How to File a Workers’ Comp Claim in IL
If you suffer a workplace injury, the Illinois Workers’ Compensation Act ensures that you can get the medical treatment you need, along with partial wage replacement while you recover. Injured workers need to file a workers’ compensation claim, but this requires following the right steps to avoid delays in benefits or a denial of the claim.
Hipskind & McAninch, LLC is a firm dedicated to helping injured workers understand workers’ comp benefits and handling employer disputes in the Illinois workers’ compensation process to seek maximum compensation. In this blog post, we explain how to file a workers’ compensation claim, negotiate a workers’ comp settlement, and how a workers’ compensation lawyer in Belleville can help.
Introduction to Illinois Workers’ Compensation
Illinois workers’ compensation is insurance coverage that employers are required to provide for employees from their first date of hire. This no-fault system covers medical care for injuries or illnesses sustained through an employee’s performance of their job duties, as well as lost income at ⅔ of the average weekly wage.
Workers’ compensation in Illinois also provides death benefits of up to $10,000 and weekly compensation for family members when a worker does not survive their workplace injury. In order to make a workers’ compensation claim, injured workers need to follow the correct steps, including reporting their injuries within 45 days and filing with the Illinois Workers’ Compensation Commission (IWCC) within three years.
The amount you receive for your settlement can vary widely and is based on the severity of your injuries and the injured body part, your impairment rating, the cost of medical care needed, your average weekly wage, and your age at the time of injury. It can help to learn more about the average workers’ comp settlement, though a workers’ comp attorney can evaluate your claim and determine the amount of your settlement.
Steps to File a Workers’ Compensation Claim: The Illinois Workers’ Compensation Process
When you suffer a workplace injury, you must follow the right steps to file your workers’ comp claim. In Illinois, the electronic filing system used requires you to create a CompFile account, which streamlines the process for making claims on a work-related accident.
Seek Medical Care Immediately for Your Work Injury
Seek medical attention right away when you have been hurt at work. Illinois allows you to choose your own doctor and you’ll need to let them know you’ve been injured on the job. If you sustain severe or life-threatening injuries, go to the nearest hospital for urgent medical treatment. Once your condition is stable, make sure you get copies of your medical records, which you’ll need to file for workers’ compensation.
Notify Your Employer
After seeking medical attention, you must notify your employer in writing within 45 days. Provide the key details on how, when, and where the injury happened during the course of your work.
Your Employer Files Your Claim with the Illinois Workers’ Compensation Commission
The next step in filing for workers’ compensation in Illinois is on your employer. Once they have been given written notice of your work injuries, they are required to report it to their workers’ compensation insurer and the Illinois Workers’ Compensation Commission (IWCC).
Document Everything
When making a claim for workers’ compensation, you must have proper evidence that you were hurt at work to get the benefits. Organize all records of your medical treatments, medical bills, and other medical expenses. You should also have a copy of your correspondence with your employer and their workers’ compensation insurance company. A copy of the accident report documenting your work injury, along with these items, can be uploaded to the digital filing system with your claim.
What to Do When Employers Refuse to File Your Claim
Illinois law protects you when your employer either doesn’t file your workers’ compensation or fails to have this insurance. You will need to notify the IWCC and begin the legal process.
Meet the Deadlines
After suffering a work injury, you have 45 days to notify your employer in writing. You also have three years to file a formal claim with the IWCC. Missing these deadlines could jeopardize your claim and prevent you from receiving the benefits you need. For these reasons, it is best to have an attorney represent you. They can also help if you need to file an appeal after the IWCC has issued a decision on your claim.
Common Mistakes to Avoid with Illinois Workers’ Compensation Filing
Injured employees often make mistakes when filing workers’ comp, and you’ll want to avoid making any to protect your claim.
Failing to Report Work-Related Injuries Promptly
Every employee hurt on the job must tell their supervisor or employer they were injured within 45 days, ideally sooner. You can verbally tell your employer, but make sure you also issue a written notice that is dated and detailed with the when, where, and how of the injury to serve as documentation. Not reporting the incident in time or failing to document it in writing could mean your claim is denied.
Delaying Medical Care
When you suffer an injury in the workplace, you need to seek medical attention right away. If you don’t, your employer’s workers’ comp insurer will likely deny the claim, as it suggests your injury isn’t serious. It’s also important that you tell the doctor treating you that you were injured at work.
Missing Deadlines
You can’t get full coverage of your medical expenses or lost wages if you don’t file your claim within the time limits. The deadline to file with the IWCC is 3 years from the date of your injury.
Not Following Medical Advice
Illinois workers who sustain injuries in a workplace accident need to follow all the advice provided by their doctors. If your doctor imposes work restrictions, you must follow them. When told you need to see a specialist, you need to go. Not doing these things can result in the insurer refusing to approve your claim.
Posting on Social Media
Watch what you share on your social media platforms, as the insurer can use any photos or updates you post against you to claim your injuries aren’t severe.
Failing to Document with Evidence
In order to get full coverage of medical expenses for your injury, you need to record all details and keep copies of your medical records and receipts. It’s better to have too much evidence than too little, and without any, it’s easy to be denied benefits.
Not Disclosing Pre-Existing Conditions
In Illinois, you can still get workers’ comp even if you have a pre-existing injury; however, you need to be honest about any previous conditions. If your work incident aggravates a pre-existing condition, it should be covered, but you will need documentation and an attorney to help you overcome any challenges.
Trying to Handle Your Workplace Injury Claim Yourself
Employees with work-related injuries often don’t understand their rights, and that means they often accept low settlements or miss important steps in the process. It’s a good idea to use a free initial consultation with an attorney to help you learn more about the compensation you should receive or how to handle an employer who fails to report your injuries.
Understanding Your Rights and Benefits in the IL Workers Comp Process
Injured employees have the following rights and benefits for workers’ comp in Illinois:
Right to Full Coverage for Medical Expenses
Employers are required to cover all reasonable and necessary costs of medical care related to your injury in the workplace. This includes hospital bills, emergency room care, doctor visits, prescriptions, and more. You do not need to pay anything out of your own pocket.
Lost Income Benefits
Your employer must also provide compensation for your lost income after an accident at work. If you are unable to work and the doctor issues a no-work order, you can get Temporary Total Disability (TTD), which provides you with ⅔ of your average weekly wage. The doctor could also clear you for light duty, which qualifies for Temporary Partial Disability (TPD), giving you ⅔ of the difference between your wages pre-injury and light-duty pay. If your accident left you permanently disabled, you may receive Permanent Partial Disability (PPD) or Permanent Total Disability (PTD) that gives you benefits after you reach Maximum Medical Improvement (MMI).
Vocational Rehabilitation Training
Some work accidents may make it impossible for you to return to your previous job, though you are still capable of working in some capacity. For these situations, training may be provided to help you adjust to a new job.
Death Benefits
In certain professions, there are greater chances of fatal illnesses or injuries. When an employee does not survive, their family members can receive death benefits. This includes coverage for funeral and burial costs, as well as benefits paid out weekly.
Illinois requires almost all employers to carry workers’ compensation insurance that covers full-time, part-time, or seasonal employees from their start date. This coverage must be in place when a company has one or more employees, and those in hazardous occupations, such as construction, and all public entities, are required by law to have it or face hefty fines. If your employer failed to keep an active status on their workers’ comp insurance, did not report your injury to the IWCC, or you were injured by a third party, do not hesitate to speak to a lawyer as soon as possible to avoid missing deadlines.
The Role of Medical Evidence in Your Claim
Any employee who sustains injuries or illnesses while performing the duties of their job can file a workers’ comp claim through their employer. However, medical evidence is required to prove that the injury is work-related. Evaluations from doctors help determine the payment you receive and your return-to-work status. Medical evidence plays a huge role in your claim and your eligibility for these benefits.
Proving Causation
Medical records and documentation help you prove that your injury is related to work. When you go to the hospital or see a doctor after your injury, make sure that you let them know you were injured on the job. Your medical records will then prove that your condition is connected to your job duties.
Various Types of Evidence
What the doctors say bears a lot of weight in these decisions, and their notes should be comprehensive for sharing their medical opinions. Along with these notes, you should have imaging results from MRIs or X-rays, test results, notes from your physical therapy sessions, and detailed treatment plans. This tells the insurer about the severity and scope of your injuries.
Independent Medical Examinations (IMEs)
Workers’ comp insurers will also use independent medical examinations (IMEs) to challenge the need for certain treatments or force you to return to work. They do this to reduce the amount of your benefits or to put an end to them completely. Since the insurer picks the doctor for the IME, they may be biased, but you have the right to request your own IME to challenge the results.
Documenting Pre-Existing Conditions
You can still collect workers’ comp even if you have a pre-existing condition. It is a bit more challenging to prove, though a lawyer can help you gather the evidence you need to show that the incident at work aggravated or accelerated your condition.
Weak medical documentation is one of the most common reasons for claim denials. The strength of what you present matters and directly impacts the value of your claim. When you’ve sustained serious injuries doing your job, you must use medical evidence to prove you are eligible for these benefits.
Hipskind & McAninch, LLC’s Approach to Handling Claims
Hipskind & McAninch, LLC meticulously builds strong cases on behalf of injured workers to maximize compensation. Our client-focused approach and trial-ready investigations ensure that we can stand up to employers and their insurers when claim denials or low settlements are wrongfully issued.
Speak with us today in a free, no-obligation initial consultation to learn more about how to file your claim and overcome challenges to get the workers’ comp settlement you deserve.
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