Workers Compensation Act of Illinois: Frequently Asking Questions

If you are hurt at work, the Workers' Compensation Act of Illinois sets forth your rights. Understanding your workers' compensation rights is therefore important. When others deny or limit these rights you must decide either to fight for them or forget them. The mere fact that the law gives you certain rights does not mean others will recognize them.

While these questions and answers highlight those rights, it is impossible to cover every situation. Recognizing this limitation, we hope you will find the following information a helpfull reference source. The information provided is only general information and should not be construed as legal advice or applicable to all factual situations.

We will be happy, without charge, to answer any questions you might have. Your questions are the best indicatiors of what clarifications or additions are needed.

HOW DOES THE WORKER'S COMPENSATION SYSTEM WORK?

Ordinarily, if you are hurt at work, a claim is filed with the Illinois Industrial Commission, whose members are appointed by the Governor. There are two stages of proceedings before the Industrial Commission: arbitration and review. If the parties cannot settle voluntarily, then an arbitrator is assigned to hear both sides. If either party is dissatisfied with the arbitrator's decision, a review (appeal) to the Commission is allowed. A panel of at least three Commissioners will review the Arbitrator's decision. In most cases, that is the extent of any hearings. However, if a party is still dissatisfied, there are provisions to appeal to the Circuit Court of the County where the accident occurred and, thereafter, to the Illinois Appellate and Supreme Court.

IS THE FILING OF A WORKERS' COMPENSATION CLAIM A PROTECTED RIGHT?

The Act provides:

It shall be unlawful for any employer, insurance company or service or adjustment company to interfere with, restrain or coerce an employee in any manner whatsoever in the exercise of the rights or remedies granted to him or her by this Act or to discriminate, attempt to discriminate or threaten to discriminate against an employee in any way because of his or her exercise of the rights or remedies granted to him or her by this Act.

It shall be unlawful for any employer, individually or through any insurance company or service or adjustment company, to discharge or to threaten to discharge, or to refuse to rehire or recall to active service in a suitable capacity an employee because of his or her exercise of his or her rights or remedies granted to him or her by this Act.

WHEN MUST YOU FILE YOUR CLAIM?

Your claim must be field with the Illinois Industrial Commission within three years of the date of accident or within two years of the last payment of compensation, whichever is later. If your injury resulted from repeated stresses associated with your employment, rather than a single incident, then your claim must be filed within three years of the date when you as a reasonable person would both know of the injury and that it was caused by your employment. Filing the claim with your employer or your employer's insurance company is not enough.

The fact that you are under medical care does not extend the time for filing. The fact that your employer has paid group sickness and accident insurance benefits rather than workers' compensation benefits can, under certain circumstances extend the time for filing, however, there are a number of exceptions and reliance on this is risky. If your employer or their insurance company misleads you so that you do not file on time, courts may stop the employer from objecting to the late filing of your claim. If your employer settles with you without obtaining approval of the Illinois Industrial Commission, then you may be able to file your claim even after the time for filing has expired.

While you have a fairly good amount of time within which to file your claim, an early filing is in your best interest. The legislature can, at any time, shorten your filing time. An early filing guarantees that you will not overlook the date by which your claim must be filed. Further, important witnesses and records often disappear if one waits too long and intervening accidents, injuries or health conditions may unnecessarily complicate your case.

WHERE WILL MY CASE BE HEARD?

If your case is not voluntarily settled, the State will appoint an arbitrator to hear your case near the area where the accident occurred.

WHAT BENEFITS ARE PROVIDED BY THE WORKERS' COMPENSATION ACT?

When you are injured by an accident at work you are entitled to:

  1. Immediate and continuing medical attention including rehabilitation or retraining;
  2. Compensation for your period of time lost from work;
  3. Compensation for permanent injuries resulting from the industrial accident.

The Industrial Commission pays for these benefits and not the employer or employee. You must be restored as completely as possible to good health and be well compensated for any remaining disability.

WHAT IS AN ACCIDENT?

An accident is any unexpected event or result. If you lift something and injure your back or fall and break your leg, the accident is easily noted. While not as obvious, a hearing loss due to loud noise levels and heart attacks, carpal tunnel syndrome or similar conditions following repeated physical stress are also accidental. Psychological injuries following a severe, identifiable mental stress are often considered accidental.

An injury is accidental even if it aggravates an old condition or injury. This is true whether or not compensation for the old injury or condition has been previously paid.

IS COMPENSATION PAYBALE WHERE THE ACCIDENT AGGRAVATES AN OLD CONDITION?

Except for hearing loss claims, (see page 8)where an employee aggravates or re-injures a pre-existing condition, he has all the rights under the compensation law as though he had no previous condition or injury.

WHAT ACCIDENTS ARE COMPENSABLE?

All accidents which arise out of and in the course of your employment are compensable. Such accidents are compensable regardless of who is at fault. An obvious example is an accident, which occurs due to performance of you regular work duties.

A few examples of less recognized but usually compensable accidents include accidents, while engaged in reasonably expected conduct, due to hazards on company-owned, maintained or controlled property, including accidents which occur at company-sponsored sporting, social or recreational events which you are required to attend, accidents while carrying out a mission at your employer's direction, accidental injuries due to work-related fights if you are not the aggressor, horseplay accidents at work if you are the victim and lunch and break time accidents.

WHAT NOTICE SHOULD BE GIVEN TO YOUR EMPLOYER WHEN AN ACCIDENT OCCURS?

Your employer should be should of the accident as soon as it occurs even though the law allows you forty-five (45) days to do so. It is best to notify your employer immediately as this will avoid a dispute which could delay payment of benefits.

Notification of the accident must be given to a company foreman, superintendent, nurse or other management person in charge. Notice of the accident to a co-employee or your union is not notice to your employer. Notice can be given orally or in writing.

Failure to notify you employer may result in the denial or delay in the payment of benefits.

Your notice may prompt a call from your employer or their insurance carrier seeking a recorded or signed statement. They often represent that a statement is required if they are to pay lost time or medical benefits. Such a statement is not legally required and cannot be compelled. The employer should have sufficient information through your notice, the employer's records and medical reports. When a statement is insisted on, it is usually an indication that you are in need of legal advice. More often than not they are looking to confirm some specific fact or set of circumstances which will allow them to delay and dispute your claim.

WHAT IS MEDICAL ATTENTION?

Medical care starts with first aid. It continues with such care that is required by the nature of the injury. The settlement of your case will customarily release your employer from their obligation to pay for further medical care. However, where needed, there are legal means to keep your right to paid medical care open for the remainder of your life.

You can select your own doctor, hospital, chiropractor and under certain circumstances, a faith healer. You need not use doctors designated by your employer. While your employer cannot control who treats you, they can require an evaluation by a doctor of their choosing provided they advance payment of your expenses including travel, meal money and lost wages, and if necessary a means of getting to their appointment.

IMPORTANT: You have the right to choose your first doctor. If you are dissatisfied with that choice, you can choose a second doctor. The use of any health care provider in the chain of referrals from your chosen doctor, is not another choice. If you wish to choose a third doctor, it requires your employer's approval or you pay. If your employer does not approve of your third choice, they must choose and provided all further medical care. You can always choose who treats you at your expense.

WHAT VOCATIONAL REHABILITATION SERVICES ARE AVAILABLE?

If your injury does not permit you to return to your former employment activities or other suitable employment, you are entitled to vocational rehabilitation services. These are designed to return you to work hopefully at an equivalent hourly rate of pay or salary. This can include assistance in locating work, additional technical training or schooling. Insurance companies are often reluctant to involve themselves in this aspect of your claim and instead offer what they call "medical management". Medical management amounts to a company nurse or other specialist seeing you at your home or accompanying you to doctor visits. "Medical management" may be declined. Your participation in medical management is not required by the Workers' Compensation Act and your benefits may not be properly terminated if you refuse such assistance.

When it becomes apparent that the employee will be unable to resume his regular duties or when the total period of lost time exceeds 120 continuous days, whichever occurs first, the employer or their representative, in consultation with an injured employee and the employee's representative, if any, must prepare a written assessment of the course of medical care and any rehabilitation required to return the injured worker to his employment. Because these meetings often involve an interview with an employer's representative, it is best that you be completely advised and preferably represented by an attorney at the time of such an interview.

Although the law does not grant employers or their insurance companies that right, they often, if not always, will take the position that any vocational rehabilitation will be provided solely through their representatives. A dispute as to whether you work with their representatives or those of your own choosing is a signal that you are in need of legal advice.

The Workers' Compensation Act requires an employer to notify each injured employee of his rights to rehabilitation services and of the locations of available public rehabilitation centers or other rehabilitation services of which the employer has knowledge. One such agency, The Illinois Department of Rehabilitation (DORS), has offices throughout Illinois.

WHEN DO LOST TIME BENEFITS START?

There is a waiting period of three (3) working days. Compensation is payable beginning on the next day and continues so long as you are unable to work. After fourteen (14) calendar days of lost time, you are entitled to receive payment for all working days and calendar days not paid during the waiting period. Industrial Commission rules require that payment be made within fourteen(14)days of an employer's knowledge of your inability to work.

HOW LONG DO LOST TIME BENEFITS CONTINUE?

There is no time limit on lost time benefits. They continue as long as you are temporarily unable to work. If you are released for work with temporary physical restrictions, your compensation payments should continue unless your employer can return you to work within those restrictions.

FOR PURPOSES OF LOST TIME BENEFITS HOW DO I DETERMINE MY AVERAGE WEEKLY WAGE?

Your annual wage includes your regular pay, base earnings from mandatory overtime and earnings from a second job if the employer, for whom you were working when injured had knowledge of your other employment. Your weekly lost time benefit is figured as follows:

  1. If you were in the same employment for a year before your injury, the following applies:*
    1. If in the year before your injury, illness or disablement, you worked without losing five (5) days, whether in the same week or not, divide your total earnings by fifty-two (52). The result is your average weekly wage.
    2. If in the year before your injury, illness or disablement, due to any cause, you lost five (5) or more days from work, whether in the same week or not, divide your annual earnings by the days you worked in that year. This provides you with your average daily wage. To determine your average weekly wage multiply your daily wage by the number of days which constitute your regular workweek. The result is your average weekly wage.
  2. If you were not in the same employment for a year before your injury, the following applies:
    1. Divide your regular earnings by the number of weeks during which you actually worked. The result is your average weekly wage.
    2. If due to the shortness or the casual terms of your employment, it is "impractical" to compute your average weekly wage by 2.A, then "regard" shall be had to the average weekly wage which would have been earned by a person, working for the same employer, in the same grade, and doing the same work for the prior fifty-two (52) weeks.

Any dispute as to your proper rate indicates a need for legal advice.

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*Employees in the construction trades are usually treated as fifty-two week employees where the nature of their employer's business or weather account for less than fifty-two (52) weeks of work per year.

ARE LOST TIME BENEFITS SUBJECT TO MAXIMUM AND MINIMUM AMOUNTS?

The law does limit your maximum and minimum lost time payments. Your weekly maximum benefit depends on the date of accident, as follows:

  • From
  • To
  • Weekly Benefits


  • January 15, 1996
  • July 14, 1996
  • $760.51


  • July 15, 1996
  • January 14, 1997
  • $767.71


  • January 15, 1997
  • July 14, 1997
  • $781.17


  • July 15, 1997
  • January 14, 1998
  • $796.97


  • January 15, 1998
  • July 14, 1998
  • $815.08


  • July 15, 1998
  • January 14, 1999
  • $843.47


  • January 15,1999
  • July 14, 1999
  • $862.80


  • July 15, 1999
  • January 14, 2000
  • $885.53


Your weekly minimum benefits depend on your marital/dependent status.

  • Single
  • $100.90


  • Married

  • $105.50


  • Married, One Child

  • $108.30


  • Married, Two Children

  • $113.40


  • Married, Four or more Children

  • $124.30


If your gross wage is less than these amounts then your gross wage is payable as a minimum benefit.

IF INJURED WHILE WORKING AS A MEMBER OR TRAINEE OF A VOLUNTEER FIREMAN, POLICEMAN OR CIVIL DEFENSE UNIT, WHAT RATE OF COMPENSATION DO I RECEIVE?

Your weekly compensation benefit will be based on your average weekly wage in your regular employment.

AFTER PAYMENT OF LOST TIME AND MEDICAL BENEFITS, AM I ENTITLED TO ADDITIONAL PAYMENTS FOR MY INURY?

You are entitled to additional compensation for most injuries.

Often insurance carriers will offer what you may think is a generous settlement. A settlement, if approved by an Arbitrator or a Commissioner of the Industrial Commission, ordinarily terminates your claim and you are left unprotected in the event your condition worsens. A trial, as opposed to a settlement, does not conclude your case. It leaves your right to related lost time and medical benefits open for life and a claim for additional disability benefits can be filed within thirty (30) months of the Arbitrator's or Commission's final decision.

WHAT IF MY INJURY PREVENTS ME FROM RETURNING TO MY FORMER LINE OF WORK?

If other suitable work is not available, then you should receive whatever treatment, instruction and training is necessary for your physical, mental or vocational rehabilitation. During such time, you should also receive all maintenance costs and expenses incidental to your retraining. Ordinarily this includes lost time benefits. If you must return to a lesser paying job then you may be entitled to receive certain wage loss benefits. These are payable so long as you remain disabled from resuming your previous work.

IS COMPENSATION PAYABLE FOR LOSS OF HEARING?

Compensation is payable where the injury results in partial or total loss of hearing in one or both ears.

The law effective September 15, 1980 established new hearing loss standards. A hearing loss affecting frequency tones above 3000 cycles per second is not considered disabling. A doctor or audiologist can tell you if your loss is above or below 3000 cycles per second. Your employer is not responsible for any hearing loss previously compensated or which existed on July 1, 1975.

While many other standards were enacted, their application to hearing losses before or after September 15, 1980 requires a consideration of too many individual facts as to be stated in any meaningful way.

IS SCARRING COMPENSABLE?

Compensation is payable for serious and permanent disfigurement to the head, face, neck, arm, hand, leg below the knee, or body scars above the chest line.

Some scarring in a compensable or non-compensable area may be compensated, if serious enough, on a disability basis. This can result in a more substantial benefit.

WHAT BENEFITS ARE PAYABLE WHEN THE ACCIDENT RESULTS IN TOTAL DISABILITY OR DEATH?

The benefit is based on the same formula as described on page 7, subject to certain maximum and minimum amounts.

The maximum weekly payment is established twice a year and depending on the date of the accident, with some cost of living adjustments it is as follows:

  • From

  • To
  • Weekly Benefit


  • January 15, 1997

  • July 14, 1997
  • $781.17


  • July 15, 1997

  • January 14, 1998
  • $796.97


  • January 15, 1998

  • July 14, 1998
  • $815.08


  • July 15, 1998

  • January 14, 1999
  • $843.47


  • January 15, 1999

  • July 14, 1999
  • $862.80


  • July 15, 1999

  • January 14, 2000
  • $885.53
  • January 15, 2000
  • July 14, 2000
  • $899.81
  • July 15, 2000
  • January 14, 2001
  • $1927.06


The minimum weekly payment is also established twice a year and depending on the date of the accident, is as follows:

  • From

  • To
  • Weekly Benefit


  • January 15, 1997

  • July 14, 1997
  • $292.94


  • July 15, 1997

  • January 14, 1998
  • $298.87


  • January 15, 1998

  • July 14, 1998
  • $305.66


  • July 15, 1998

  • January 14, 1999
  • $316.30


  • January 15, 1999

  • July 14, 1999
  • $323.55


  • July 15, 1999

  • January 14, 2000
  • $332.08
  • January 15, 2000
  • July 14, 2000
  • $337.43
  • July 15, 2000
  • January 14, 2001
  • $347.65


Total disability benefits are payable for life. Death benefits with some limitations as covered in the next section, are generally payable for twenty (20) years, or until $250,000.00 has been paid, whichever is greater.

TO WHOM ARE DEATH BENEFITS PAYABLE?

Where an accident results in death and there is no surviving spouse or dependent child, benefits are payable under different circumstances to relatives of the deceased. As this does not occur often and the rights of various relatives depend on a number of facts, we will concern ourselves only with the rights of surviving spouse and dependent children.

For purposes of benefits, a surviving spouse is a spouse validly married to the deceased at the time of death. If the spouse is separated, but not divorced, the marriage still validly exists.

A dependant child is a child eighteen (18) years of age or under twenty-five (25) years of age if enrolled in an accredited educational institution or, any child, regardless of age, who is physically or mentally incapacitated at the time of the parent's death.

A dependent child includes a child born after death, a child legally adopted, a child whom the deceased employee was legally obligated to support or a child over whom the employee acted as a parent, even though that child may not have been the deceased's child by birth or adoption.

If there are surviving dependent children not residing with the surviving spouse, the compensation payment is divided equally between all beneficiaries.

The remarriage of a surviving spouse may cause the termination of benefits by a lump sum equal to two (2) years of benefits. Currently, there are circumstances where remarriage does not affect the continuation of your benefits. Therefore, if you are considering remarriage you should consult and attorney to determine the applicable law.

Payments to a dependent child continue until such child reaches eighteen (18) years of age or if enrolled in an accredited educational institution, until twenty-five (25) years of age. A child less than eighteen (18) years of age at the time of the parent's death, however, receives not less than six years of benefits even if those payments continue after age eighteen (18).

For deaths on and after burial benefit is payable. In the event the employee survives the accident for a period of time, then all medical expenses and lost time benefits are payable in addition to all death benefits.

In some rare cases, an employer who "elects" to obtain life insurance policies for his employee, can also "elect" to apply such life insurance benefits in total or in partial payment of the death benefit. If such a credit is claimed, consult an attorney.

DOES THE FILING FOR GROUP BENEFITS STOP AN EMPLOYEE FROM ALSO FILING FOR WORKER'S COMPENSATION BENEFITS FOR THE SAME CONDITION?

A worker's compensation claim is often more difficult if you have mistakenly applied for group sickness and accident benefits. You may have signed forms indicating that the injury was not work related. This can often be overcome even though you have applied for or received other benefits. If you were injured at work you should file a workers' compensation claim.

SHOULD AN EMPLOYEE FILE FOR BOTH WORKERS' COMPENSATION AND SOCIAL SECURITY BENEFITS?

You should file for social security benefits if you have been disabled more than four months and believe you may be disabled for a year or more. If the Social Security Administration determines that your disability will last for a year or more, social security benefits will be payable and your future social security rights will be protected.

DO I NEED AN ATTORNEY?

An attorney is not required. However, we recommend the use of an attorney experienced in workers' compensation matters. The company will be represented by such an attorney or other experts. Your attorney will review all medical records, determine the seriousness of your injury and evaluate a proper settlement. An attorney can try your case. If your case is tried, your right to future medical benefits remains open for life and if your condition worsens, you may return to the Industrial Commission within 30 months of the initial award of permanent disability and claim additional permanent disability benefits.

If you settle your case and that settlement is approved by the Industrial Commission, your rights to future medical care or future increased disability benefits are ordinarily extinguished. If giving up these rights is important to you, you should consult an attorney.

If a workers' compensation attorney obtains a recovery for your injury either by trial or settlement, a fee of 20% of that recovery is charged. If there is no recovery there is no fee.

MAY A WORKER DRAW BOTH UNEMPLOYMENT AND WORKER'S COMPENSATION BENEFITS?

When a worker is not being paid workers' compensation benefits, either because the claim is disputed or workers' compensation benefits have been terminated, a worker may be eligible for unemployment benefits. If the employee has a return to work slip permitting restricted or light duties and the employer cannot accommodate these or has terminated the worker's employment, then the unemployment bureau may pay unemployment benefits so long as the worker is seeking work within his restrictions. In that case, should you be asked on an unemployment form whether you are ready, willing and able to resume work, the answer should be: "Yes, within my restrictions." Should the worker later recover workers' compensation benefits, the law requires that, to the extent workers' compensation is paid for the same weeks, that unemployment benefits be repaid.

CAN A WORK INJURY ENTITLE ME TO BENEFITS OTHER THAN STATE WORKERS' COMPENSATION BENEFITS?

Where your injury is caused or contributed to by circumstances created by someone other than your employer or co-employee, you can bring a court action to recover damages from other responsible parties. In such cases it is necessary to prove someone other than your employer or a co-employee was at fault. Examples of this would include negligence cases, cases against manufacturers whose products caused your injury or physicians whose malpractice has injured you further. There are other examples too numerous to mention. Such cases should be investigated early to preserve evidence and insure that all legal notices and filings are filed within the time required by law.