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Workers’ Compensation is an employer-funded insurance program that covers an employee’s medical expenses and lost wages resulting from a work-related injury. Illinois requires all employers to carry workers’ compensation insurance or be self-insured against on-the-job injuries.
Injured employees should be compensated for medical expenses related to their accident, and they may be entitled to compensation for lost wages if they are unable to work. Regardless of the severity of the injury, employees should consult an experienced workers’ comp attorney to ensure their workers’ compensation settlements in Chicago reflect the maximum possible benefits.
Injured workers are entitled to compensation for reasonable and necessary medical expenses until they reach their maximum medical improvement (MMI). Employees may be able to choose healthcare providers or providers within an employer-approved network. To ensure compensation, employees must use employer-approved networks or healthcare providers so expenses such as the following are covered:
In some cases, the employee and the insurance carrier may disagree on what medical expenses are reasonable and necessary, or when an employee has reached MMI. A knowledgeable Chicago lawyer could advocate for employees to ensure they receive the best possible workers’ compensation settlements.
MMI is reached when a medical professional determines that further treatment will not improve medical outcomes. For example, employees suffering shoulder injuries may never recover their full range of motion. Immediately following the injury, the range of motion may be 20% of what it was before the injury. After months of treatment, the maximum range of motion reaches 80%, which is determined to be the MMI for the injury. Once MMI is reached, employees are responsible for any medical expenses.
Illinois has a three-day waiting period before lost-wage benefits are available. Employees who cannot return to work after three days become eligible for lost-wage compensation, which uses the 52 weeks of pay from before an injury to determine the average weekly wage (AWW). Employees are entitled to 66.66% of their AWW, usually beginning within 14 days of an accident.
How long an employee receives lost wage benefits depends on the type of disability. Workers’ compensation recognizes temporary and permanent disability, and disfigurement.
Temporary disability means the injury prevents an employee from returning to work. Temporary total disability (TTD) applies when an injury stops the employee from returning to work on a temporary or short-term basis. Employees receive lost-wage benefits until they return to work or their MMI is reached.
Employees may receive temporary partial disability (TPD) if they return to work at a less-demanding job. If a medical professional determines employees can return to work with specific restrictions, they may return to work in a different capacity than before the injury. If the new position wages are less than the AWW, employees are compensated for the difference. The TPD benefits subtracts the new wage from the old and multiplies the difference by 66.66%. The result is the TPD benefit that is paid until MMI is reached or the employee returns to work.
When employees can never return to work or must take a lower-paying position because of the work-related injury, they are entitled to permanent disability benefits. Permanent total disability pays employees 66.66% of their pre-injury pay for the remainder of their life.
Permanent partial disability usually refers to the loss or impairment of a body part such as a leg, hand, or eye. Permanently impaired employees are entitled to compensation based on the body part and injury severity, and they receive the calculated compensation for as long as allowed by law.
Employees with visible scarring after a work-related injury are eligible for workers’ compensation benefits. The benefit is 60% of AWW for 162 weeks.
Settling a workers’ compensation claim means negotiating with an insurance company, and disputes may occur over what is reasonable and necessary care, or when MMI is reached. Different calculation methods can be applied. Without a personal injury lawyer at their side, employees may not receive the maximum possible compensation. Contact McCready Law for help with your workers’ compensation settlement in Chicago.