The Illinois system of workers' compensation is compulsory, meaning that employers are required to provide workers' compensation insurance to their employees. Workers' compensation insurance may be provided through private insurance carriers or self-insurance. Waivers may be permitted to exclude certain employees from coverage, including corporate officers, sole proprietors and children working on family farms.
Exemptions from coverage may apply to certain employees, including agricultural employees and domestic workers.
Medical Benefits are provided to employees entitled to workers' compensation benefits, with medical care subject to utilization reviews that may limit treatment.
The employee makes the choice of initial treating physician, and has the right to make two subsequent changes of doctor. In most cases only one second opinion will be allowed.
Indemnity benefits are payable to injured workers to help make up for lost income. There is a waiting period of 3 days before a worker is eligible for indemnity benefits, but if the worker's disability lasts more than 14 days indemnity benefits become retroactive to the date of the injury.
Benefits available to injured workers include the following:
Temporary Total Disability (TTD)
Temporary total disability (TTD) benefits are paid to workers who are unable to work due to injury, but who are expected to make full or partial recovery such that they may return to work. Benefits are based upon 2/3 of the worker's average pre-injury weekly wage, subject to a cap, and continue for the duration of the temporary disability.
Permanent Total Disability (PTD)
When a worker is not expected to recover from a total disability caused by a work-related injury, and as a result suffers a total loss of earning capacity, the worker becomes eligible for permanent total disability (PTD) benefits. In Illinois PTD benefits are calculated based upon 2/3 of the worker's average weekly wage, subject to a cap, with a guaranteed minimum benefit, and may continue indefinitely. Benefits are periodically adjusted for inflation.
Permanent Partial Disability (PPD)
Once an injured worker has recovered to the maximum possible extent, the worker may be able to return to employment but nonetheless remain partially disabled, and may potentially qualify for permanent partial disability (PPD) benefits. In Illinois PPD benefits are determined based on a statutory schedule. For unscheduled injuries, the amount and duration of PPD benefits are based upon the worker's functional impairment rating, and 60% of the worker's average weekly wage, with benefits payable for a maximum of 500 weeks.
Temporary Partial Disability (TPD)
When a worker suffers an injury that limits his ability to return to work, resulting in a reduction of income as a result of reduced hours or wages, the injured worker may be eligible to receive a benefit based on the difference between the worker's pre-injury earnings and their reduced, post-injury earnings. In Illinois, TPD benefits are paid based upon 2/3 of the difference between the injured worker's pre-injury and post-injury wage, subject to a cap.
Coverage may be available for cumulative trauma, disfigurement, mental stress and occupational hearing loss.
For some, more serious injuries, workers' compensation indemnity benefits may be paid according to a statutory schedule, instead of following the standard model of the weekly benefit based on the duration of the disability. Scheduled injuries include such injuries as the amputation of an arm, the loss of a dominant hand, the loss of a leg, the loss of a foot, the loss of an eye, or loss of hearing in an ear.
When a worker dies as the result of a work-related injury, workers' compensation pays additional benefits, including a burial allowance, and benefits for a surviving spouse and dependents. Survivor benefits are calculated based on 2/3 of the worker's average weekly wage, subject to a cap in amount and duration. Benefits may continue for minors until the age of 18, or the age of 25 if the dependent is a student. Spousal benefits end upon remarriage.
Attorney fees are limited by statute to 20% of the disputed amount, up to 364 weeks of benefits at the permanent total disability (PTD) rate.
This article provides a quick overview of the benefits available to injured workers, but the full formulas used for assessment of benefits, coordination of different types of benefits, and assessment of injuries and disability ratings can quickly complicate the determination of benefits. Also, states frequently revise their workers' compensation laws. Most workers who suffer a significant injury or wage loss as the result of a workplace injury will benefit from consulting a workers' compensation lawyer.
The state agency responsible for workers' compensation is:
Illinois Workers' Compensation Commission
100 West Randolph Street
Chicago, IL 60601
(312) 814-6611 or 1-866-352-3033 (Toll-Free in Illinois)