Am I Eligible for Workers’ Comp?

Am I Eligible for Workers’ Comp?

You may wonder, after a workplace accident – am I eligible for workers’ comp? If you have been injured while performing your job duties and have reported the accident to your employer within 45 days, you may be eligible for workers’ compensation benefits in Illinois. This is a type of insurance that covers the cost of medical care, rehabilitation, and disability for workers who have been injured while on the job.

Young woman having back pain while sitting at desk in office. Am I eligible for workers comp.

How Does Workers’ Compensation Work in Illinois?

Workers’ compensation is an insurance policy that financially protects employees injured while on the job. It covers work-related injuries that occur during their employment. Employees don’t have to pursue personal injury claims against their employer. If you get injured at work, workers’ compensation will reimburse you for your medical expenses, a portion of your lost income, and future expenses such as long-term medical care, rehabilitation, and future lost income.

Benefits Provided by Workers’ Comp

The U.S. Department of Labor recognizes four types of workers’ compensation benefits. These are medical benefits, wage replacement benefits, vocational rehabilitation benefits, and other benefits which include death benefits. Each benefit provides targeted coverage and support to workers who have sustained workplace injuries or illnesses.

Medical Benefits

In Illinois, injured employees are entitled to receive necessary medical attention and compensation for associated medical costs through workers’ comp. This includes a wide range of healthcare expenses such as first aid, transportation, emergency room and hospital bills, doctor visits, prescription medication and treatments, medical devices, and institutional care.

Disability Benefits

Work-related injuries can result in employees experiencing partial or permanent disabilities. These disabilities are classified into four types: Permanent Partial Disability (PPD), Permanent Total Disability (PTD), Temporary Partial Disability (TPD), and Temporary Total Disability (TTD).

PPD denotes an enduring injury that restricts an employee’s ability to perform specific job-related tasks, but still allows them to perform other responsibilities. Workers’ compensation may pay a portion of the wage differential in such cases. Alternatively, the employee may receive compensation based on the loss of use of a body part, with the amount varying depending on which body part is affected.

PTD offers lifelong financial assistance to employees who have suffered a permanent injury or illness that prevents them from working. This type of disability rating provides ongoing financial assistance to help offset the expenses associated with living with a permanent disability.

TPD benefits are intended to support employees during their recovery phase when they can only work in a limited capacity. To be eligible for TPD benefits, workers must earn less than they would if they were working at their full job capacity. TPD benefits are granted until the employee can return to their regular job or reach maximum medical improvement.

TTD benefits allow employees to claim a portion of their weekly wage until they fully recover and can return to work. If employees need time off to heal, they may not be able to work at all. Workers’ compensation allows the employee to claim a portion of his or her weekly wage until they fully recover and can resume work.

Vocational Rehabilitation Benefits

Workers’ compensation can assist employees in their ongoing care, including physical therapy or vocational rehabilitation. This helps the employee learn new skills and provides the opportunity to return to work in a different role. In addition, workers’ comp can cover new training and certifications that may be required.

Death and Funeral Benefits

If an employee loses his or her life because of a work-related injury or illness, the family and beneficiaries may receive benefits through workers’ compensation. These benefits cover expenses like funeral costs and lost income. However, most coverage plans have state-specific limits for these expenses, and insurance companies may reject claims for expenses deemed excessive or unnecessary.

Typically, immediate family members or dependents living with the deceased employee receive workers’ compensation benefits. This includes parents, children, and spouses.

What Are the Eligibility Requirements for Workers’ Compensation in Illinois?

What are the requirements for workers’ compensation eligibility? In Illinois, employees must meet certain conditions to qualify for workers’ compensation.

Employment Relationship

For a claim to be considered legitimate, it is necessary to establish an employment relationship between the employer and the employee. Depending on the employment circumstances, some independent contractors may be covered by workers’ compensation policies, while others may not be eligible for coverage.

The Injury Was Work-Related

The injury must happen while performing a job related duty. If an employee gets injured while performing a duty related to his or her work, it could be challenging to demonstrate that the injury occurred outside the scope of employment, especially if it occurred outside the workplace or during non-working hours. In such situations, it is advisable to seek the advice of a workers’ compensation lawyer. Injuries resulting from pre-existing conditions or other accidents are not eligible for compensation.

Economic and Non-Economic Damages

There must be damages sustained due to the workplace accident; otherwise, there is nothing to claim. Workers who experience losses due to work-related injuries or illnesses may be entitled to receive benefits. These benefits may cover medical expenses, lost wages, reduced work capacity, pain and suffering, and other damages that can be substantiated.

The Employer Must Be Notified

How long do you have to file a workers’ compensation claim after a work injury? In Illinois, employees are required to inform their employer within 45 days. They should follow the policies and procedures set by their employer when reporting the injury.

Coverage for Different Types of Workers

Nearly every employee in Illinois is covered by the Workers’ Compensation Act, which pays benefits to workers and certain dependent survivors. Types of workers that are covered include:

  • Except Illinois police and firefighters, most government employees at state, county, and local levels are covered.
  • Workers of religious or charitable organizations.
  • Workers of private companies, regardless of the size of the company.
  • Employees who were injured outside of Illinois but were hired in Illinois or whose primary workplace is in Illinois.
  • While workers’ compensation may cover domestic workers and farmworkers, it depends on the circumstances.
  • Landscape workers.

Common Misconceptions About Workers’ Compensation Eligibility

There are many misconceptions around workers’ compensation, which can prevent employees from accessing their benefits.

Workers’ Compensation Covers Only Workplace Injuries

Many people mistakenly believe that workers’ compensation only covers injuries that occur within the physical boundaries of the workplace. However, the coverage of workers’ compensation extends beyond the workplace to a wide range of work-related injuries and illnesses that may occur both on and off the premises.

Workers’ compensation also covers occupational diseases that result from exposure or conditions directly related to the work environment. This includes diseases such as lung diseases caused by exposure to hazardous substances or repetitive stress injuries resulting from repetitive tasks. Moreover, if pre-existing conditions are directly connected to the job duties or workplace environment, workers’ compensation may also cover the aggravation or worsening of such conditions.

Workers’ Compensation Is Only for Serious Injuries

Workers’ compensation covers severe injuries and provides benefits for various work-related injuries and illnesses, such as strains, sprains, repetitive stress injuries, and occupational diseases. Even minor injuries that necessitate medical treatment or result in temporary disability may qualify for workers’ compensation benefits.

You Can’t File a Claim if the Accident Was Your Fault

Workers’ compensation is considered a “no-fault” system, meaning employees are eligible for benefits regardless of who was responsible for the injury. The requirement is that employees suffer an injury or accident in the course of employment. Even if an employee’s actions contributed to the accident, he or she may still be eligible for workers’ compensation benefits, as long as the injury occurred during work.

How a Workers’ Compensation Attorney Can Help You

If you have been injured at work and need to file a claim for workers’ compensation, hiring an experienced attorney is beneficial. An attorney can guide you through the process, address any concerns, and know what mistakes to avoid when filing a workers’ comp claim, allowing you to focus on your recovery. An attorney can take care of many aspects of your claim, including:

  • Gathering all the necessary evidence relating to your accident and injury, which may include reaching out to witnesses and obtaining their statements.
  • Assessing the compensation that you are eligible to receive based on the evidence collected.
  • Filing the claim on your behalf with the appropriate parties.
  • Negotiating a fair settlement with the insurance company on your behalf.
  • Resolving any disputes or legal proceedings that may arise, such as representing you in a hearing or trial.
  • Managing all communication with the insurance company to ensure insurance compliance and protect your interests.

If you hire a workers’ compensation attorney early in the process, you are more likely to have your claim approved faster and receive a higher settlement amount. Additionally, you will have a lawyer who is ready to represent you in case your case needs to go to trial or hearing.

David W. Martay David W. Martay
David W. Martay

David W. Martay, a partner at Martay Law Office in Chicago, IL, is a top-rated workers’ compensation lawyer who represents injured employees throughout the state. Known as a highly-skilled advocate for his clients, David has recovered millions for victims of workplace accidents.

Years of Experience: More than 25 years
Illinois Registration Status: Active

Bar Admissions: Illinois State Bar Association

David W. Martay David W. Martay
David W. Martay

David W. Martay, a partner at Martay Law Office in Chicago, IL, is a top-rated workers’ compensation lawyer who represents injured employees throughout the state. Known as a highly-skilled advocate for his clients, David has recovered millions for victims of workplace accidents.

Years of Experience: More than 25 years
Illinois Registration Status: Active

Bar Admissions: Illinois State Bar Association