The process for filing a claim and getting benefits after an Illinois work injury is different from the process of filing a lawsuit after a non-work injury. Here is what you can expect in a typical case:
Injury. This often happens because of an accident at work. A slip and fall, a machine injury, a car accident on the job, lifting something heavy, etc. The majority of work injuries are sudden, although some, like carpal tunnel or other repetitive stress injuries, develop over time.
Medical treatment. After a work accident, or as soon as you realize you are injured, you should see a doctor. Generally speaking, you get to choose which doctor you see. Immediate medical attention is good for your overall health and also for your benefits claim.
Notify employer. You have 45 days to notify your employer of a work injury. If your injury occurs over time, and you do not have an exact date of injury, then your date of injury is the day you knew or should have known that you had a work injury.
Hire attorney. It’s a good idea to hire an attorney at the beginning of your case, especially if your injury is serious or permanent. Although it’s never too late if you realize later on that you want legal help.
File a claim. Claims in Illinois are made by filling out a form called an Application for Adjustment of Claim and filing it with the Illinois Workers’ Compensation Commission. Most claims are filed at the main offices in downtown Chicago. You have three years from the date of your injury to file a claim.
Get assigned to an arbitrator. Once your claim is filed, the commission will assign an arbitrator (similar to a judge) to your case. They will follow the progress of your claim and hold hearings if there is a dispute. They’ll also oversee your trial if you have one. Your arbitrator will be at a hearing site, most likely the site closest to where you were injured.
Start getting benefits. Benefits should start fairly quickly. You are eligible for TTD four days after you get hurt. You can expect TTD checks every two weeks. Medical benefits should start right away. You should be covered for 100% of all reasonable treatment, including medications, ER visits, doctor appointments, physical therapy and surgery.
Status hearings. Your arbitrator will have your case on the calendar every three months for a status update. Your attorney can request a hearing or trial at that time, or simply put the case on the calendar for another few months.
Other hearings. Your attorney can request a hearing if there is a dispute, especially if you are not receiving benefits. At the hearing, your attorney will tell the arbitrator why you are entitled to benefits and ask that you be paid all the past benefits you are owed.
Settlement and end of claim. Many claims settle. This is where the insurance company agrees to pay you a certain amount and you agree to close your claim. This souldn’t happen until your recovery is over and you’re as good as you’re going to get. It’s recommended that you walk through the settlement process with an experienced attorney who knows how insurance companies work. It’s your best bet for getting a fair settlement.
Trial if necessary. If your claim does not settle, it can go to trial. Your attorney and the insurance company will present their sides and the arbitrator will rule on your case.