Worker holding wooden block with inscription Workers Compensation

Injuries That Qualify for Workers’ Compensation

The Law Office of David Hunt Nov. 20, 2023

Workers’ compensation is an insurance system mandated by 49 states, Illinois included. It is a no-fault system to provide benefits to employees who are injured on the job or who fall ill due to workplace conditions such as from toxic fumes or allergens. Benefits cover medical and ongoing care expenses, plus lost wages if the work-related condition requires time off to recover. 

If you are injured on the job, or fall ill due to workplace conditions, in or around Peoria, Illinois, contact me at The Law Office of David Hunt. I have more than three decades’ experience in helping clients with their workers’ compensation claims. Reach out immediately after you’ve received medical attention and filed your claim, so I can help you assemble all the necessary documentation and evidence needed to advance your claim to receive the just compensation due you. I serve injured workers throughout Peoria County, Woodford County, and Caswell County. 

Overview of Workers’ Compensation in Illinois

Each state has a few variations on workers’ compensation laws, but they all have the basic structure of providing benefits to cover: 

  • medical expenses, including doctors’ visits, prescriptions, tests, and the like 

  • ongoing care, including physical or rehabilitative therapy, even mental and psychological therapy 

  • missed wages because your injury or illness keeps you from working 

  • disability benefits if your injury or illness is severe enough to cause a temporary or permanent disability to any part of your body 

  • funeral expenses and death benefits for your family if you lose your life because of a work-related injury or illness  

In Illinois, here are a few important notes: 

First, if your employer arranges a Preferred Provider Program (PPP) network of doctors, then you must use one on the list to qualify for workers’ compensation. If there’s no PPP, you can choose any provider you like. If you are constrained by a PPP, you can switch providers on the list once after beginning your treatment. It is also possible to opt out of the PPP, but you have to do so prior to any injury or illness. 

Second, if you miss work to recover or undergo treatment, there is a three-day waiting period. You qualify for benefits on the fourth day. If you miss two weeks of work, then you will receive back pay for the three-day waiting period. Also, your lost-wage benefits will generally be calculated at two-thirds of your weekly wage at the time of your injury or illness. 

Finally, your injury or illness must occur during “the scope and course” of your duties. This means if you get in an accident driving to work in your own vehicle, workers’ compensation won’t cover you. Similarly, if you leave your job site to go out for lunch and get injured, you will not be covered. If you’re running an errand for your employer, however, you will be covered, even in your own vehicle. 

Working With Insurance Companies

Being a no-fault system, this means that neither employee nor employer can sue the other for accidents or work-induced illnesses. Instead, claims are handled by an insurance company contracted for by the employer, while everything, including appeals, is overseen by the Illinois Workers’ Compensation Commission. 

Insurance companies are for-profit institutions, so filing a workers’ compensation claim will certainly be put under a microscope to verify if it’s real and if the injury or illness is exactly as stated in the claim. Before agreeing to benefits, the insurer may actually request further medical documentation or even evidence of how the injury or illness occurred. 

In other words, workers’ compensation claims can be challenging. Notifying your employer and filling out a claims form seems simple enough, but insurance companies have attorneys and representatives on payroll to vet every claim.    

Injuries That Qualify for Workers’ Compensation

Injuries at work can occur in various ways. Construction sites are the rifest with possibilities. A wrench or other object can fall from on high and strike you. You can get run over by a jitney or other vehicle. You yourself might fall from scaffolding. In an office setting, injuries can occur through slips and falls on wet surfaces or on loose carpeting, or a handrail may fail on a stairway.  

Other injuries covered are known as repetitive stress injuries. The most talked about of these is carpal tunnel syndrome, which affects those who do data entry on keyboards eight hours a day, but there are other types of repetitive injuries. A clerk using a cash register all day can be affected. Someone who stocks shelves throughout the workday is also subject to repetitive stress. The list goes on, including people using jackhammers, or even doing repetitive tasks on an assembly line. 

Work-induced illnesses include a lot of illnesses, often caused by asbestos exposure. Mesothelioma has become such a widespread problem that it now has legal protections all of its own. However, toxic chemicals including even some cleaning agents, along with allergens, can also lead to illnesses. 

What’s Not Covered Under Workers’ Compensation?

If you’re drunk or high on an illegal substance and you get injured, workers’ compensation will not cover you. Likewise, if you and a coworker get into a tussle and you’re injured, that won’t be covered either. Also, if you’re off-premises and not engaged in an activity to benefit your employer, you will not be covered.  

Filing a Workers’ Compensation Claim

Your first act is to notify your employer. You have 45 days to do so, but the sooner, the better. Waiting can only raise suspicion on the part of the insurance company.  

After notifying your employer, you should file a workers’ compensation claim by filling out the provided form available through human resources or from the workers’ compensation representative on site.  

It would be nice if everything were that simple: Report, file and receive benefits. However, insurers are not in the habit of writing black checks, so to speak, so you can expect to have to answer further questions and field requests for more documentation and evidence. That’s where having an experienced workers’ compensation attorney on your side can prove invaluable. 

Understanding Your Rights

If you’re injured or fall ill at work due to an accident or toxic conditions, your first responsibility is to take care of your health and well-being. After that, you need to begin the claims process. If you’re in or around Peoria, Illinois, contact me immediately at The Law Office of David Hunt.  

I will help you navigate the system and advise you on what documentation and evidence you need to help press your case forward. If at any point, your claim is denied or your benefits reduced and you need to file an appeal, I will help you with that as well. Together, let’s exercise your full rights to just compensation.