Benefits overview

Every once in a while, we post a re-cap of the benefits you’re entitled to if you’re injured on the job in Illinois. The laws changed recently, so here is an updated overview:

Medical: Your medical bills should be covered 100% for an injury that arose out of and in the course of your employment. So anything that happens while working or doing something related to working should be covered. Illinois law changed recently and now allows employers to set up preferred provider networks (PPOs). This limits your choice of doctors more than before. Disputes often arise over medical care. It has to be relevant and necessary, and the insurance company might argue that you are asking for something (therapy, surgery) that is not necessary. If you can’t negotiate a solution, you can request a hearing.

Lost wages: If you are unable to work because of your injury, you are entitled to 2/3 of your average weekly wage; this is called TTD (temporary total disability). If you are able to do some work, but it pays less, you get 2/3 of the difference in wages; this is called wage differential. A worker can only receive wage differential benefits for five years or until they turn 67, whichever is later.

Permanent disability: If your injury is permanent, which you won’t know right away (or at least it won’t be agreed upon right away), you should get a settlement. Usually this is a lump sum paid to you by the insurance company. In exchange, they usually have you waive future medical benefits. This means that if your injury acts up years later, you can’t go back to them to pay for treatment. It’s all negotiable, and in some cases medical benefits are left open. There also are benefits available for scarring caused by an injury or illness.

There are other ancillary benefits, such as vocational rehabilitation, which helps you train and find another job if your injury prevents you from returning to your previous job or career. Note that in a work injury case, pain and suffering is not available, as it is in other types of injury cases. In cases where death results, benefits are available for the surviving spouse or minor children.

If someone from the insurance company tells you that you are not eligible for benefits or that your medical treatment is not necessary, don’t assume they are right. Their job is to save the insurance company money, not give it to you. In an ideal situation, your attorney should be the one talking with the insurance company. Insurance companies are known for taking advantage of unrepresented claimants

We are workers' compensation attorneys who help people with Illinois work injuries anywhere in IL via our statewide network of attorneys. Contact us and we will answer your questions or find the right lawyer for your situation.

2/2/12

One case or two? When Illinois work injuries lead to multiple problems

A reader asks:

I suffered a torn rotator cuff injury which I had surgery. Since then have had numbness to my hand. The numbness comes during periods of time standing or walking. My doctor who is well qualified thinks it might be carpal tunnel but waiting to see if the swelling in the shoulder is possibly causing it.  My question is that if it turns out to be carpal tunnel is this a new case or is this a injury that came from the rotator cuff injury?

We see this a lot where one injury caused another.  We've had clients with leg injuries who have fallen down the stairs and broke their arm.  We've had others that used crutches and ended up with an elbow injury.  And we've seen some clients start with rotator cuff surgery that end up with carpal tunnel.

As for whether it's one case or a bunch of separate cases, that answer depends on what your doctor thinks was the cause of your problem and whether or not there was a new accident.  It's often a big benefit for the client to have a 2nd case because the more recent an injury date, the higher the PPD or TTD rates can be.

In general though, we don't think you should worry about whether you have one cases or two cases.  The most important thing is to get the proper medical treatment so you have your health.

We are workers' compensation attorneys that help people with Illinois work injuries anywhere in IL via our statewide network of attorneys.  Contact us and we will answer your questions or find the right lawyer for your situation.

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Illinois permanent partial disability: How do you measure it for MRSA?

A reader asks:

Do you know how permanent partial disability is valued for contracting MRSA
or C-diff?

Those are two terrible infections.  But unlike a back injury or ACL repair, usually when you go through the horrible treatment for those problems, you are as good as new.  So how do we determine what your case is worth or is it even a case at all?

The reality is that permanent partial disability for the most part is a myth.  You can break a bone and it can grow back stronger than before, but you would still receive a settlement for that injury.  Same with MRSA and other internal injuries. 

Permanency is typically figured out by looking at your medical records, comparing your problem to past cases and seeing how this injury will affect you in the future.  Even with a full duty return to work and even if you are now feeling great, there is still some permanency.  Having those treatments weakens your immune system and could cause additional problems in the future.

We can't tell you what the injury is worth without a review of the records, but it is certainly worth something and most likely that something is somewhere in the five figures.  MRSA or other staph infections are known to come back too, so before you settle it's a good idea to make sure that you've been treatment free for many months.  You might still have it, but not be experiencing any symptoms.

So while we can't just give an answer that says your case is worth $X, you can bet that if you have MRSA, C-diff, etc. that is is worth something.

We are workers' compensation attorneys that help people with Illinois work injuries anywhere in IL via our statewide network of attorneys.  Contact us and we will answer your questions or find the right lawyer for your situation.

Ten Illinois work comp benefits you should be aware of

If you are injured on the job, you are not filing a lawsuit, you are making a claim for benefits.  Here are the benefits you can get starting with the three most common:

Medical- No co-pays, no out of pocket expenses, no deductible for any reasonable and related medical care for your work injury.  You choose your own doctor and the insurance company or employer has no right to talk directly to your doctor's office other than to ask for copies of records or bills.

Temporary total disability (TTD)- This is 2/3 of your average weekly wage, tax free, for the time that you are authorized off work for a work injury or have restrictions that your employer can't accommodate.  There is no limit to the amount of time you can receive TTD.

Permanent partial disability (PPD)- When you are all better or as good as you can get, you are entitled to pursue a settlement or go to a trial to get a PPD award from an Arbitrator. The amount you are entitled to depends on the extent of your injury as well as your earnings before you were hurt.

Temporary partial disability (TPD)- Similar to TTD, but this is for people who can return to work, but only on a part-time basis.  You get TPD benefits to make up the difference.

Section 19(h) rights- By going to trial, if you win you will be able to receive medical treatment that relates to the work injury for the rest of your life.  This as referred to as Section 19(h) rights.

Travel expenses- While you typically don't get paid for having to go to your doctor, you should be compensated for the mileage between your house and any doctor that the insurance company chooses to send you to.

Vocational rehabilitation- If your employer can not accommodate permanent restrictions that you have, you are entitled, at their expense, for a job counselor to help you search for new work within your restrictions.  In fact, once you are off work for 120 days the Illinois Workers' Compensation Act requires your employer to begin to develop a plan to return you to work.  This plan almost never happens and is probably the most overlooked law on the work comp books.

Maintenance- This is similar to TTD benefits.  You get this when you are undergoing vocational rehabilitation.  As long as you are cooperating with vocational rehabilitation then maintenance benefits should continue.  There is no time limit for how long you can receive these benefits.

Death benefits- If an injured worker dies from a work related accident and leaves either a spouse or a dependent then those survivors are eligible for death benefits which can be as high as the TTD rate.  The benefits can continue for up to 20 years and there is a minimum of $500,000.00 that should be paid.  In addition there is an $8,000.00 benefit for burial expenses.

Advances- If you are ready for trial and the insurance company isn't, you do not have to suffer.  If they are not paying you for your time off work your attorney can ask for a PPD advance.  This often happens in cases where everyone agrees that money will be owed at the end of the case, but there is a dispute as to whether the worker should be authorized off work or not.  It's not uncommon for the insurance company to "advance" a few thousand dollars up front and then when the case is resolved take a credit for that.  In other words if they advance $3,000 now, if a year from now the case settles for $20,000.00 you will only get $17,000.00 in new money.  The advance is always tax free and there is no interest applied to that so essentially the injured worker gets more money in the end.

We are workers' compensation attorneys that help people with Illinois work injuries anywhere in IL via our statewide network of attorneys.  Contact us and we will answer your questions or find the right lawyer for your situation.

What is my case worth? Illinois PPD

The following was submitted recently:

I recently was injured at work and ruptured my left distal bicep tendon. It was surgically repaired 4 days later. I don't know if I can return to my old job and do not know how much function or strength  I will regain. Am I entitled to a settlement and if so, any idea of possibly how much?

We give more free advice than any attorney we have come across, but other than saying yes that this person is entitled to a settlement although depending on the ultimate recovery it might make more sense to not settle and keep his medical rights open.  Either way, we can't tell what the case is worth until he is as good as he is going to get medically speaking and we see what type of work he can do.

Bottom line is that it's worth something, probably a lot, but as an injured worker we suggest that you first focus on your health.  We have never seen a situation where someone received more without a lawyer than they would have with one.  If you want our help with evaluating your case let us know.

We are workers' compensation attorneys that help people with Illinois work injuries anywhere in IL via our statewide network of attorneys.  Contact us and we will answer your questions or find the right lawyer for your situation.

Illinois permanent partial disability: Doctors don't "rate" the case

A recent caller wanted to know what his case was worth because his doctor had given him a 5-10% impairment rating concerning his shoulder injury.  In many states doctors rate the case and that is how you know what it is worth.

Illinois specifically does NOT recognize doctor ratings to determine the value of an injury.  We determine permanent partial disability based on a review of the medical records, the status of your job and comparing all of that to past cases decided at the Illinois Workers' Compensation Commission.

In the case of the caller, he had a rotator cuff repair with permanent restrictions and a likely 2nd surgery.  It's too soon to say what the case is worth, but we can tell you that it's going to be worth way more than 5-10% loss of the arm no matter what the doctor says in his impairment rating.  Literally an impairment rating by a doctor has no impact on the case and it's not supposed to be admitted as evidence.

We are workers' compensation attorneys that help people with Illinois work injuries anywhere in IL via our statewide network of attorneys.  Contact us and we will answer your questions or find the right lawyer for your situation.

If you have a scar from a work injury it might be worth something (and it might not)

When someone sustains a permanent scar from a job accident it can possibly entitle you to compensation for what is called disfigurement.  There are a few things to think about in these cases:

1. You can't settle a scar case until your scar is at least six months old.

2. Scars that occur above your knees or below the breast line do not qualify for compensation (although you might be able to get compensation for permanent partial disability if there is some other problem to that part of the body).  Please note that scars on your arms in between these two points can get compensation.

3. A scar on your face is worth more money that any other part of your body.

4. A scar that is raised or keyloid has more settlement value.

5. You can't get permanent partial disability (ppd) and dis-figuration money for the same body part.  e.g. if you are cut by a saw at work and sever a tendon, you will get ppd, but won't get disfigurement.

This is one area of workers' compensation where your medical records don't help a Judge decide what your case is worth.  If we can't settle a scar case we usually just take our client in front of the Judge and let him/her offer their opinion.  The case typically settles after that.

We are workers' compensation attorneys that help people with Illinois work injuries anywhere in IL via our statewide network of attorneys.  Contact us and we will answer your questions or find the right lawyer for your situation.

If your accident date was after July 1, 2008 your case may be worth more now

The Illinois Workers' Compensation Commission just released the following statement:

 

 

In plain English, permanent partial disability is what you get for the permanent nature of your injury once you are all better.  The amount you get paid is based on the date you were hurt, the extent of your injury and the amount you were earning when you got hurt.  The PPD rate is 60% of your wage and is subject to a maximum amount.  Click here for the rate chart.  The Commission had incorrectly stated that the maximum rate was $643.82.  If you are a high wage earner your case is probably worth more money now.

We are workers' compensation attorneys that help people with Illinois work injuries anywhere in IL via our statewide network of attorneys.  Contact us and we will answer your questions or find the right lawyer for your situation.

 

Due to a clerical error, the maximum PPD rate for 7/1/08 - 6/30/09 that was posted in January 2009 was wrong. Please note the correct rate is $664.72. We apologize for the inconvenience.

New TTD & PPD rates announced

The amount you get paid for your time off of work (TTD benefits) and the amount your case is worth (PPD) benefits is determined from a formula based on your average weekly wage prior to the injury. 

These rates are subject to maximum earnings - the TTD rate is 2/3 of your wage, but if a pro athlete or millionaire businessman got hurt they wouldn't get that much, most people are not affected.  The new maximum TTD rate in Illinois is $1,231.41.  The new maximum PPD rate is $643.82.

These were the smallest Illinois workers' compensation benefit increases in years and reflect our poor economy.  That said, an Illinois work injury is worth more than any other state so all things considered no one should be complaining.

We are workers' compensation attorneys that help people with Illinois work injuries anywhere in IL via our statewide network of attorneys.  Contact us and we will answer your questions or find the right lawyer for your situation.

There are three main benefits under Illinois workers' compensation law

Illinois workers' compensation cases are not lawsuits.  Employees in Illinois can typically not sue their employer for negligence.  Instead they get workers' compensation benefits and don't have to prove any fault or negligence if their injuries arose out of and in the course of their employment.   Injured workers usually can receive:

100% of their medical bills:  That means no co-pays or out of pocket expenses if the treatment is reasonable and necessary.

66% of your average weekly wage:  This is also known as TTD benefits or temporary total disability.  You get 2/3 of your average wage over the last 52 weeks.  Unlike some other benefits, there is no maximum amount of time to receive TTD.  You get it until you are back to work at your old job or can work with restrictions.

A settlement for the permanent nature of your injury:  This is known as PPD or permanent partial disability benefits.   The amount you receive for this depends on your wage and the impact of the injury on your life and how it will effect you in the future.  Lawyers determine this by looking at your medical records and comparing your situation to past cases that have been settled or decided by a Judge in Illinois.

In some instances you can get penalties and fees against your employer which will increase your compensation.  This usually happens when benefits are denied without any basis.  There is no provision under the Illinois Workers' Compensation Act to receive "punitive damages" or compensation for "pain and suffering."

We are workers' compensation attorneys that help people with Illinois work injuries anywhere in IL via our statewide network of attorneys.  Contact us and we will answer your questions or find the right lawyer for your situation.