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How Does Workers’ Compensation Insurance Work?

In the United States, employers are required to have workers’ compensation insurance to help workers injured on the job with their medical expenses, as well as to compensate them for any lost wages due to the injury. Essentially, these benefits are designed to aid a worker after sustaining a workplace injury so they can focus on healing; unfortunately, every government benefit has its limitations. If you are filing a workers’ comp claim, it is important to have a strong foundation of knowledge concerning how these claims are handled to ensure that you receive a fair payout.

What Does Workers’ Comp Cover?

A wide array of work-related injuries, from carpal tunnel syndrome to broken bones, are covered under workers’ comp insurance. To qualify for benefits, an employee must have been on the clock when they were injured, and the injury must stem either from the nature of their employment or a workplace accident.

For instance, office workers are known to develop carpal tunnel syndrome from typing on low-quality keyboards every day, and they could file a claim if their pain persists. No accident caused the carpal tunnel to develop; the conditions of their position simply put them at a higher risk of developing the injury and the poor quality of their company office supplies did nothing to protect them from this risk.

Some other workplace injuries that are likely to qualify for workers’ comp include the following:

  • Neck and back injuries
  • Spinal cord injuries
  • Burns and lacerations
  • Electrical shock
  • Strains and sprains
  • Slip and fall injuries
  • Tool- and material-related injuries

Please note: Not every workplace injury is covered under the Illinois Workers’ Compensation Act. Injuries sustained while engaging in horseplay, violating company policy, or under the influence of alcohol and/or drugs will not be covered by state benefits.

Furthermore, workers are required to report the accident within 45 days of their injury. Notifying your employer promptly in writing on the day of the injury is most advisable, as they can get started on filing your claim quickly.

Medical Treatment and Economic Damages

If your workers’ comp claim is approved, medical care to treat the injury and relieve pain will be paid for. Sadly, there is often some disagreement between the employee, employer, and insurance company over which types of medical care will be covered. In such cases, it is vital to contact an attorney skilled in handling these claims because they can help you square off against an employer/insurance agent and prevent them from denying you the medical treatment you need.

Temporary and Permanent Disability Benefits

In addition to medical care, workers’ comp will often cover wages lost as a result of your injury. These benefits are referred to as “disability benefits,” and they fall under workers’ comp law. They are calculated based on how much you earn during a standard workweek and exist to make up for temporary or permanent disability and partial or total wage loss.

The types of disability benefits available under Illinois workers’ comp law are:

  • Temporary Total Disability: These monies are paid out to temporarily disabled workers who miss work due to their injury.
  • Temporary Partial Disability: When an employee is able to return to work but unable to earn the same wages as they did prior to the injury, they may temporarily receive two-thirds of the difference.
  • Vocational Rehabilitation: These benefits cover vocational training/rehabilitation when the injury rendered the worker unable to work in their previously chosen field.
  • Permanent Partial Disability: These are benefits paid to compensate for the complete or partial loss of one or more body parts. This includes the loss of the use of any body parts.
  • Permanent Total Disability: If you lose a limb or suffer lifelong disability as a result of the injury and are now unable to work in any field, you may qualify for disability payments for the rest of your life.

If your loved one died on the job, you and your family may receive benefits in the form of two-thirds of their pay and monies to cover funeral and burial expenses.

What About Non-Economic Damages?

Workers’ comp does not cover non-economic damages, onlyeconomic ones. This means that you will not be able to file a workers’ comp claim for pain and suffering, emotional distress, a reduced quality of life, or anything unaccompanied by an itemized bill.

If you were injured because of another person’s (not your employer) negligence and want to recover non-economic damages, filing an injury claim through the civil justice system may be a more viable route to compensation for you. The downside is that legal claimants must prove their injury was caused by another’s negligence beyond a reasonable doubt, a condition that workers’ comp does not consider.

Please note that you cannot sue your employer for a workplace injury; state law mandates workers’ comp as the sole remedy injured workers can take against their employers.

My Employer Offered Me a Settlement Agreement

Sometimes, employers request that their workers accept a settlement agreement to wrap up a workers’ comp claim. Once a settlement offer is accepted, the worker is often rendered ineligible to pursue any further compensation for that injury. Therefore, even if the settlement amount that your employer proposes seems sufficient, it is best to consult with an attorney before accepting it, as it could be lower than it should be.

About The Tapella & Eberspacher Law Firm

The Tapella & Eberspacher Law Firm is home to a legal team comprising highly skilled, experienced attorneys. Since 1996, we have won millions of dollars in compensation for our clients. If you are seeking assistance with your workers’ compensation claim, contact our attorneys online or call us at (217) 394-5885.