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Illinois workers compensation

Illinois Work Comp – Can I Sue The Insurance Company?

We provide free legal guidance and attorney referrals on Illinois workers’ compensation claims. We are lawyers who will give you the same guidance we would give to a friend who reached out for us to help.

Usually when someone calls me on a case where they already have an attorney, it is because the lawyer is not doing a good job for them. We will go over what has been done, what should be done and if it makes sense to stick with them or not.

I got that type of call recently and thought the lawyer was going to be a bad one because the first thing the injured worker said to me was:

Can I sue the insurance company?

That is the type of thing a good Illinois workers’ compensation attorney would go over with their client, so I thought it was another scenario where they had a bad one. Fortunately that was not the case.

The reason this worker wanted to sue the insurance company is because his benefits have been delayed. In his mind, there is no reason for the delay and the insurance company is just playing games. Sadly, that happens all of the time. It has been more than four months since he has received a TTD check and the surgery he needs has not been approved. You can get why he is angry.

The bad news is that you can not sue an insurance company in an Illinois workers’ compensation case. Bad faith laws do not apply there. That is because these cases are not lawsuits, but rather administrative claims for benefits. All disputes have to be resolved through the Illinois Workers’ Compensation Commission.

The good news is that if your work comp benefits are unreasonably denied, you can file for what is called “penalties and fees” at the Illinois Workers’ Compensation Commission. These penalties can be significant, including up to 50% for what medical care they are not providing and $10,000 for delayed TTD benefits. They also can get hit for your attorney fees over this.

In other words, you can not sue, but you can still penalize them and get compensation from them if they are acting in an unreasonable way. That means they have no basis for not paying your benefits.

Back to the lawyer. We searched and they had done everything correctly. They filed a petition for immediate hearing when the benefits were cut off. That forces the insurance company to respond as to why benefits are being denied. When they can not give a good reason, that is when the penalties and fees motion comes into play.

In fact, his lawyer had filed that motion. Normally a case like this would have gone to hearing by now. To do that, you usually need to take the deposition of your doctor before that happens. You would also need to take a deposition of the insurance company doctor if they sent you to one.

Unfortunately for this worker, his doctor only takes one deposition a week and the waiting time to get on the schedule can be six months. So his lawyer’s hands are tied. The deposition is scheduled so I told him that there would be no benefit in getting a new firm.

Illinois work comp laws generally favor the worker. Insurance companies can make the process difficult and that can be frustrating. The good news is that there are remedies to solve that frustration. Your job is to get a good attorney for your case or get a new one if they are not doing their job.

If you would like our help in finding a great Illinois workers’ compensation lawyer, please contact us any time for free at 312-346-5320.

How Much Do You Get for Workers’ Compensation in Illinois?

Accident on the job are common. In fact, in 2023, there were 2.6 million nonfatal workplace injuries and illnesses reported across the United States. If you’re hurt on the job, one of the first questions you probably ask is “Can I get workers’ compensation?” and “How much do you get for workers’ compensation” in Illinois? It’s a fair question—your bills don’t stop just because you’re injured, and you still need to take care of yourself and your family.

Illinois workers’ compensation laws can feel confusing and at times the experience can be frustrating. The good news is that the system is designed to pay your medical bills, cover part of your lost wages, and compensate you for any permanent harm from the injury. In this workers’ compensation payout guide, we break down exactly how the payout system works, what benefits you can expect, and where to get help if something doesn’t seem right.

We’ve been helping injured workers since 2001. Our job is simple—give you real, honest guidance and connect you with the best workers’ compensation attorney for your situation. We have helped tens of thousands of injured workers and would love to help you. Please call us any time at 312-346-5320 for a FREE consultation. We recommend great work comp attorneys everywhere in Illinois.

The Key Things To Take From This

  • How much you get for workers’ compensation depends on your wages, how long you’re off work, and the seriousness of your injury.
  • Illinois is a no-fault system, meaning you don’t have to prove your employer did anything wrong.
  • Benefits include medical care (everything gets paid, nothing out of pocket), wage payments (2/3 of your average weekly wage) and eventually a settlement.
  • A workers’ compensation attorney can help if payments are delayed, denied, or miscalculated. But it costs nothing to hire a lawyer and a good one can of

Payments Made Under Illinois Workers’ Compensation Law

1. Payment of All Medical Bills

You should never pay:

  • ER visits
  • Surgery
  • Physical therapy
  • Medication
  • Specialists
  • Tests (MRI, X-ray, CT scan)

You should never pay for any medical care that is related to your work injury. Other things you might not think of as medical care could be included such as gym memberships, home modification (typically if someone is wheelchair bound), vocational rehabilitation to look for a new job if needed or even transportation.

2. Temporary Total Disability (TTD): Your Wage Replacement

This is the benefit everyone wants to understand: how much does workers’ compensation pay when you can’t work?

In Illinois, TTD pays two-thirds (66⅔%) of your average weekly wage. This is your average payout for workers’ compensation while you’re off work.

Example:

If you earn $1200 per week before taxes → your TTD benefit is $800 per week. This money is tax free.

These checks continue until:

  • Your doctor releases you back to work
  • Your employer accommodates restrictions
  • You reach maximum medical improvement or find a new job

Illinois also has minimum and maximum rates that change every year. These wages are often miscalculated in a way that puts less money in your pocket than you are entitled to. The good news is that this is a problem that can be fixed. Same if your checks are late.

3. A Settlement

Almost every Illinois workers’ compensation case is worth something if it’s more than a contusion. The cases that are not worth anything are usually when you hurt your eye, but have no vision loss or claim to be hurt, but get little to no medical care.

So what are cases worth? It depends on what your injury is. An injury to your back is likely going to be worth more than one to your little finger. But there are many factors involved in determining case value, including:

  • How much medical care did you have?
  • How old are you?
  • What job did you return to?
  • What defenses does the insurance company have if any?
  • Do you need future medical care?
  • Do you have any permanent restrictions?
  • What is your average weekly wage?
  • Did you have a second job?

The reality is that every case is different. Some cases are worth hundreds of thousands of dollars. The worst injuries and recoveries could be worth in the seven figures. In cases where the worker makes a good recovery, they still could be entitled to something in the five figures. In other words, if you tear your ACL, have surgery and get back to work and feel great, that case is probably still worth more than $40,000 if you have a high wage.

And in some cases, if you were injured on the job due to the negligence of someone else, your case may be worth a lot more because you can sue that party. Work comp cases that might alone be worth $250,000 can suddenly be worth millions.

Common Problems In Illinois Work Comp Cases

Even though Illinois is a no-fault state, workers often run into issues like:

  • The adjuster miscalculating your wage
  • Being forced back to work too early
  • Employer ignoring doctor restrictions
  • Delays in checks
  • Wrongful termination
  • Denial of medical treatment

These are red flags that you may need an attorney for workers’ compensation right away. The good news is that these problems are usually solvable.

How to Get the Best Possible Workers’ Comp Payout

Here’s what you can do right now:

  1. Report your injury immediately
  2. See a doctor and follow their treatment plan
  3. Save every document—medical records, check stubs, emails
  4. Don’t let a nurse case manager push you around – In fact, in many cases they should not be allowed to take part at all.

If you have a workers’ comp case, call us anytime at 312-346-5320 or fill out our online form. We’ll make sure you get pointed in the right direction and matched with the best workers’ compensation attorney for FREE.

Illinois Workers Comp – Where’s The IME Report

We are Illinois attorneys who will help you find the best lawyer for your case. Call us at 312-346-5320 for help anywhere in Illinois. We have helped tens of thousands of injured workers since 2001.

When you are injured on the job in Illinois, you generally speaking have the right to choose your own doctor. And the insurance company has to pay for 100% of that care.

The work comp insurance company for your employer has a right to send you to a doctor of their own choosing called an independent medical examination or IME. This is not a doctor who is there to treat you or look out for your best interests. Their job is to review your medical records and examine you to answer questions the insurance company has. These questions include do you have a work related injury, what treatment is needed, can you return to work and more.

Many of these IME doctors are hired guns who will say whatever the insurance company wants and hurt your case. Some of them are honest even if they skew their opinions in favor of the insurance companies.

When the IME doctor writes a report that says you can return to work or your injuries aren’t work related, you can bet that the insurance company will tell you about it right away. They are looking for any reason possible to cut you off. So when they have news that helps them, they will go forward with it.

But many times an IME happens and you don’t hear anything. Not hearing within a week or two can be normal. Over a month isn’t. So where is the IME report?

There is no law that requires the insurance company to give you or your lawyer a copy of the IME. We’ve seen many cases where they simply don’t do that. In that case we can subpoena the doctor directly to try to get a copy of the report. That is usually but not always successful.

In other cases, the doctor simply won’t write a report. What they will do is call the insurance adjuster or defense attorney and tell them what they would say. They’ll then ask if they should write a report or not. If it’s bad news, the insurance company will say don’t do it. Does that sound sleazy? Hell yes, but it’s totally legal.

So what do you do if you can’t get a report?

A smart attorney will push forward. When an IME happens and isn’t produced, it’s assumed in court that the findings would be in your favor. So while you might not have the evidence in hand, it actually will work for you.

Realistically though, once your lawyer pushes forward, most insurance companies will roll over because they know that they don’t have a defense.

The bottom line is that you shouldn’t wait forever. If it’s been two weeks and there’s no report, it’s time to get aggressive. If you’d like our help in any way, please let us know.

Winning An Illinois Work Comp Fall In A Parking Lot

We are Illinois attorneys with over 25 years of experience helping people with work injury cases. Call us at 312-346-5320 any time to speak with a lawyer for free. We help with work injuries everywhere in Illinois.

One thing that most people don’t know is that just because you are injured while at work doesn’t always mean you have a good workers’ compensation claim. You have to prove that something about the job increased your risk of injury.

For example, if you slip on a wet floor at work, the job increased your risk of injury. On the other hand, if you don’t tie your shoes and trip over your own two feet, it’s likely not a case because the job didn’t contribute to your accident.

Sometimes it’s clear that an injury is work related, other times a real analysis is needed. One area in which this is especially true is when an injured worker falls in a parking lot.

Typically if a worker is in a parking lot, they either haven’t started their work day, just finished their work day or are coming back from a break. But you don’t have to be clocked in to have a valid work comp case. What you do need is to show that the job increased your risk of getting hurt.

The number one thing that Illinois workers compensation attorneys look for when a worker falls in a parking lot is who owns the parking lot. If your employer owns and maintains the lot, it’s highly likely that a fall in that lot will be covered by the Illinois Workers’ Compensation Act. In other words, a slip and fall on an icy lot owned by your employer is similar to falling in the office on a wet floor.

The other thing we look for if your employer doesn’t own the lot is did you have to park in a certain spot and/or was that area open to the general public or not.

If your employer directs you to park in a certain location (such as the back of a store) then they are exercising control over you and increasing your risk of injury as compared to the general public. In a similar manor, if a parking area is only for employees, it also could increase your risk of injuries. The key factor is the control that they have over you.

On the other hand, if you work at a place like a shopping mall and can park anywhere, a fall in that lot wouldn’t likely be covered unless your employer owned the lot. It’s the same thing in places like the City of Chicago where you can have a parking lot across from your building, but not be required to drive.

There are a couple of big exceptions. 1. If you are carrying something for work and that leads to your accident, you’d likely have a case. For example, if you are carrying a box of supplies and slip on wet pavement, if the box prevents you from breaking your fall that would show that your job increased your risk of injury. 2. If you are a traveling employee, most falls would be covered because the act of having to drive for work increases the chance that you will get injured. Your driving is a benefit to the company so you get the benefit of work comp coverage.

This can be confusing which is why we are happy to talk to you for free to see if you have a case. Whatever you do, don’t take the word of your employer or the insurance company if they say you don’t have a case. They often lie or don’t know what they are talking about and certainly aren’t looking out for you.

How much does Illinois workers’ compensation pay?

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If you are injured on the job, Illinois law says that you get 2/3 of your wages while you are unable to work. If you earn $900 a week, you should get checks for $600 a week. All of your related medical bills should be covered too, and you might get a settlement if your injury is serious of permanent. That’s the simple answer.

The more complicated answer is that you are entitled to these things if you are eligible. You have to be eligible, your injury has to be eligible, you have to notify your employer and see a doctor, and you can’t miss the deadline for filing a claim.

In order to be eligible, you have to be an employee, not an independent contractor (but don’t take your employer’s word for it – it’s fairly common to be mislabeled). Most importantly, your injury has to arise out of and in the course of your employment. This means that you have to be doing your job, or at least something for the benefit of your employer, when you got hurt. Also, the injury has to be related to your job. A random heart attack at work is not covered.

Illinois law requires injured workers to notify their employer within 45 days in order to be eligible for benefits. There also is a statute of limitations, or deadline, for filing a claim. A claim is a formal request for benefits and is filed with the Illinois Workers’ Compensation Commission. You might start getting benefits without a formal claim, but we suggest filing one anyway just in case. The outside limit on a claim is three years from the date of injury or two years from the last payment of benefits. There are some exceptions.

Always get medical attention after an accident at work, and explain to your doctor how you were injured. Your doctor’s opinion matters, especially if the insurance company tries to argue that your injury does not qualify as a work injury.

Although 2/3 of your wages might seem simple to calculate, it’s more complicated if your pay isn’t regular. Also, there are minimum and maximum amounts set by law. Sometimes, an employee can still work in a different position but it doesn’t pay as much. If this happens to you, you may be able to get 2/3 of the difference. If you suspect that your benefits aren’t being calculated properly or if you’ve been denied, talk to an Illinois workers’ compensation attorney. The insurance company that pays your benefits is more concerned about their bottom line than making sure you’re fully compensated.
Written by Michael Helfand

When surveillance is used in Illinois workers’ compensation cases

In Illinois workers’ compensation cases, the employer’s insurance company might decide to keep an eye on you, and they might use various forms of surveillance to do this. It’s not uncommon in claims that are expensive for the insurance company, such as those involving serious or permanent injuries.

The insurance company, not your employer, is paying your benefits. If you’re getting checks because you can’t work and reimbursement for medical expenses, it’s coming from the insurance company. All of this costs them money. Their goal, in using surveillance, is to see if you are really as hurt as you say you are. They might have an investigator follow you around. They might watch you while you’re shopping, playing with your kids at the park or doing yard work.

Basically, they’re hoping to catch you doing something you said you couldn’t do, or something your doctor said you should not do. They will then use this information to deny or stop your benefits. Common times to use surveillance are right before surgery (they hope to avoid paying for it) or at the settlement stage of your case if your injury is permanent and you can’t return to your old job. This generally makes your claim more expensive and they want to make sure it’s legitimate.

Generally, it’s legal for them to do this because the surveillance is done out in public. There’s not really a way to stop it, but there are things you can do to make the surveillance useless to the insurance company. First and foremost, you should always be honest about your injury. If you are as hurt as you say you are, then that’s a great start. That said, be extra careful if you think you are being followed.

Even if you are being honest, you can potentially put your benefits at risk by being careless. Follow your doctor’s orders. If you have a family to take care of, we realize this can be hard to do. If you have a back injury and you are told not to lift anything that weighs more than five pounds, don’t carry heavy grocery bags or do yard work. It’s inconvenient, but it could hurt your claim.

The majority of surveillance videos that the insurance companies take end up being useless because the people they’re following are legitimately injured and act accordingly. Don’t give them a reason to single you out. If they see that you are being honest, they’ll stop the surveillance because that, too, costs them money.

If you are injured at work, you are entitled to medical coverage and payment for lost wages. This is the law in Illinois. But keep in mind that the insurance company is a business. They may seem harmless on the phone and actually appear helpful, but paying out benefits is something they want to avoid if possible. Don’t give them a reason to deny your benefits. You don’t have to hide in your house, but be smart. Don’t play golf or basketball on the weekend if you are injured.

If you have questions about your work injury or need help dealing with the insurance company, contact us. You can call us at (312) 346-5320 or (800) 517-1614, or fill out the form to the right. It’s free and confidential.

 

Illinois workers compensation when you don’t want a surgery

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A caller to our office injured his arm and was diagnosed with a torn rotator cuff.   The good news for him was that he found an attorney that was able to secure benefits for him.

The bad news is that his orthopedic doctor wants to do surgery and he’s not so sure that he wants to go through it.  Suddenly his lawyer isn’t giving the best customer service and he isn’t answering his question as to whether or not he has to have the surgery.

The answer is that under the Illinois Workers’ Compensation Act, you can not be forced to have a surgery.  If you decline to do so, it should not effect your right to benefits in any way at all.

On the flip side, you can’t refuse medical care that isn’t invasive.  For example, if you refuse to do physical therapy, that isn’t a reasonable act on your part and it could result in your benefits being suspended or terminated.

But something like shoulder surgery can’t be forced upon you.  In this case, if the caller declines the surgery then his doctor will have to decide if alternative treatment is available or if that is as good as he’s going to get.

When you can’t get any better, that’s called being at maximum medical improvement or MMI.  If that happens, most likely the doctor would discharge him with permanent restrictions.  If the employer can accommodate them, then the workers will return on a light duty basis.  If they can’t then vocational rehabilitation will take place.  This involves a job counselor helping you look for new work that you can physically perform.

If the new job doesn’t pay as much as the old one does then you’d get paid 2/3 of the difference, tax free until you turn at least 67.  If it does then you can still get a settlement.

So there’s a lot to think of both medically and legally before you have surgery.  It’s a shame for this caller that he hired someone who isn’t delivering good service or information.  Because when you are hurt on the job, that alone can be a big stressor.  You don’t need a lazy lawyer making it worse.

 

Illinois workers’ compensation – when you are getting screwed over

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A reader sent us the following question:

Not getting my workers compensation like I should, they owe me a lot of money still and I am getting tired of waiting for them to pay me.  I get paid every once in awhile but nothing like I should.  Wonder if I should sue because of all the issues I have had so far, fell at work, slip in a oily area that we have been complaining about for over a year, nothing really ever seemed to get done about it, my l5-s1 disk is pushing up against my sciatic nerve, have surgery august 12th so I am going to be off work for a long time.  Doctor orders are for me not to work right now.  I have been working off and on when doctors allowed me to.  Information on how to get them to get them off their butts and get me the back pay of workman’s compensation that they owe me.  I need money bad because of this accident that happened at work, wondering if I can make them pay interest since it is taking them so long and I might have to pay some interest on my credit  card because of them.  Any info would be good.

The bad news is that he’s getting jerked around.  The worse news is that you aren’t allowed to sue the insurance company when they are acting in bad faith like this.  It’s barred under the Illinois Workers’ Compensation Act.

The good news is that his problem is easily solvable.  He needs to hire a lawyer and they can file a 19(b) petition for immediate hearing that will get an official ruling that payment is required.  The better news is that he can file for what is called penalties and fees which will punish the insurance company for their bad behavior.  It’s not a lawsuit, but it is part of the system in Illinois.  For every day they were late, they can get fined.  For every medical bill that wasn’t paid, a 50% penalty can be applied.  All of this goes directly in to the pocket of the injured worker.

The problem is that this guy doesn’t want to be involved with attorneys.  He just wants to get healthy and get back to work.  But unfortunately insurance companies take advantage of guys like this.

So he can either get legal help, solve his problem and focus on his health or continue to be stressed and have to deal with the nonsense.  And while it’s not taught in school, the reality is that a big part of being an attorney is dealing with nonsense.  We do it every day and we know how to stop it.

It’s kind of pathetic because it would be nice if everyone would just do the right thing.  But that’s not how an insurance company makes money.  Every day they don’t pay him is more money in their pocket.  So if you want to know what to do when you are being messed with, the simple answer is that you have to look out for yourself, even if you don’t want to.

Written by Michael Helfand

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