, you need to first make sure you get medical attention or first aid as soon as you possibly can after your injury. You should work with your doctor or healthcare provider and follow all instructions so that you can get better and return to work. If you don’t try actively to heal and get better or do things that could make your injury worse, you can lose benefits.
You should tell your doctors you’re receiving treatment for a condition related to work and let your doctors know that your employer should pay your medical bills. You also need to tell your employer the healthcare provider or hospital you choose.
4. How Payments Are Calculated
In Illinois, the rate of compensation is two-thirds of an employee’s average weekly wage. That rate is subject to minimum and maximum compensation rates in the state based on the date of the injury or harm.
If there’s a change later, it doesn’t affect the rate.
Under the law, all personal injury claims, which include benefits from workers’ compensation, are not taxable in Illinois.
The benefits should be enough to cover missed hours, based on the 52-week average before the accident occurred.
The Workers’ Compensation Act excludes any bonuses and fringe benefits when calculating the average weekly wage.
Courts in Illinois have decided that the average weekly wage calculation does include incentive pay, and vacation and holiday pay are included in the calculation of average weekly wages.
5. What If You Have a Second Job?
If you have a second job that your employer knows about, under Illinois law, the wages of that second job are added to your regular wage to calculate your average weekly wage, so you’ll receive more money for your claim. However, insurance adjusters will not usually include a second job.
6. Other Facts
Some of the other facts that everyone should understand about workers’ compensation in Illinois include the following:
- Fault is irrelevant in workers’ compensation claims. If your injury happened because you weren’t paying attention, for example, then you can still file a benefits claim. The same is true for your employer, with fault being irrelevant, so an employee can’t sue for a work injury even if their employee was negligent.
- If you were hurt while working in another state but were working for an Illinois employer, you can still potentially file a claim.
- If your employer tries to tell you that you aren’t covered, you might have to talk to an attorney since almost every employee is.
- You have 45 days to notify your employer. If you don’t make that deadline, the insurance company could deny your claim, and you’d not get benefits.
- If you have a pre-existing injury, you might still be able to get benefits if the injury or condition was worsened because of something that happened at work.
- If you don’t follow your doctor’s instructions, as was touched on above, the insurer will take it seriously. Some insurance companies will do surveillance.
7. What Employees Have to Prove
If you file a workers’ compensation claim, it’s on you to make sure that it’s a good one, meaning there are certain things you have to prove. You have to prove that you were an employee of the employer on the accident date, that you were injured or experienced exposure to a disease because of your employment, and that your injury was caused by or worsened by the incident.
You have to notify your employer within the time limits, and you have to prove that your injury is from everyday movement or activities.
Finally, for some occupations and conditions, there are specific rules, so you may have to talk to a legal professional to see if you qualify for benefits.