When you are injured while working (it does not necessarily have to occur at your place of work), you generally have only one remedy: a worker’ compensation claim against your employer. You do not file a lawsuit (it’s called a “claim” instead, and are not entitled to many of the commonly referred to damages, such as pain & suffering or lost wages, and are limited in what compensation is available.
Unlike a lawsuit under a negligence theory (like an auto crash), there are no filing fees. Then again, nearly everything is completely different from negligence cases. The Application generally states what happened, what type of injury was sustained, and when. It is filed with the Illinois Workers’ Compensation Commission (IWCC) and must be sent to the injured worker’s employer, who will forward it to their workers’ compensation insurer.
The employee must report the injury to his or her employer within 45 days of the injury. Failure to do so is a defense to the workers’ compensation claim. Even if you do report within the 45 days, it is often difficult to connect the injury to the work activity if a long period of time passes between injury and reporting and/or medical treatment. Further, the Application MUST be filed within 3 years of the date of injury OR within 2 years after the last benefits (TTD or Medical) were paid—but not longer than 3 years in any case.
Most work injuries are automatically covered if your injury "arises out of" and "in the course of" your employment. Essentially, if you are doing what your job description calls for, and you are at a higher risk for injury than the general public, you should have a compensable case. There are thousands of pages of court opinions defining exactly what constitutes a compensable injury that "arises out of" and "in the course of" employment. For example, if you park your car in a lot at work that is open to employees and the general public and you fall in a hole, you might not be covered, as you would arguably be subjected to the same risk as the public. However, if that parking lot is ONLY for employees, then you probably would have a valid WC case. There are some limited situations where intoxication can be used to deny what would ordinarily be a compensable claim.
In what is commonly known as an IME, or “independent medical exam,” the employer can have the injured worker examined by a doctor chosen by them. This occurs under Section 12 of the Illinois Workers’ Compensation Act. The doctor chosen is paid for by the employer. You can see where he or she would be motivated to find the worker able to return to work, even if the worker’s own doctor disagrees. If a Section 12 doctor consistently saves an employer money by returning injured workers to work, that doctor will continue to receive these assignments and profit from them. Failure to attend a Section 12 provides your employer the basis to cut off all further medical and TTD benefits. SO, YOU CAN HAVE YOUR WORKERS’ COMPENSATION BENEFITS CUT OFF FOR FAILING TO ATTEND THE SECTION 12 EXAM OR BECAUSE THE SECTION 12 DOCTOR BELIEVES YOU ARE ABLE TO RETURN TO WORK.
Your case is assigned to an arbitrator, not a judge. The arbitrator is a lawyer and the rules of evidence apply, although the IWCC has special rules that are not exactly the same as those in “regular court.”
If you are injured on the job site, consult a lawyer immediately to determine what rights you may have under the Act. Attorney Stephen Hoffman has been representing injured parties for over 25 years. Contact the Law Office of Stephen L. Hoffman today to schedule a free consultation: call (773) 944-9737 or email firstname.lastname@example.org.