Workers’ compensation helps injured employees get back to work after a job injury. The laws vary from state to state, but the system in Illinois entitles injured workers to coverage of their medical bills and payment of lost wages. Those with any permanent impairment usually will be compensated for that, as well, once their medical treatment is complete.
The types of injuries that occur at work are infinite. Some are foreseeable, especially for employees who have to take risks, such as working with hazardous materials or dangerous equipment. But all employees are susceptible to injury. Even a seemingly minor slip and fall can cause a lifelong disability depending on the circumstances.
A less common injury is one that involves something cosmetic. What if your teeth get knocked out, or (and this has actually happened) you have breast implants and one is ruptured in a work accident? Your health isn’t at risk and you can still do your job, but you would probably consider these injuries serious and want to get the surgery to fix them. Does workers’ compensation cover the expense of cosmetic treatment?
This kind of injury is usually called “disfigurement” in the area of workers’ compensation, and it can fall in a gray area. The insurance companies, which are hired by employers to pay workers the benefits they get under the law, love gray areas. When they are faced with a claim that is in a gray area, they see an opportunity to deny the claim and save some money. It’s how they operate. So if you suffer an injury that requires cosmetic treatment, you might have to do some convincing.
Illinois workers’ compensation law requires employers (usually through their insurers) to pay for all “necessary” medical care that is “reasonably required” to treat a work injury. You can see where the gray area is … is cosmetic surgery necessary and reasonable? On one hand, if you have a small scar on your leg, fixing it with cosmetic surgery probably isn’t necessary and reasonable. But in the examples we used above – missing teeth or a ruptured implant – it seems both reasonable and necessary.
This gray area doesn’t extend to serious disfigurement, for which treatment would likely be approved and a settlement awarded. But for any case where your appearance is significantly altered, there’s a good argument that it should be covered under workers’ compensation. The best way to make sure you get all of the benefits you’re entitled to – including disfigurement – is to get an experienced workers’ compensation attorney on board sooner rather than later.
We are a network of experienced work injury lawyers that help injured workers throughout Illinois. We are happy to talk to you about your case for free and in confidence.