By Lee Alhambra
Qualifying for Benefits:
Illinois workers' compensation is a no-fault system. The employer cannot claim that the accident was due to the employee's negligence and therefore is not entitled to benefits. Benefits are provided regardless of who was at fault, as long as the requirements discussed below are met.
In order to qualify for benefits under the Illinois' Workers Compensations, you must establish the following: 1) you are an "employee" under the Act, 2) you were injured "in the course of" your employment, 3) by a risk "arising out of" your employment," 4) proper notice was given to your employer and 4) a claim was filed in a timely manner.
Employee: You must first show that you are an "employee" under the Act. Drivers are often confronted with the claim that they are independent contractors and therefore do not qualify for workers compensation benefits. A common misconception is that a contract or lease, which states that the individual is an "independent contractor", is the final word on one's employment status. However, how your employer or a contract labels you is not the final word; it is only one of many factors that the court considers. More importantly, the court considers the degree of control the employer has over the individual. Generally, the more control the employer has over the worker, the more likely he or she will be deemed an "employee" covered under the Act.
In the Course of Employment: The "course of" your employment pertains to the time and place where the injury occurred. Employees are covered during their work hours, and depending on the nature of their employment, may be covered for a reasonable time before and after work. Additionally, employees who travel as part of their employment, such as Cab and limo drivers, are covered during their travel.
Arising Out of Employment: The mere fact that the injury occurred while you were at work is not enough to be compensable. The injury must also "arise out" of your employment to be covered under the Act. This is established by showing that the injury was caused, aggravated or accelerated by some risk of the employment or by showing the employee was subject to a greater risk than the general public. For example, while all drivers are subject to the risk of being injured in a motor vehicle accident, cab and limo drivers are subject to an even greater risk than the general public because they spend their entire work shift navigating through traffic.
Notice: Notice of the injury must be given to your employer within 45 days for an injury to be covered by the Act. However, it is best if the notice is given as soon as possible after the injury. Notice should be given to a person in a supervisory position over the employee. Notice can be given orally or in writing.
Statute of Limitations: A claim for workers' compensation benefits must be filed with the Illinois workers compensation Commission within three years of the date of injury or two years from when benefits were last paid, whichever is later. A common misconception among employees is that this requirement is satisfied by filling out the employer's accident forms. Filling out forms with the employer does not satisfy this requirement. It is only satisfied by completing a form called the "Application for Adjustment of Claim" and filing the application with the Illinois Workers' Compensation Commission.
Workers' Compensation Benefits
Once you have established the above requirements, the Illinois Workers' Compensation Act provides three types of benefits for the injured worker: 1) medical treatment 2) total temporary disability (lost time benefits) and 3) permanent partial disability.
Medical benefits: An employer is required to pay reasonable and necessary medical benefits related to the work injury. This doctors visits, medication, assistive devices (crutches, brace), etc. The employee is not required to pay deductibles or co-payments.
Total Temporary Disability: If the employee is taken off of work by the physician or is placed on work restrictions by her doctor that the employer cannot accommodate, the Act requires the employer to pay lost wages as Total Temporary Disability (TTD) benefits. Total temporary disability is equal to 66.67% of the employee's average weekly wage. There is a three day waiting period for TTD if the employee is off of work for less than 14 days. If the employee is off work more than 14 days benefits start from day one. An employee may be entitled to TTD even if terminated or laid off by the employer.
Permanent Partial Disability: An employee may be entitled to a Permanent Partial Disability award or settlement. When an individual sustains an injury but is able to resume his or her regular earning potential, such injuries are recognized to be a percentage loss of the injured body part. The schedule of body parts is listed below.
| Body Part | Weeks | Body Part | Weeks |
| Thumb | 76 | Foot | 167 |
| Index finger | 43 | Leg | 215 |
| Middle finger | 38 | Eye | 162 |
| Ring Finger | 27 | Testicle - 1 | 54 |
| Little Finger | 22 | Testicle - 2 | 162 |
| Great Toe | 38 | Body as a Whole | 500 |
| Other Toe | 13 | Hearing (complete) | |
| Hand | 205 | 1 ear | 54 |
| Arm | 253 | 2 ears | 215 |
Compensation under this schedule is based on a percentage loss of use of each body part multiplied by 60 percent of the employee's average weekly wage. For example, if we assume a cab driver sustained a fracture to left his leg, receives an award of 20% loss of use of the leg and had an average weekly wage (AWW) of $1000, the PPD award would be calculated as follows:
[ 215 weeks x 20% ] x [ $1000 x 60%] = $25,800
(Leg) (% loss of use) (AWW )
The percentage loss of use of the body part is determined by a number of factors such as the severity of the injury, the treatment (surgery, therapy, etc.) and permanent limitations or restrictions as a result of the injury. Additionally, employees are entitled to compensation for scarring/disfigurement, permanent wage loss or permanent total disability.
Contributing author Lee Alhambra, is an attorney with Woodruff Johnson & Palermo Injury Law Offices 877-202-4221.
