Law Office of John S. Xydakis, P.C.
Suite 3600
55 E. Washington St .
Chicago , Illinois 60602
(312) 727-1100    

             WORKER’S COMPENSATION

Workplace injuries in Illinois are covered by worker’s compensations laws.  Benefits are paid to the employee regardless of fault.  Let me say that again, fault is not an issue.  Only two questions are relevant: was the employee injured, and did the injury occur during the employee’s job performance.

1. What is workers’ compensation?

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.

2. Who is covered?

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.

3. Who provides the benefits?

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.

4. For what injuries and diseases are benefits paid?

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.

5. Can an employee be fired because he or she reported an accident?

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..6

6. Are workers' compensation benefits subject to income tax?

No. Workers' compensation payments are not subject to state or federal income tax and need not be reported on returns as income..7

7. Who should the injured worker notify?

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.

8. What should the notice include?

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.

9. Must the notice be in writing?

Notice may be given orally or in writing.

10. What are the time limits for notifying the employer?

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.

11. Can the employee choose the treating doctor or hospital?

Yes. An employee may choose any doctor or hospital at the employer's expense. It is recommended that the employee inform his or her employer in writing of the name and address of the doctor or hospital chosen. An employee may also obtain treatment from a doctor or

hospital selected by the employer. Under some circumstances, the employee may rely upon

treatment by prayer or spiritual means alone.

12. Is there a limit to the number of doctors an injured employee may select at the employer's expense?

Yes. The employer’s responsibility is to pay for all first aid and emergency services, two treating physicians, surgeons or hospitals of the employee’s choice, and any additional medical care providers to whom the employee is referred by the two physicians, surgeons or hospitals.

Thereafter, the employee must obtain the employer’s approval of additional doctors or hospital services. If the employee chooses to see any other medical care providers not approved by the employer, the employer is not required to pay for their services. Emergency and first aid care will not be considered one of the employee's two choices of doctors.

13. Must the employer pay all physician and hospital bills?

If the treatment provided is reasonably required to cure or relieve the employee from the effects of the injury or disease, and the provider of the services has given the employer the information required by law, the employer is required to pay all reasonable charges. If these requirements are not met, the fact that the employee has already paid all or part of a bill does not necessarily obligate the employer to pay the bill. If the employer refuses to pay a medical bill, it must promptly give the employee a written explanation of the basis for the refusal.

14. Can the employer ask for an evaluation by its own doctor?

Yes. If an employee claims to be entitled to benefits and the employer asks for an examination by a doctor of its choice, the employee must undergo the examination at a reasonable time and place. The employer must pay for this examination. In addition, the employer must pay, in advance, sufficient money to defray travel expenses by the most convenient means and the cost of meals necessary during the trip. If the employee loses time from work, the employer must provide reimbursement for lost wages. An employee's refusal to be examined by the employer's doctor can result in loss of benefits.

15. What if an employee cannot return to the same occupation after an injury or exposure and cannot earn as much money?

The employee may be entitled to receive a wage differential. The wage differential is two-thirds of the difference between the amount the injured worker is able to earn and the amount he or she would be earning in the occupation in which the employee worked at the time of the accident.

An employee may be compensated for either the loss of wages or a permanent disability related to the same injury or exposure.

16. Is the employee entitled to vocational rehabilitation?

Where appropriate, the employer must pay for treatment, instruction and training necessary for the physical, mental and vocational rehabilitation of the employee, including all maintenance costs and incidental expenses. The employee must cooperate in a reasonable rehabilitative program. The employee may choose the provider of such reasonable vocational rehabilitation services or may accept the services of a provider selected by the employer.

17. What benefits are provided?

First, 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.

Second, 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. The payments represent two-thirds (66 2/3%) of the employee’s average weekly earnings during the year before the accident or last exposure, subject to certain limits. 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 these 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.  If an employer stops or withholds payment of these benefits before the employee has returned to work, the employer must give the employee a written explanation for this action no later than the date of the last payment. Failure to provide this notice may result in assessment of penalties against the employer, as well as an order to pay the employee’s attorney fees. If an employer unreasonably delays payment or fails to pay these benefits, the employer may be required to pay a penalty to the employee.

Thirdly, 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.

These include permanent partial disability benefits, permanent total disability benefits, and survivor’s benefits.

Permanent Partial Disability (PPD) Benefits

A permanent partial disability is the complete or partial loss or loss of use of a part of the body, or the partial loss of use of the body as a whole. “Loss of use” is not specifically defined in the law, but it generally means the employee is unable to do things with the body part or with the body as the whole that he or she was able to do before the injury.

1. When are PPD benefits paid?

Permanent partial disability benefits are paid only if the job-related injury or disease results in some permanent loss or loss of use of a part of the body or the whole body. Not all injuries and diseases result in permanent partial disability. PPD benefits will be paid only after the employee's condition has reached a point where it will not improve any more.

2. How is the amount of PPD benefits determined?

On a case-by-case basis, the Industrial Commission evaluates the physical impairment and the effect of the disability on the injured worker's life. Factors that may be considered include the individual's age, skill, occupation, training, inability to engage in certain kinds of work or

activities, pain, stiffness or limitation of motion.. There are two ways in which PPD benefits may be determined. In the first method, the amount depends on the part of the body injured and the extent of the loss. The law places a value on certain body parts, expressed as a number of weeks of compensation for each part. The number of weeks provided for the various parts of the body are listed in the following chart. If a body part is amputated, or if it cannot be used at all because of the injury, the employee is paid at his or her weekly rate for the number of weeks the law has set. Compensation for a partial loss of use is calculated by multiplying the percentage of loss by the number of weeks listed. Alternately, if the disability imposes certain limitations on an employee, he or she may be entitled to the percentage of 500 weeks that the partial disability bears to total disability.

Permanent Partial Disability Benefits For 100% Loss of Use Body part Weeks Paid

The thumb 70

The 1st (or index) finger 40

The 2nd finger 35

The 3rd finger 25

The 4th finger 20

The great toe 35

Each other toe 12

The hand 190

The arm 235

The foot 155

The leg 200

The loss of one testicle 50

The loss of both testicles 150

The sight of one eye 150

The removal of one eye 160

The hearing of one ear:

Due to an accident or trauma 50

Due to an occupational disease 100

The hearing of both ears 200

Fractures resulting in permanent disability: Not less than

Skull fracture 6

Fracture of a facial bone 2

Fracture of a vertebra 6

Fracture of a spine or transverse process 3

Removal of a kidney, spleen or lung 10

Loss of a part of the thumb, finger or toe up to the first joint from the tip is considered loss of one-half the digit, e.g., 35 weeks for half a thumb. Loss beyond the first joint is considered 100% loss of the digit. If an arm is amputated above the elbow, the employee is entitled to 250

weeks of compensation. If an arm is amputated at the shoulder joint and no artificial arm can be used, the employee is entitled to 300 weeks of compensation. If a leg is amputated above the knee, the employee is entitled to 225 weeks. If a leg is amputated at the hip joint and no artificial leg can be used, the employee is entitled to 275 weeks of compensation

3. How are disabilities not listed on the chart compensated?

An employee who sustains a permanent injury or impairment to parts of the body not listed in the chart is entitled to the percentage of 500 weeks that the partial disability bears to total disability.

4. What if an injury causes a disfigurement?

An employee who suffers a serious and permanent disfigurement to the hand, head, face, neck, arms, legs below the knee, or chest above the armpits as a result of a job-related injury is entitled to benefits for up to 150 weeks at the PPD rate. An employee may not collect compensation for

disfigurement and PPD benefits for the same body part. Unless a settlement has been reached at an earlier date, the employee must wait at least six months from the day of injury for a hearing to determine if a disfigurement resulting from the accident is serious and permanent..19

Permanent Total Disability (PTD) Benefits

A permanent total disability is defined as a complete disability which renders the employee permanently unable to do any kind of work for which there is a reasonably stable employment

market; or the loss of use of both hands, both arms, both feet, both legs, both eyes, or any two such parts, e.g., one leg and one arm.

1. How long is the PTD benefit paid?

An employee who is permanently and totally disabled is entitled to benefits for life.

If an employee who has been assigned PTD benefits returns to work or is able to return to work, benefits may be terminated or modified.

2. How is the PTD benefit determined?

The benefit is two-thirds (66 2/3%) of the employee’s gross average weekly wage. The average is based on the employee’s wages during the year before the injury or exposure, subject to certain limits. PTD recipients are also entitled to additional payments four times a year, beginning in the second year after the award, which reflects the increase in the statewide average weekly wage during the preceding year. These payments are made from the Rate Adjustment Fund, administered by the Industrial Commission.

3. What is the minimum PTD benefit?

The weekly benefit cannot be less than 50% of the statewide average weekly wage at the time of the injury or last exposure.

4. What is the maximum PTD benefit?

The maximum benefit can be no more than 133 1/3% of the statewide average weekly wage at the time of the injury or last exposure.

Survivors’ Benefits

1. Who is entitled to survivors’ benefits?

If the injury or disease results in the death of the employee, full benefits are paid to the spouse and/or children. Benefits are paid to children until age 18; or until age 25 if a full-time student; or, if physically or mentally incapacitated, for the duration of the incapacity. If there is no eligible spouse or child, the benefits will be paid to totally dependent parents. If the spouse remarries and there are no children at the time of remarriage who are entitled to benefits, the spouse is entitled to a final lump sum payment equal to two years of compensation. All rights to further benefits are extinguished. In cases where there is no eligible spouse, child or totally

dependent parent, benefits may be paid to other survivors, such as partially dependent children, parents, grandparents, grandchildren or other heirs who were at least 50% dependent on the employee. The benefit for such individuals will depend on the degree of their dependency.

2. How is the amount of the survivors’ benefit determined?

The benefit is two-thirds (66 2/3%) of the employee’s gross average weekly wage. The average is based on the employee’s wages during the year before the injury or exposure, subject to certain limits. In addition, beneficiaries who have been awarded a survivors’ benefit are entitled to payments from the Rate Adjustment Fund in the same manner as those awarded

permanent and total disability benefits.

3. What is the minimum survivors’ benefit?

Subject to reductions for partially dependent individuals, the weekly benefit cannot be less than 50% of the statewide average weekly wage.

4. What is the maximum survivors’ benefit?

The maximum benefit can be no more than 133 1/3% of the statewide average weekly wage at the time of the injury or last exposure

5. Is there a limit to the total amount payable for a survivors' benefit?

Yes. The survivors’ benefit is limited to 20 years of weekly benefits or $250,000, whichever is more.

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Law Office of John S. Xydakis, P.C.