What Does Workers’ Compensation Actually Cover? 

Sustaining an injury on the job brings immediate chaos to your life, replacing your daily routine with physical pain, medical costs and the terrifying uncertainty of how you will pay your bills without a steady paycheck. While the Illinois workers’ compensation system offers a financial safety net, navigating its rules while you are trying to heal isn’t easy. At Brassfield & Krueger, LTD, our experienced attorney can help you recognize the full scope of coverage you are entitled to under the law, cutting through the red tape so you can seek every benefit available while you focus on your recovery.

Employees in Illinois should know what workers comp covers:

• Medical Costs: Coverage includes 100% of reasonable and necessary medical bills.
• Lost Wages: You typically receive two-thirds of your average weekly wage while recovering.
• Disability: Benefits exist for both partial and total permanent disabilities.
• Third-Party Claims: You may be able to sue negligent parties other than your employer.
• Timelines: Strict deadlines apply for notifying your employer and filing a claim.

Will workers’ comp pay for my medical bills and lost wages?

The primary purpose of workers’ compensation is to help you avoid suffering financial ruin because of a workplace accident. In Illinois, the law requires your employer’s insurance to pay for all medical care that is “reasonable and necessary” to cure or relieve the effects of your injury. This includes first aid, emergency room visits, doctor appointments, surgery, physical therapy and even prescriptions. Unlike regular health insurance, there are no deductibles or co-pays for you to worry about.

Regarding your income, you are entitled to Temporary Total Disability (TTD) benefits if your doctor says you cannot work while you recover. These payments are generally calculated at two-thirds (66 2/3%) of your average weekly wage. If your doctor clears you for “light duty” but your employer cannot accommodate those restrictions, you are still eligible for these TTD payments until you have recovered as much as possible.

What if my work injury results in a permanent disability?

Sometimes, an injury leaves lasting damage that prevents you from returning to your previous job or working at full capacity. Illinois law provides specific benefits for these situations, compensating you for the permanent impact on your life and earning potential.

• Permanent Partial Disability (PPD): If you suffer the complete or partial loss of use of a body part (like a hand or leg) but can still work, you receive compensation based on a statutory schedule.
• Wage Differential Benefits: If your injury forces you to take a new job that pays less than your old one, you may receive a benefit equal to two-thirds of the difference between your old and new wages.
• Permanent Total Disability (PTD): If you are left permanently unable to work in any gainful capacity, or if you lose two major body parts (like both arms or legs), you may be eligible for benefits for the rest of your life.
• Disfigurement: You can receive compensation for serious and permanent changes to your appearance, like scarring on the face, head, neck, arms or legs below the knee.

Can I sue anyone else besides my employer?

Workers’ compensation is a “no-fault” system. This means you do not need to prove your employer was negligent to get benefits, but in exchange, you generally cannot sue your employer for the injury.

If a person or company other than your employer caused your accident, you might have grounds for a third-party personal injury lawsuit. For example, if you are a delivery driver hit by a drunk driver, or a construction worker injured by a defective power tool manufactured by a separate company, you can file a workers’ comp claim and sue the negligent third party. A third-party claim can be vital because it allows you to recover damages that workers’ comp does not cover, such as pain and suffering.

What are the steps to file a workers’ compensation claim in Illinois?

Securing these benefits requires you to follow specific legal procedures. Missing a deadline or failing to document your injury correctly can give the insurance company an excuse to deny your claim. To protect your rights, you must act quickly and follow these essential steps:

1. Seek Medical Attention Immediately: Your health is the priority. Go to a doctor or hospital right away and explicitly tell them your injury happened at work.
2. Notify Your Employer: Illinois law requires you to notify your employer of the injury within 45 days. It is best to do this in writing and keep a copy for your records. If you miss this deadline, you may lose your right to benefits entirely.
3. File a Claim with the Commission: While notifying your employer starts the process, you may need to officially file a claim with the Illinois Workers’ Compensation Commission to resolve disputes. Generally, you have three years from the date of the injury to file this claim.
4. Keep Detailed Records: Save copies of all medical reports, work restrictions from your doctor and any correspondence with your employer or their insurance company.

Let Us Help You Seek the Compensation You Deserve

Workers’ compensation laws are complex, and insurance companies often try to minimize payouts or deny valid claims. Understanding exactly what is covered, from medical bills to wage differentials, is the first step toward protecting your financial future.

If you have been injured on the job, Brassfield & Krueger, LTD can help you fight for your benefits. We leave no stone unturned in representing our clients. Contact us today for a free consultation to discuss your case.