How Does Workman’s Comp in Illinois Work? Guide to Getting Benefits

If you have a work-related injury or illness in the Prairie State, do you know how to get workers’ compensation benefits? Can you go to see your own doctor, or do you need to notify your manager first? When do new hires become eligible for workman’s comp in Illinois? And if you’re undocumented, is it okay to file a claim for work injuries or occupational diseases?

We’ve created a comprehensive guide to explain how workers’ compensation benefits work in the state of Illinois below.

Illinois Workers’ Compensation Benefits Guide: Key Takeaways

• The state of Illinois requires most businesses to carry workers’ compensation insurance for employees with a work-related injury or illness. However, some employees are automatically exempt from this coverage requirement.
• This no-fault insurance system covers medical expenses and some lost wages until injured workers can go back to work. It also can provide death benefits to eligible family members of workers killed on the job.
• Your injury or illness must happen in the course and scope of your employment to qualify for workman’s comp in Illinois.
• Undocumented covered workers have the right to receive workman’s comp in Illinois.
• Mental health conditions may qualify for Illinois workers’ comp benefits, but it’s not easy to get these payments. An experienced workers’ comp lawyer is essential for proving your injury is work-related with strong evidence.

Understanding How Illinois Workers’ Compensation Laws Work for Covered Employees

Illinois workers’ compensation laws provide benefits for eligible employees with a workplace injury or illness. The State of Illinois requires employers with at least one part-time or full-time employee to carry workers’ compensation insurance. Covered workers are eligible to file for benefits starting on day one of their employment.

However, certain types of employees are automatically exempt from this insurance coverage requirement under state law.

Which Workers Are Automatically Exempt from Workers’ Compensation Insurance Coverage Under State Law?

If your job-related injuries happen while working in one of these positions, you may not have coverage. Confirm your coverage before you apply for workman’s comp in Illinois if you’re one of the automatically exempt workers listed below:

• Business partnership partners
• Corporate officers
• Domestic workers
• Federal government employees (i.e., USPS postal carriers, railroad workers, harbor workers)
• Independent contractors working in job sectors other than construction, trucking, or similar “extra-hazardous occupations” listed in the Employee Classification Act
• Members of limited liability companies (LLCs)
• Sole proprietors
• Volunteers working for free

How to File Your Illinois Workers’ Compensation Claim for Benefits

While every claim is unique, generally, the steps you’ll follow to apply for workman’s comp in Illinois are as follows:

1. Notify your employer about your workplace injury or illness and ask for a list of doctors authorized to treat you. If your employer has no Preferred Provider Program (PPP), then you can see any doctor for medical care.

You’ll need to report your workplace injury within 45 days to potentially qualify for Illinois workers’ compensation benefits. For an illness that arises after radiological exposure, you must notify your employer within 90 days. And for claims involving occupational diseases, notify your employer as soon as a doctor provides your diagnosis.

When you report accidental injuries, it’s best to notify your employer in writing and include:

• Date, time, and location at the time of your accident
• Names and contact info for any witnesses who saw what happened
• Which doctor or healthcare facility is treating your injury or illness

Important: The deadline for filing workers' compensation cases in the state of Illinois is three years. This deadline is also known as the statute of limitations, and it varies from state to state.

2. Your employer then alerts the Illinois Workers’ Compensation Commission and their insurance company about your accident.

This officially starts your workers’ compensation benefits claim. That way, if your physician says you cannot work due to your injury or illness, you may qualify for paid time off.

3. If approved, you must miss at least three work shifts to qualify for workers’ comp payments that cover your lost wages.

State law says that your first three days of missed work are usually unpaid unless you’re out of work for two weeks or longer. Once day 15 arrives, if you still can’t work, then Illinois workers’ compensation insurance covers those first unpaid days off.

4. Denied benefits? Contact your employer’s insurance company first to help resolve any disputes.

If that doesn’t work, you may request arbitration services by filing Form 45 directly with the Illinois workers’ compensation commission. In the event arbitration fails or you disagree with that decision, you may then appeal again to the circuit court. Additional appeals may then proceed to the appellate court, with your final appeal heading to Illinois supreme court.

Once decide to file an appeal, we strongly recommend hiring a workers’ compensation lawyer.

Pro Tip: If you think you were wrongly denied workers' comp in Illinois, consult a workers' compensation attorney for free.

Types of Benefits Available to Injured Employees Through Workman’s Comp in Illinois

Once your claim’s approved, all injured workers qualify for medical benefits. Whether you are eligible for benefits that cover lost wages depends on how long the doctor says you need off work.

Medical Benefits

You can receive unlimited medical benefits once your employer’s insurance carrier approves your claim. Approved claims mean your employer’s insurance company automatically pays for all your medical bills, including:

• Doctor’s visits
• Physical therapy
• Prescription medications and over-the-counter drugs to manage your symptoms
• Required medical devices, such as canes, crutches, walkers, handicapped parking placards, etc.
• X-rays, MRIs, CT scans, and other imaging needs
• Hospital stays
• Surgery costs (for example: torn rotator cuff surgery)
• Travel expenses to receive necessary care (i.e., mileage reimbursement and hotel rooms, etc.)

Lost Wages

If you cannot work due to your work injuries, then you may qualify for biweekly payments to partially cover your lost wages. Your first payment should start about 14 days after you file your Illinois workers’ compensation claim.

These payments come in several different varieties, depending on the extent and severity of your workplace injury:

• Temporary total disability payments (TTD benefits). TTD benefits pay two-thirds of the average weekly wage (AWW) for an injured worker every two weeks. However, that amount is subject to the state’s minimum and maximum benefit amounts for the relevant calendar year. TTD payments automatically end once you return to work earning your usual job wages.
• Temporary partial disability benefits (TPD payments). TPD payments equal two-thirds of the difference between your pre-injury and post-injury work income. You may be eligible for these payments if you can go back to work on light duty or part-time hours only. Refusing light-duty work could cost you your access to benefits.
• Permanent partial disability benefits (PPD payments). PPD benefits equal the same amount as TPD payments, assuming you can never return to your pre-injury work income. You can receive PPD benefits for up to 60 months from your accident date or until you turn 67, whichever is later. You must reach Maximum Medical Improvement (MMI) before your doctor can assess you for PPD benefits. This usually happens during an exam called a Functional Capacity Evaluation (FCE).
• Permanent total disability benefits (PTD payments). If you can never work again after your job accident, you may qualify for PTD benefits for life. The state calculates these the same way they do TTD benefits, but makes payments each week.

Important: If you work while receiving PTD workers' comp benefits, you could lose those payments.

Death Benefits

If an injured worker dies from a workplace injury, death benefits may be available to certain dependent survivors. (Eligible dependent survivors usually include the deceased worker’s spouse and children until they turn 18 years old.) If you qualify for death benefits, you may receive:

• $8,000 for funeral and burial expenses.
• Survivor’s benefits paid monthly equal to TTD benefits until the widowed spouse remarries. If there are minor children at home, death benefits continue after remarriage. Otherwise, the spouse receives a lump-sum benefit equal to two years of survivor benefit payments upon remarriage.

Permanent Disability Settlements

In the event that you suffer a permanent disability, you may qualify for a lump-sum award through a settlement contract. However, you should know that choosing this option may cause other benefits to end, such as ongoing medical care.

Traumatic injuries leading to disfigurement that exists at least 6 months after your injury date may result in this type of settlement. Any disfiguring injury not listed in the table below pays a maximum of 162 weeks of PPD benefits x 60% of your AWW.

However, if your condition changes after you get a lump-sum award, the Commission could adjust your pay amount. For example: If your health seriously deteriorates within 30 months after you settle, you may petition for additional medical benefits.

Here are the scheduled award amounts based on the body part you lost or can no longer use, according to the Commission’s handbook:

Body Part	Weeks of PPD Payments You May Be Owed in a Lump-Sum Settlement:
Permanent disfigurement	162
Thumb	76
Index finger (pointer finger)	43
Middle finger	38
Ring finger	27
Pinky finger	22
Big toe	38
All other toes	13
Hand	205
Carpal tunnel syndrome due to repetitive motion injuries	28.5 to 57
Arm	253
Arm surgically removed above the elbow	270
Arm surgically removed at the shoulder joint	323
Foot	167
Leg	215
Leg surgically removed above the knee	242
Leg surgically removed at the hip joint	296
Eye	162
Surgical removal of one eye	173
Hearing loss in one ear (under the Illinois Workers’ Compensation Act definition in Ch. 48, par. 172.42	54
Hearing loss in both ears	215
One testicle	54
Both testicles	162

Vocational Rehabilitation Benefits

If you cannot return to your old job at the same pay rate, you may also qualify for vocational rehabilitation benefits. These may include:

• Job search counseling
• Vocational training to help you transition into a new role or career path
• Participation in a job search program through an approved vocational rehabilitation provider
• Paying for you to take education classes at an approved, accredited learning institution

Important: Your employer's responsible for paying all costs, fees, and incidental expenses for a reasonable vocational rehabilitation program. You may choose the program you feel best fits your needs, or you can accept services from your employer's preferred provider.

You will also continue receiving TTD benefits while you participate in vocational rehabilitation.

Let LegalASAP Connect You with a Workers’ Compensation Lawyer for Free Today

Most people benefit from consulting an attorney who thoroughly understands the Illinois Workers’ Compensation Act for free. At LegalASAP, our attorney network includes hundreds of law firms throughout the United States who provide free, no-obligation consultations.

The attorneys in our network primarily work under contingency. That means that their legal services come out of your final settlement so you pay nothing out of your own pocket.

Ready to see if you may qualify? Request your free workers’ compensation consultation now: