On July 22, 2005, the Illinois legislature enacted amendments to the workers' compensation statute that include, but are not limited to, medical fee scheduling and the amount awarded for permanent disability. If you have any questions about these changes please contact a qualified attorney.

What should I do when I have been injured at work?
When you have been injured at work you should immediately notify your supervisor of the fact that you had a work accident. Occasionally, an employer designates an individual to receive notice of work accidents. Under the Illinois Workers' Compensation Act an employee has forty five (45) days in which to notify his or her employer, either orally or in writing. Failure to notify an employer of the work accident within the notice period may result in the denial of a claim. It is strongly recommended that notice be given immediately after a work accident even if the employee does not believe that the accident will result in serious injury. When notifying your employer of a work accident, describe the accident fully and the area of your body that was injured.

Do I have to receive medical treatment from the company doctor?
Under the Illinois Workers' Compensation Act, the injured employee has the right to receive medical treatment from two (2) physicians of their own choice. An employer may not compel an employee to receive treatment from its company physician.* Those two physicians may refer an employee to any other physician, clinic or hospital that is reasonable and necessary to cure the employee. All subsequent providers are considered to be within the "chain of referral" and so count as only one physician. An employer is entitled to have the employee examined by a physician of its own choosing but the employee is not required to follow the treatment suggestions of that physician.

Some employers have entered into agreements with employee unions that restrict the choice of physicians from which injured employees may receive treatment to certain select physicians. These physicians are called "panel physicians" and an employee must select a panel physician to provide the necessary treatment.

Can my employer or its workers' compensation insurance company refuse to authorize medical treatment that my doctor has recommended?
The Illinois Workers' Compensation Act does not give your employer, or its workers' compensation insurance company, the right to authorize, or refuse to authorize, payment for medical treatment. By the same token, the Workers' Compensation Act does not explicitly require your employer or its insurance company to provide authorization for payment. This problem arises when a treating physician refuses to provide treatment without authorization from the employer's insurance company. Consult a qualified attorney if this situation arises to determine your options.

How long will it take for my claim to be resolved?
Generally, the length of time that it takes for workers' compensation claims to be resolved depends in large part on the severity of the injury and the length of active medical treatment. Once your doctors have released you from their care, your attorney can begin preparing your case for settlement or arbitration. There are certain factors that may delay the settlement or arbitration of your claim. However, if your attorney is diligent, these delays can be minimized. Such a delay may include obtaining medical testimony from your treating physician or the insurance company's examining physician before the settlement or arbitration of a claim or vocational rehabilitation if the condition prevents the injured worker from returning to their previous occupation .

Additionally, if no acceptable settlement is offered and the injured worker chooses to present his claim to an arbitrator (judge) from the Illinois Workers' Compensation Commission, appeals may delay a final decision. Generally, the arbitrator will issue a decision within two to three months after the date of arbitration. If either party finds fault with the arbitrator's decision, the Illinois Workers' Compensation Act provides a procedure to seek review (appeal) of the arbitrator's decision. The first step in this process is to have the arbitrator's decision reviewed by a three member panel of the Illinois Workers' Compensation Commission. Although additional appeals allow a workers' compensation claim to be appealed all the way to the Illinois Supreme Court, the vast majority of claims are not appealed once the Illinois Workers' Compensation Commission has issued its decision on review.

Can I afford to hire an attorney to represent me in my workers' compensation claim?
Under the Illinois Workers' Compensation Act, attorney fees are limited to a total of 20% of the amount recovered by way of settlement or arbitration. Attorney fees are not recoverable on medical expenses or temporary total disability benefits which are paid in a timely manner and without dispute. Attorneys are allowed to advance payment of the costs of litigation for the client. Such costs include costs of medical records, reports, court reporting fees and costs associated with obtaining a deposition of a physician. If there is no recovery, the attorney may not request that the injured worker reimburse the attorney for the costs he has advanced on the claim. Likewise, if there is no recovery the injured worker pays no attorney fees.

Is my employer required to pay me if my injury prevents me from working?
An employer must pay the employee 66 and 2/3 of his average weekly wage while the work injury incapacitates the worker. This benefit is called temporary total disability benefits (TTD). The employee must be unable to work for at least three days before the right to receive TTD begins. After fourteen days of continuous inability to work, the employee then becomes entitled to TTD from the day after the date of accident. No taxes or social security is withheld from these benefits. A worker need not be rendered completely disabled for this obligation of the employer to pay TTD to arise. If a worker is placed on light duty by his or her treating physician as a result of a work injury, and the employer cannot or refuses to provide light duty work, the same obligation to pay TTD arises.

Can my employer refuse to pay my TTD benefits?
The Illinois Workers' Compensation Act allows an employer to withhold TTD benefits if it has a good faith reason to believe that the accidental injury did not occur as alleged, or if it has a medical opinion from a physician indicating that the condition alleged was not caused by the alleged work accident. A special, emergency arbitration hearing process exists which allows for the relatively prompt resolution of such disputes. If the employer is found by the Workers' Compensation Commission to have unreasonably, vexatiously or in bad faith refused to timely pay compensation, the Workers' Compensation Commission has the power to penalize the employer for its conduct. Such penalties may include an additional award of the amount of attorneys fees, 50% of the compensation awarded and $30.00 per day for each day that an employer withholds payment up to a maximum of 250 days.

How will I be compensated for my injury?
The Illinois Workers' Compensation Act provides different methods by which injured employees can be compensated for permanent disability caused by the injury. You should never assume that your injury has resulted in no permanent disability. There are many factors which are considered in evaluating the extent of permanent disability. Factors considered include: the nature of the injury; the treatment provided; whether the worker has any permanent work restrictions; whether the worker has any permanent symptoms; whether, and in what capacity, the worker is capable of returning to work, and; most importantly, whether the injury has affected the future earning capacity of the worker. Always consult a qualified attorney to determine whether you may be entitled to be compensated for your permanent disability and to determine which method of compensation will more fully compensate you for your injury.

What if my doctor releases me from care with permanent restrictions and my employer will not let me return to work in my previous occupation?
If the permanent effects of the work injury prevent the injured worker from returning to his or her previous occupation, the employer is obligated to provide vocational rehabilitation to the injured worker. Vocational rehabilitation may include assistance in finding a new job or retraining. If the employee has made a diligent attempt to find suitable work without success, the employer may be obligated to retrain the employee and pay additional benefits until the worker has successfully returned to the work force.

What happens if I cannot find work within my permanent restrictions?
If the injured worker has conducted a diligent, yet unsuccessful, job search and vocational retraining is not deemed to be an option, the employee may be found to be permanently and totally disabled. If an employee is found to be permanently and totally disabled the employee is entitled to receive the equivalent of his or her temporary total disability benefits for as long as his or her condition continues. Often your attorney will be able to negotiate a lump sum cash settlement for an amount which would represent the present value of the weekly benefits the disabled employee would be entitled to receive for the remainder of the worker's life expectancy. You should consult a qualified attorney to determine whether you may be entitled to make such a claim.

Apart from my rights under the Illinois Workers' Compensation Act, are there any other rights that I may have?
If a worker is injured by an entity that is not connected with the employment, the worker may have a "third party" claim. Examples of common third party claims include workers injured in automobile accidents during the course of their employment or injury occasioned by a defective product. Always consult a qualified attorney to determine whether you may have a third party claim.

An injured employee may also be eligible to receive Social Security Disability benefits if the employee expects that his injury will prevent him from working for an extended period of time.

Additionally, an employee may have additional rights under the Americans with Disabilities Act. Always contact a qualified attorney to determine whether the Americans with Disabilities Act may provide additional protection.

CAVEAT: The above constitutes general rules which may or may not apply to your unique situation. It is impossible to adequately address all of the potential factual scenarios which may arise in a workers' compensation claim. You should consult a qualified attorney to determine your rights under the Illinois Workers' Compensation Act.

I was obviously injured at work, why would an insurance company deny my workers' compensation benefits?
An insurance company is responsible to make a financial profit for its stockholders. An insurance company does not make a profit by paying out claims without contesting them. An insurance company receives premium payments from its policy holders, like employers, and invests the money it receives in the stock market. Insurance is merely legalized gambling. The insurance company bets that it can make enough interest, or appreciation, on the premiums that it has invested to pay any claims that it is finally forced to pay. The longer an insurance company delays paying those benefits, the more interest that the insurance company makes on its investment. The injured worker needs a qualified, aggressive law firm and attorney, with a reputation for obtaining excellent results for their clients, to force the insurance company to pay the benefits the injured worker deserves.