Taking the Confusion Out of Common Injury and Estate Planning Worries: Answers to Your Frequent Questions
The most important job for any attorney is making sure that his client understands every aspect of her case. Although some lawyers are comfortable keeping their clients in the dark, we feel that you deserve more. You deserve to have all of your questions and concerns addressed in order to pursue your own case confidently and successfully. This is why we take the initiative to answer common questions that you may have even before you even step into our office. If you don't see your question answered below, please contact our office at 855-522-5291.
- Page 1
What is a work-related injury?
While some work-related injuries are fairly straightforward, others may be more difficult to identify. A person who is struck by a falling box in a storeroom—on the clock and on company property—has undoubtedly suffered a work injury. However, injuries that occur away from work, off the clock, and slowly over time may also be considered work-related injuries under the Illinois Workers’ Compensation Act. So what exactly is the definition of a “work-related” injury?
Injuries That May Qualify for Illinois Workers’ Compensation Benefits
Most courts consider an injury to be work-related if the injury resulted from actions you performed on behalf of your employer or during the course of your employment. In order to claim workers' compensation, you must be able to prove that there was a connection between your employment and the injury you have suffered.
Common work-related injuries include:
- Sudden trauma, such as falling from a ladder during construction work or spraining an ankle after tripping on uneven carpeting in the company conference room
- Occupational diseases, such as mesothelioma as a result of asbestos exposure on the job
- Car accidents during work-related travel, while running an errand for an employer, or other journeys that are not an employee’s regular commute
- Repetitive strain injuries, such as carpal tunnel syndrome caused by computer use or back injuries due to repeated lifting
- Accidents at work-related functions, such as sports injuries at the company picnic or falling from the deck of an employer-sponsored social event
- Certain off-the-clock injuries, such as accidents on lunch breaks or before or after shifts caused by defects on company property
- Injuries away from the company property, such as accidents during meetings away from the main employment site or sustained while an employee is traveling for work
- Pre-existing conditions that have worsened during the course of employment, such as old knee injuries or back injuries that have been aggravated by the physical demands of the workplace
- Mental injuries (such as anxiety or depression) that have arisen as a result of a compensable physical injury
If you have suffered an injury in the course of your employment, our workers’ compensation attorneys can advise you on your next steps at no cost to you. Contact Tapella & Eberspacher today at (855) 522-5291 or fill out our online contact form to schedule your free consultation.
I have a pre-existing condition that was aggravated at work. Could I have a workers’ comp claim?
The Illinois Workers’ Compensation Act covers injuries that occur in the course of employment, including those caused by the aggravation of a pre-existing condition. As long as the aggravation of a prior injury is work-related, the injured employee may be entitled to medical payments and temporary or permanent disability benefits. Unfortunately, seeking workers’ compensation for a prior injury can make the claims process more complicated.
Pre-Existing Injuries May Be Covered by Workers' Compensation
Workers’ compensation laws operate on the policy that an employer agrees to take an employee as he or she is. If an employee has a pre-existing condition, the employer assumes responsibility for the aggravation of this condition sustained at work. However, this does not mean that the employer is responsible for paying the costs to correct the original injury.
Workers’ compensation benefits may be available for prior injuries such as:
- Aggravation of a non-work-related condition. If you suffered from an injury in the past (such as a slipped disc) that was made worse through the course of your current employment, you may be able to collect benefits to treat the aggravation, but not for the previous injury’s damage.
- A second work-related injury. If you collected benefits in the past for an injury at your current employer, then reinjure the same part of your body, you can still receive workers’ compensation for the second injury. You are entitled to payment for your new medical costs, but the amount of disability you receive may be adjusted based on your previous awards.
- Diseases. Certain workplace conditions can adversely affect an employee’s health, especially if he or she is already suffering from a disease. If an employee has a breathing condition (such as asthma or emphysema) and normal workplace conditions make symptoms unbearable, the employee may have a claim for workers’ compensation.
Your employer’s insurance company is unlikely to pay for an injury that could possibly have been caused outside of work. If you are seeking to claim workers' compensation benefits for an aggravated injury, our workers’ compensation attorneys can gather evidence to strengthen your claim and advise you on your next steps at no cost to you. Contact Tapella & Eberspacher today at (855) 522-5291 or fill out our online contact form to schedule your free consultation.
What is maximum medical improvement?
Maximum medical improvement (MMI) is the term used when an injury is not expected to get better even if treatment continues. In Illinois, employees are entitled to medical treatment and wage loss benefits after a workplace injury during the period of medical recovery. If an employee reaches MMI but is still suffering from the effects of the injury, he or she may be entitled to continue receiving workers' compensation benefits.
How Maximum Medical Improvement Affects a Work Injury Claim
When determining MMI, the treating physician should exhaust all potential treatment options and consider the effects of any additional treatment (including surgery). The treating physician’s medical opinion during the period of MMI should consider your:
- Work restrictions. The treating physician may perform functional capacity testing to determine whether the employee has any restrictions that can make it difficult to perform certain types of work. Typical restrictions may include an inability to lift heavy objects, sit for long periods, or perform physical actions without pain or fatigue (such as bending or kneeling). Once the doctor has assigned these work restrictions, your employer must decide whether to accommodate the restrictions by implementing assistive devices or transitioning you into a different position within the company.
- Permanent disability benefits. Employees who are unable to perform any type of work may be entitled to permanent total disability benefits, while those who can perform limited work may be entitled to permanent partial disability benefits. Partial disability benefits can be used to make up the difference between the employee’s pre- and post-injury wages, as well as pay for vocational retraining so the employee can enter another career path.
- Future impairment. While MMI means the injury is not expected to improve, it does not mean the condition could not get worse. The physician should carefully consider whether the injury could cause future disability or hardship for the patient, as well as treatment recommendations for known complications. For example, doctors may recommend joint replacement surgery for a knee injury if the patient is unable to bear weight on the knee in the future.
If you suffered a work injury in Illinois, our workers’ compensation attorneys can help you maximize the amount of available benefits. Contact Tapella & Eberspacher today at (855) 522-5291 or fill out our online contact form to schedule your free consultation.
Can I get a second medical opinion if the company doctor says my injury was not work-related?
Under the Illinois Workers’ Compensation Act, employees have the right to two different medical opinions on treatment for a work-related injury. If you are injured at work and do not agree with the assessment of the first doctor you see, you are free to seek another doctor’s advice and the workers’ compensation insurance company has to pay for it. However, there may be an exception for injury victims if the first doctor says that the injury is not work-related.
Getting a Second Doctor’s Opinion After Your Injury is Deemed Not Work-Related
Illinois employers are allowed to contract certain hospitals or doctors to provide health care to their employees. When an employee is injured, the employer may demand that the employee see one of its approved physicians for treatment. As the physician is directly beholden to the employer, the medical opinion may not be in the patient’s best interest.
As a result, the law allows the patient to seek a second opinion for an Illinois work injury for any reason, including if:
- He or she disagrees with the doctor’s diagnosis
- He or she disagrees with the doctor’s treatment plan
- The doctor has cleared the patient to return to work, but the patient does not feel ready
- The doctor has recommended surgery
- The doctor’s medical opinion has been influenced by recommendations from the insurance company’s nurse case manager
- The patient does not feel like the doctor is listening to his or her concerns
- The doctor is misinterpreting or giving too much weight to previous medical history when evaluating the current injury
While the right to a second medical opinion is automatic, there is an exception to the insurance company’s responsibility to pay for the second doctor’s visit: if the first doctor says that the injury doesn't qualify for workers’ compensation. If you seek a second opinion and your new doctor agrees that the problem is not work-related, you will likely have to pay for this visit out-of-pocket. On the other hand, even if the new doctor believes that the injury is work-related, you may still have difficulty getting the workers’ compensation commission to consider the second opinion.
If you suffered a work injury in Illinois, our workers’ compensation attorneys can determine whether you are owed payment through workers’ compensation benefits or a third-party lawsuit. Contact Tapella & Eberspacher today at (855) 522-5291 or fill out our online contact form to schedule your free consultation.
Can I pursue a third-party lawsuit if I was hurt at work?
Employees who have suffered a life-changing injury may not be able to survive on the amount provided by Illinois workers’ compensation benefits. For this reason, it is a good idea to consider whether a third party could be held liable for the costs of your injury. If third-party negligence played a role in a work accident, an injury lawsuit could provide payment for permanent disability, income losses, and even the wrongful death of the worker.
Types of Third-Party Work Injury Lawsuits in Illinois
There are two notable differences between collecting workers’ compensation and suing a third-party. The first is that benefits provided under workers’ compensation are limited, while a third-party claim is not limited in the amount a victim can receive for pain and suffering and permanent losses. The second is that workers’ compensation is a no-fault system, meaning benefits are provided regardless of fault. In an injury case, victims will have to provide proof of negligence—and the percentage of their own fault may have a bearing on the amount of damages they receive.
That said, there may be several third parties who can be held liable in a work injury case, including:
- Product manufacturers. Injuries that were caused by defective equipment or components may qualify for a product liability lawsuit. Manufacturers or distributors of dangerous products can be held responsible if the products were poorly designed, badly assembled, or did not contain proper warnings to the user.
- Property owners. If you were injured while performing work at a location that is not owned or managed by your employer, you could be eligible for a third-party lawsuit against the property owner if he or she allowed a dangerous condition to exist on the property.
- Drivers. Work-related car accidents can occur if the victim is a professional driver (such as operating a taxi, truck, or limousine) or is performing a work-related task for the benefit of an employer. Employees who are injured in a crash may be able to file a car accident lawsuit against an at-fault driver.
- Independent contractors. If you were injured by someone at your workplace who does not have the same employer (such as an electrician on a job site or visiting guest at your workplace), you have the right to file a lawsuit against the person who caused your injuries in addition to filing a work accident claim.
If you suffered significant losses as a result of a work injury in Illinois, our attorneys can help you maximize the amount of available benefits. Contact Tapella & Eberspacher today at 855-522-5291 or fill out our online contact form to schedule your free consultation.
Can I pursue a workers’ comp case and a personal injury lawsuit?
Workers’ compensation laws were created to provide payment for a work injury without the need to file a lawsuit. As a result, employees covered under workers’ compensation can only sue their employers if the employer intentionally caused harm. Intentional harm is usually limited to cases of direct assault, battery, or defamation. However, workers may file injury claims if someone other than the employer played a part in the accident.
What Employees Should Know About Filing Work Injury Lawsuits
Although workers' compensation laws generally prohibit employees from filing injury lawsuits against their employers, there is no law against suing someone else whose negligence causes a work injury. These cases are called third-party lawsuits, since they involve someone other than the first party (the injury victim) and the second party (the employer).
Although employees may file third-party lawsuits in addition to collecting workers’ compensation, these cases may be complicated by:
- Type of injury lawsuit. The ability to bring a third-party case will depend on the type of laws and requirements of the type of case. For example, an injury caused by a defective product will be subject to product liability laws, while an injury on someone else’s property will require the knowledge of a premises liability attorney.
- Burden of proof. While workers’ compensation provides benefits regardless of who was at fault for your injuries, injury lawsuits require victims to provide proof of negligence in order to recover damages. In addition, the victim’s own percentage of fault in causing the accident will be considered when calculating the amount of compensation.
- Liens on damages. If your third-party case is successful, the employer’s insurance company will likely want to be paid back for the workers’ compensation benefits they paid to you. Insurers are allowed to place a lien on any damages you are awarded, and you may have to pay a portion of the recovery back to the insurance company.
If you suffered a work injury in Illinois, our workers’ compensation attorneys can help you maximize the amount of available benefits. Contact Tapella & Eberspacher today at 855-522-5291 or fill out our online contact form to schedule your free consultation.
What are the penalties if an employer does not have workers’ compensation insurance?
The State of Illinois requires all public or private employers with at least one employee to secure valid workers’ compensation insurance to cover job-related injuries. If the employer does not obtain coverage, the business itself may face steep fines and closed doors, while the corporate officers may be held personally liable for damages.
Penalties for Employers Without Illinois Workers’ Compensation Insurance
One of the most important consequences for employers who fail to provide workers’ compensation coverage is the loss of the exclusive remedy protection. Under workers’ compensation law, employees are forbidden from suing an employer in exchange for benefits. However, if the employer did not secure workers’ compensation coverage, the employee is free to file a lawsuit directly against the employer. In addition, employers named in these lawsuits cannot use certain defenses (such as negligence of a co-employee) and the burden is on the employer to show freedom of negligence relating to the injury.
In addition to legal liability, employers who fail to obtain workers’ compensation coverage in Illinois may face:
- Work stoppage. Investigators with the Illinois Workers' Compensation Commission (IWCC) Insurance Compliance Division can issue a work-stop order on an employer for failure to secure workers’ compensation insurance. IWCC can request the intervention of state law enforcement to prevent any employee from occupying the place of employment until proof of insurance is provided and the work-stop order is lifted.
- Criminal charges. Illinois law allows individuals such as corporate officers, directors, partners, and members of an employer limited liability company to be charged with criminal acts and face personal liability for failing to provide workers’ compensation coverage. Individuals who knowingly violate the insurance requirement may be found guilty of a Class 4 felony, while those who negligently fail to provide coverage may be charged with a Class A misdemeanor.
- Fines. IWCC investigators may issue citations to employers for insurance non-compliance in an amount between $500 and $2,500, which must be paid in addition to providing proof of valid workers' compensation insurance. If the employer does not comply with the citation, the Commission may assess a civil penalty of up to $500 per day for each day without insurance, with a minimum fine of $10,000.
If you have suffered a work injury in Illinois, we can help you get the compensation you deserve. Contact the experienced workers' compensation attorneys at Tapella & Eberspacher today at (855) 522-5291 or fill out our online contact form to schedule your free consultation.
Do out-of-state employers have to provide Illinois workers’ compensation insurance if they have an employee in Illinois?
In most cases, yes. Although workers’ compensation laws vary from state to state, Illinois requires all companies with at least one employee in the state to be covered under Illinois workers’ compensation requirements. As long as the employee is not exempt from workers’ compensation benefits, the out-of-state employer is required to include Illinois-compliant benefits on its insurance policy.
When Out-of-State Employers Need Illinois Workers’ Compensation Coverage
Under Illinois law, an employer must purchase valid Illinois workers’ compensation insurance to cover:
- Remote employees who live in Illinois. An out-of-state employer must cover employees in Illinois, even if there is only one employee in Illinois and the company and all other employees are located in a different state.
- Employees whose majority of work takes place in Illinois. A company that is headquartered in another state but has a satellite office or factory in Illinois must provide workers’ compensation insurance that includes Illinois coverage.
- Business operations in Illinois. Out-of-state companies that conduct regular business in Illinois must provide a workers' compensation insurance policy that includes Illinois coverage, even if all workers reside in the same state as the company.
- Employees hired in Illinois. Any workers whose employment contracts were entered into in Illinois must be covered by Illinois workers’ compensation insurance.
- Work-related injuries that occur in Illinois. If an employee from an out-of-state company is injured while doing a work-related task in Illinois, he or she has the right to file a workers’ compensation claim in Illinois.
If you are eligible for Illinois workers’ compensation coverage, you have a right to collect benefits for an on-the-job injury regardless of where it occurs. Contact the experienced workers' compensation attorneys at Tapella & Eberspacher today at (855) 522-5291 or fill out our online contact form to schedule your free consultation.
How long do I have to be employed to be eligible for workers’ comp?
While there are many things that can affect eligibility for Illinois workers’ compensation benefits, the length of employment generally isn’t one of them. Coverage is guaranteed on whether you are a non-exempt employee, so if you are covered, you qualify for benefits whether you have worked for an employer for 10 years or 10 days. However, there are some instances where workers’ compensation coverage can exist in a gray area—and insurers may wrongfully deny payment if employees don’t know their rights.
Non-Work Situations in Which Workers’ Compensation May Apply
If you are injured on your employer’s premises while performing your regular job duties, filing a workers’ compensation claim is usually straightforward. Unfortunately, those injured before or after a shift or away from the work environment may be required to prove the validity of their claims—and may be denied medical and wage loss benefits if they are unable to do so.
Some cases where it may be more difficult to get workers’ compensation benefits include injuries that occur:
- Off the clock. If you are attending an orientation or training session before your workday begins, or are injured on work premises before or after clocking out, you are likely still covered by workers’ compensation.
- Traveling to or from work. In most cases, daily commutes are not covered by workers’ compensation. However, if the employee was performing a work-related task as part of the commute (such as making a pickup or delivery), workers’ compensation covers the journey.
- Away from the main working environment. Injuries suffered outside the office, job site, or regular work location may be covered if they are in any way associated with the duties and performance of your job. This can include mandatory meetings as well as sponsored events like company picnics.
- Under coverage of multiple benefit providers. Some employees may be covered by more than one work injury compensation program, especially if they work in an occupation that involves the overlap of federal and state injury laws.
The important thing to remember is that workers’ compensation coverage applies to any injury that is work-related—no matter when or where it occurs. If you have been injured on the job, contact the experienced workers' compensation attorneys at Tapella & Eberspacher today at (855) 522-5291 or fill out our online contact form to schedule your free consultation.
What if my employer is retaliating against me for filing a workers’ compensation claim?
Workers' compensation laws do not only guarantee medical and lost wage payments to injured employees, they also prevent employees from being discriminated against for collecting benefits. If an employer is found guilty of discrimination, the employer can lose the “exclusive remedy” protection of workers' compensation, allowing the employee to directly sue the employer for damages.
Common Forms of Employer Retaliation in a Workers’ Compensation Case
The Illinois workers’ compensation system protects employees from many adverse actions in the workplace as a result of filing a benefits claim. The law protects injured employees from discrimination immediately after the injury occurs, covering them from adverse employment actions even before the formal workers' compensation claim is filed.
Common ways an employer may punish an employee for filing a claim include:
- Discharge. Terminating or laying off employees who exercise their rights under workers' compensation laws is expressly forbidden. This is known as "retaliatory discharge,” and is grounds for an employee to bring a civil action against his or her employer.
- Disciplinary action. Employees cannot be placed on leave or denied wages as a result of filing a benefits claim.
- Demotion. An employee who is forced out of his role or into another position may have a valid discrimination claim.
- Harassment. Employers may be guilty of retaliation if they discourage an employee from filing a claim, threaten termination, or otherwise harass the employee.
- Salary reduction. Employers may retaliate by forcing the employee to sacrifice sick hours, paid time off, pension benefits, and other earnings.
If you believe that your employer has unjustly terminated or discriminated against you for filing a workers' compensation claim, you may be able to sue your employer for lost wages, pain and suffering, and punitive damages. In many cases, employers will often attempt to claim that the reason for the retaliation is unrelated to the filing of the claim. However, the law states that employees still have a valid claim if collecting workers’ compensation benefits was not the sole reason for the discharge.
Our experienced workers' compensation attorneys can evaluate your case and advise you on your next steps at no cost to you. Contact Tapella & Eberspacher today at (855) 522-5291 or fill out our online contact form to schedule your free consultation.