Illinois Workers' Compensation Claims: Eligibility, Filing and Appeals
Employers in Illinois are required to purchase workers’ compensation insurance for their employees and the insurance companies fund the payment of worker’s compensation benefits for employees' claims. In the event of a dispute, the Illinois Workers’ Compensation Commission (IWCC, or the Commision) enforces the state's worker’s compensation laws and protects worker rights.
Collecting Illinois Workers Compensation Benefits
Illinois workers' comp benefits include reasonable medical care required to cure or relieve the impact of the injury, temporary total or partial disability disability benefits, vocational rehabilitation, permanent partial or total disability benefits, and death benefits. Workers' comp benefits are not taxable.
Temporary disability benefits are paid at 66 2/3% of your average weekly wage, up to state maximums. Temporary disability benefits are paid once three days of work are missed, unless more then 14 days of work are missed, in which case the first three days of lost wages are paid as well. For more information, see our article on Illinois workers' comp benefits.
Permanent disability is paid either by calculating 66 2/3% of the difference in wages from before and after the injury, or by looking at a “schedule of injuries,” which lists a number of weeks of payments you are entitled to. Or, if you are disfigured, you can obtain up to 162 weeks of benefits at 60% of average weekly wages. For more information, see our article on how to calculate permanent disability payments.
How to File an Illinois Workers Compensation Claim
There are two steps to filing a workers' comp claim in Illinois.
Notify Your Employer
When you are injured at work, you should immediately notify your employer. You must include the date and place of the accident in your notification. Although the notice can be written or oral, the Illinois Workers' Compensation Commission recommends filing the noticed in writing. (Note that telling a co-worker who is not in management does not count as notifying your employer.)
You must notify your employer within 45 days of an accident in order to preserve your right to collect benefits. (If you wait to notify your employer until just before 45 days, however, your benefits will be delayed at least until then, of course.) A delay of more than 45 days may result in the loss of all workers' comp benefits. There are a few exceptions to this rule: If you have a slow-developing illness or cumulative trauma injury (a.k.a. repetitive stress injury), you must notify your employer as soon as you are aware of the condition, know that it's work-related, and suffer a disability from it). If you suffered an injury from exposure to radiation, you have 90 days after you know or suspect that you were exposed to unsafe radiation to notify your employer.
File an Application for Adjustment of Claim
To file a claim with the Commission, you need to mail or give to your employer an Application for Adjustment of Claim, along with a proof or service stating that you’ve mailed or given a copy of the application to your employer. For most injuries, you must file the Application for Adjustment of Claim within three years after your injury or disablement (or within two years of the last compensation payment you received, if this date is later). Here are some exceptions to this general rule:
- Asbestos-related injury, such as mesothelioma or asbestosis: 25 years after the last exposure.
- Pneumoconiosis: 5 years after the last exposure.
- Radiation exposure: 25 years after the last exposure.
- Berylliosis or diseases caused by the inhalation of silica dust: 3 years from the last exposure.
If your employer is paying for your medical treatment and temporary or permanent disability payments as expected, there is no need to file this form. But if you need the Commission to order your employer to pay benefits to you, you need to file a claim. Or, if you anticipate that your employer may need to be forced to pay you benefits in the future (for example, for permanent disability or back surgery), you should file this form.
Your Employer’s Response
Once you notify your employer that you suffered a work-related injury, your employer is obligated to give you a list of approved medical providers and inform their insurer to begin the claims process.
If your injury caused you to not be able to work for more than three days, within 14 days, your employer must either accept your claim and start paying you temporary disability payments or send you a written explanation of why your claim is being denied or delayed in order to investigate (along with what further information from you is needed, if any).
Your employer must also file an accident report with the Commission (Form IC45, Employer’s First Report of Injury) within 30 days of being notified of your injury (if your injury caused you to not be able to work for more than three days). Note that the accident report does not trigger any action by the Commission. If the employer does not respond to your injury notification, you’ll need to file a claim with the Commission.
Appealing an Illinois Workers' Compensation Denial
Common reasons for denial of a workers' comp claim include failure to notify your employer of an injury within 45 days, and failure to prove that the injury arose out of and in the course of work. If you notified your employer of you rinjury within 45 days, but your employer denied your claim, you can petition for review with the Workers’ Compensation Commission. The Commission will hold a hearing and make a determination on your claim. For further information, see our article on appealing a denial of a Illinois workers’ comp claim.
Hiring an Illinois Workers' Compensation Lawyer
Hiring an attorney is not required, but the Workers’ Compensation Commission advises that most employers and employees hire attorneys for contested cases. An attorney can help facilitate settlement and/or request a formal hearing. An attorney can also help prepare evidence when a claim is heard at a trial.
Illinois Workers' Compensation Office Locations
100 W. Randolph St. #8-200
Chicago, IL 60601
401 Main St., Suite 640
Peoria, IL 61602
200 S. Wyman
Rockford, IL 61101
4500 S. Sixth St. Frontage Road
Springfield, IL 62703