Frequently Asked Questions  

Table of Contents

Page

Chapter 1

General Information ..................................................................3

Chapter 2

Reporting An Injury or Exposure ................................................7

Chapter 3

Medical Benefits .........................................................................9

Chapter 4

Compensation Benefits

Temporary Total Disability Benefits ............................................13

Permanent Partial Disability Benefits.......................................... 16

Permanent Total Disability Benefits............................................. 21

Survivors’ Benefits ......................................................................23

Chapter 5

Claims, Settlements and the Hearing Process ...............................25

Chapter 1

General Information

Workers' compensation is a system of benefits provided by law to most workers who have job-related injuries or diseases. These benefits are paid regardless of fault. The amount of the benefits is limited by law.

Almost every employee who is hired, injured or whose employment is localized in the state of Illinois is covered by workers' compensation. These employees are covered from the moment they begin their jobs.

The employer is responsible for providing benefits. The employer pays the benefits either directly or through a service or insurance company that administers the program for the employer. No part of the workers'

compensation insurance premium or benefits can be charged to the employee.

The employer must post a notice in the work place indicating the name, business address and business telephone number of the person, service company or insurance company (including the insurance policy number) to contact for questions relating to workers’ compensation.

In most instances, workers’ compensation benefits are paid for accidental injuries that are caused, in whole or in part, by the employee’s work. Workers may also be compensated for aggravation of a pre-existing condition.

Injuries are accidental if they happen unexpectedly, without plan or design. This includes injuries brought on by the repetitive use of a part of the body, as well as strokes, heart attacks or any other physical problem caused by work.

Injuries suffered in employer-sponsored recreational programs (e.g., athletic events, parties, picnics) are not covered unless the employee is ordered by the employer to participate. Accidental injuries incurred while participating

as a patient in a drug or alcohol rehabilitation program are not covered.

A. Medical care benefits

The injured employee is entitled to receive all necessary first aid, medical, surgical and hospital services reasonably required to cure or relieve the effects of the injury or disease. Where necessary, the employee is also entitled to receive appropriate physical, mental or vocational rehabilitation. (For more information, please see Chapter 3.)

B. Temporary total disability benefits

Employees who must lose time from work in order to recover from the injury or disease are entitled to receive weekly payments until they are able to return to work that is reasonably available to them.

No compensation is payable for the first three working days, unless the lost time continues for 14 or more calendar days from the date of injury.

If temporary total disability benefits are not paid within 14 days, and the employer cannot justify the delay in payment, the employer may be required to pay a penalty to the employee. (For more information, please see Chapter

4, Section 1.)

C. Permanent disability, disfigurement and death benefits

When the employee has sustained an injury or disease which results in permanent disability, scarring or other disfigurement, additional benefits are provided to the employee. The circumstances under which these benefits are payable and the method of determining the amount of the benefit is explained in Chapter 4, Sections 2 and 3.

If the injury or disease results in the employee's death, certain members of the employee's family are entitled to benefits. The way in which beneficiaries and the amount of these benefits are determined is explained in Chapter 4, Section 4.

The Industrial Commission is responsible for administering the law, providing information and assistance to employees and employers, and resolving any disputes regarding employees’ entitlement to benefits and the amount of  benefits. The Industrial Commission does not pay benefits--this is the responsibility of the employer.

It is against the law for the employer to harass, discharge, refuse to rehire or in any way discriminate against an employee for exercising his or her rights under the Workers' Compensation or Occupational Diseases Acts.

Such conduct by the employer may give rise to a right to file a separate suit for damages in the Circuit Court.

No. Workers' compensation payments are not subject to state or federal income tax and need not be reported on returns as income.

Chapter 2

Reporting An Injury or Exposure

The employee must inform the employer promptly. Any delay in the notice to the employer can delay the payment of benefits; a delay of more than 45 days may result in the loss of all benefits. Notice to a fellow worker who is not a

part of management is not considered notice to the employer.

The law requires the employee to notify the employer of the date and place of the accident, if known.

To avoid possible delays, it is recommended that the notice to the employer also include the employee's name, address, telephone number and Social Security number, and a brief description of the injury, accident or disease.

Notice may be given orally or in writing.

For accidental injuries, within 45 days after the accident.

For injuries resulting from radiological exposure, the employee must notify the employer 90 days after the employee knows or suspects that he or she has received an excessive dose of radiation.

For occupational diseases, the employee must notify the employer as soon as practicable after he or she becomes aware of the condition.

The employer should promptly take the following steps:

(a) Inform the insurance carrier or administrator responsible for the workers' compensation program.

(b) Provide all necessary first aid and medical services, and pay temporary total disability benefits when due.

(c) If the employee cannot work for more than three days because of the injury, the employer must do one of the following:

(i) begin payments of temporary total disability; or

(ii) provide the employee with a written explanation of what additional information the employer needs before payments can begin; or

(iii) provide the employee with a written explanation of why benefits are being denied.

Employers are required by law to maintain accurate records of work-related deaths, injuries or illness (other than minor injuries requiring only first aid and not involving further medical treatment, loss of consciousness, restriction of work or motion, or transfer to another job).

Written reports of all job-related accidental deaths must be made to the Commission no later than two working days following the death.

Written reports of job-related injuries or illness resulting in the loss of more than three scheduled work days must be made to the Commission between the 15th and 25th of each month.

Initial reports are made on form #45, called "Employer's First Report of Injury or Illness;" subsequent reports are made on form #85, called "Employer's Supplementary or Final Report of Injury or Illness."

Chapter 3

Medical Benefits......

Click here for a complete copy of the HandBook