Who is eligible for workers’ compensation? You may ask this question after suffering an injury or falling ill while doing your job duties. In Illinois, you qualify for workers’ compensation benefits if you suffer injuries or become unwell within the scope of your employment. The state laws require you to report a work-related injury or sickness within 45 days. This 45-day deadline starts running from the day of the incident.
Besides the eligibility requirements, complex legal issues and challenges can jeopardize an otherwise strong workers’ comp claim. That is why you should get legal assistance as soon as possible. Illinois workers’ compensation lawyers have the experience and resources to secure the best outcome possible in your case. They also know the law and can streamline the claim process.
If you or a family member got injured or ill at work in Naperville, Illinois, call Chute, O’Malley, Knobloch, and Turcy, LLC at 630-412-4747 to set up a free consultation.
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Eligibility Requirements in Illinois
The most recent Survey of Occupational Injuries and Illnesses in Illinois shows that 122,500 private sector employees suffered nonfatal work-related injuries and illnesses in 2022. In the same year, 21,000 employees working for local and state government agencies suffered occupational injuries and Illnesses.
These figures show you are always at risk of getting injured or ill whether you work in the private or public sector in Illinois. So, knowing the eligibility requirements for workers’ compensation is crucial. These requirements include:
You Must Be an Employee
Workers’ compensation insurance covers employees – those working full-time or part-time. Independent contractors are generally ineligible for coverage. You must show that you are an employee to qualify for workers’ compensation benefits. Job offer letters and payslips are essential for proving the existence of an employment relationship between you and your employer.
Your Employer Must Be Required to Have Workers’ Compensation Insurance
Most employers are required to have workers’ comp insurance. These employers can purchase coverage from an insurance provider or opt for self-insurance – settle claims from their pockets.
Illinois laws dictate which employers must have workers’ comp insurance based on the number of workers, the nature of business, and the type of work done. Some employers exempted from carrying this insurance purchase it to avoid lawsuits.
Your Injury or Illness Must Be Job-Related
Workers’ comp applies to injuries or illnesses occurring within the scope of employment. Simply put, you must have been harmed while doing your job duties or because of your job to be entitled to workers’ comp benefits.
Injuries resulting from getting hit by a flying or falling object in a construction site or warehouse qualify as job-related. You are also eligible for workers’ comp benefits if you get injured while on a business trip. Injuries sustained during regular commutes to and from work may not qualify as job-related.
You Must Satisfy Work Injury Reporting and Filing Deadlines
As mentioned earlier, you have up to 45 days to ensure your employer knows about your work injuries or illnesses. You also have up to 3 years from when you were injured or diagnosed with an occupational illness to open a workers’ comp claim.
These two deadlines are separate. You must report your injury within the deadline before filing a claim. Otherwise, your employer’d insurance may deny your claim. You may also struggle to link your injury to your work without a copy of an injury report signed by you and your employer.
Are There Exceptions to Eligibility?
Some occupations are not eligible for coverage under the Illinois workers’ comp laws. Agricultural workers, seasonal workers, people working in private residencies, and undocumented workers may not receive workers’ comp benefits even after getting injured in the line of their work.
Injuries sustained while engaging in an unlawful activity at work are ineligible for coverage. Self-inflicted injuries and those sustained because of conduct that breaches the company’s policies are also excluded.
Don’t start the claim process with doubt in your mind. Instead, ask your lawyer all workers’ compensation questions you have regarding your eligibility.
How to File a Workers’ Comp Claim
Now that you know workers’ comp eligibility requirements and exceptions, you can file your claim. Work with your workers’ comp lawyer throughout the filing process to ensure you do everything right the first time. That way, you will avoid unnecessary delays and lower the likelihood of your employer or the insurer denying your claim.
Seek Medical Attention
Seek medical assistance after getting injured during the performance of your job duties or developing symptoms of an occupational illness like carpal tunnel syndrome. Visit an emergency room if your injuries are too serious and require urgent medical care.
Remember to tell your medical provider that your injuries happened at work. The goal is to ensure the provider indicates in his or her notes that your injuries are job-related. Proper medical documentation can prove direct causation and maximize your benefits under workers’ comp.
Document Your Injury
Evidence is key to a successful result, especially in contested workers’ compensation claims. So, collect all evidence and document information about your injury to support your claim. Take detailed photos of the accident scene and your injuries.
Write down the names and contact details of coworkers or other people present when you got injured. The testimony of these people can help prove that you were working when the accident happened and the accident was serious enough to inflict injuries on you.
Maintain a record containing all medical providers who have treated you and a summary of their opinions. Create a diary of the pain you experience and how it affects your life. Obtain and safely keep bills, receipts, and other financial documents from medical professionals, pharmacies, and drug stores where you purchase over-the-counter medications for your injuries.
Notify Your Employer
Inform your employer of your injury, either orally or in writing. The best way to deliver this information, however, is through a written notice of injury. Ensure you keep a copy of the notice to help you prove that you reported your injury on time.
Your employer will give you a list of approved medical providers you can see for treatment. The employer will also commence the claim process with the workers’ comp insurance company. The employer has 14 days to approve or deny your injury claim if you have been away from work for at least three days because of your injuries or illness.
Your employer also has 30 days to notify the Illinois Workers’ Compensation Commission (IWCC) of your injury. The 30-day deadline starts when the employer receives your injury report.
Stay in Touch With Your Employer
A smooth flow of communication from one party to another is crucial for a successful resolution. Information may sometimes fail to flow from the insurance adjuster to you, your lawyer, or your employer. Other times, your doctor may forget to update your employer on your progress. So, communicating regularly with your employer is an effective way to ensure the employer knows your current health situation.
Keep Track of Your Workers’ Compensation Claim
Monitor the progress of your case by checking its status on the IWCC website. File an appeal if the insurer fails to approve some components of your claim or denies the entire claim altogether.
How a Workers’ Comp Lawyer Can Help You
A workers’ comp lawyer is a valuable asset to the success of your workers’ comp case. The first thing your lawyer will do is to evaluate the circumstances of your injuries, such as workplace conditions, equipment, or machinery involved, and steps you and those near you took. This evaluation will help your lawyer determine if you have a viable claim.
Your lawyer will scrutinize the evidence and do an additional investigation to collect more evidence. The lawyer may, for instance, interview eyewitnesses. He or she may also subpoena relevant workplace documents like workplace safety guidelines and equipment/machinery maintenance logs.
Your lawyer will oversee the filing process to make sure you have completed all necessary documents accurately and filed them on time. The lawyer will also use his or her negotiation skills to convince the insurance company to give you a settlement that matches your situation.
If negotiation efforts are unsuccessful, going to court for a workers’ compensation claim is the best option. During the trial, your lawyer will present a clear and compelling account to show the validity of your claim and the nature and level of your suffering. The lawyer will thoroughly cross-examine opposing witnesses to uncover contradictions in their testimonies.
Legal support does not stop at trial. You can count on your lawyer to correctly disburse your compensation after a successful claim. The lawyer can also take charge of the appeal process in the event of an unfavorable verdict.
Our knowledgeable workers’ compensation lawyers at Chute, O’Malley, Knobloch, and Turcy, LLC are ready to assess your situation, determine your eligibility, and help you fight for reasonable compensation. Contact us for a free consultation.