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| Leading Illinois Workers' Compensation Law Attorneys |
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Workers' compensation law is complicated and its regulations and procedures frequently change. A worker with questions concerning workers' compensation should consult an attorney, particularly after suffering an injury. This chapter provides an outline of Illinois' workers' compensation program. Other employment issues, including discrimination against persons with disabilities, are discussed in the Employment Law Chapter.
Workers' compensation came to the United States in about 1910, when New York and Massachusetts adopted programs. Illinois adopted its workers' compensation program in 1911. This program is administered by the Illinois Industrial Commission.
The advent of workers' compensation relieved injured employees from having to sue their employers to collect any sort of damages. Before workers' compensation, an employee had to prove that the employer had negligently failed to provide a safe work environment. This was often difficult and resulted in many injured workers going without compensation. Under workers' compensation, however, employees usually collect benefits regardless of fault. That is, even if an employee is responsible for his or her own accidental injury, the employee is covered by workers' compensation under most circumstances, as long as the injury occurred on the job. The main restriction to the program is that in most cases, workers' compensation benefits are the only form of remedy for workplace injuries. After receiving benefits, an injured employee may not sue his or her employer for further compensation.
Employers who are not automatically required to carry coverage under the Workers' Compensation Act may elect to do so voluntarily, or they may elect to be self-insured. In 1988, Illinois passed legislation that encourages businesses to apply for self-insurer status. Selection of one option does not, however, preclude an employer from changing to the other status at a later date. Regardless of the option selected, every employer must post notices in the workplace that provide employees with the name, business address, and telephone number of the person, service company, or insurance company to contact for information regarding the coverage.
An employee's injury must arise "out of and in the course of employment" to be covered by workers' compensation. Basically, this means that the injury has to occur while the employee is involved in some activity directly related to his or her job. For example, an employee injured at the job site while performing tasks at the direction of the employer is covered. An employee who is injured on a business trip is covered as long as the employee is engaged in employment duties. Workers' compensation coverage even extends to an emergency situation in which an employee leaves work intending to save life or property. Under Illinois law, however, an employee is not covered during volunteer work-related or work-sponsored recreational events (such as sporting events, picnics, or parties) unless the employee was assigned or ordered by his or her supervisor to participate. An employee is not covered while traveling to or from the place of employment, unless the employer asks the employee to perform a special duty on the way. Employees injured during work breaks when no work is being performed also may not be covered, depending on the circumstances.
Nature of Injury
Workers' compensation benefits primarily cover accidental injuries. Accidental injuries are those that happen unexpectedly, without design or plan. This includes many repetitive stress injuries such as carpal-tunnel syndrome, as well as heart attacks, strokes, or other physical problems caused by work. In addition to accidental injuries, an employee also may recover if a pre-existing physical condition is made worse by his or her work. Workers' compensation does not cover injuries caused by intentional acts of assault or aggression by an employer or a fellow employee. For those types of injuries, an employee would seek compensation in the civil courts.
Available Benefits
Workers' compensation entitles an employee to all reasonable and necessary medical care related to the injury, to payments for lost wages, and to rehabilitation and training. Under the Illinois Workers' Compensation Act an injured employee may be eligible for some or all of the following benefits:
The trade-off for an employee's relatively simple route to compensation is a limit to the amount of money that can be awarded for a work-related injury. Employers who maintain workers' compensation insurance programs to cover on-the-job injuries are immune from liability unless they act intentionally to cause injury. Coverage under the act does not, however, limit a person from seeking compensation for injuries from a third party whose negligence may have contributed to the injury or death of the worker.
Employers are prohibited from harassing, discharging, or threatening any employee for asserting a valid claim for workers' compensation benefits. It is illegal for an employer to refuse to hire or rehire an individual because he or she exercised his or her rights under the Workers' Compensation Act. It is also unlawful for an employer to refuse to hire or rehire an employee who has a disabling condition from a prior injury. However, if an employee suffers an injury that is made worse because of a condition existing prior to the time of hiring, the employer is protected from some liability under the Illinois Second Injury Law. The purpose of this law is to encourage employers to hire people who may have disabilities from a previous injury.
After receiving actual or constructive notice of the injury, an employer must promptly notify its insurance carrier or the administrator responsible for its workers' compensation program. If the injury or illness keeps the employee off work for more than three days, the employer must do one of the following: (1) start to pay the employee temporary total disability; (2) notify the employee in writing of the additional information needed to begin making payments; or (3) provide the employee with a written explanation of why benefits are being denied. The employer also must file an Employer's First Report of Injury or Illness Form with the Illinois Industrial Commission for all injuries resulting in loss of work of three days or more. These reports must be filed between the 15th and the 25th of each month. If a death has occurred, the employer must notify the Industrial Commission in writing within 48 hours of the death. The employer also must notify each injured employee of his or her right to rehabilitation services, of the locations of available public rehabilitation centers, and of any other services known to the employer. The Illinois Industrial Commission also provides employees with benefits information.
An employee may select his or her own treating doctor or hospital, and should notify the employer of this selection. The employer is responsible for the costs of all first aid and emergency services, two treating physicians, surgeons or hospitals of the employee's choice, and additional care provided through referrals. After this initial treatment phase, the employee must obtain approval from the employer before seeking treatment from additional physicians or at other hospitals. If the employee is treated by non-approved providers, the employer is not required to pay.
The employer may require a person receiving benefits under the Workers' Compensation Act to submit to a medical examination by a physician selected and paid by the employer. This exam may be required to determine the nature, extent, and possible duration of the injury and the disability compensation amounts. The employee may also be required to submit to examination by medical experts selected and paid by the employer. Refusal to submit to required examinations, or attempts to unnecessarily obstruct the exams, may result in the temporary suspension of benefit payments. Suspended payments cannot later be recovered.
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