The Illinois Workers’ Compensation Act provides for a bunch of benefits that have to be provided and one benefit that can be provided but doesn’t have to.
In simpler terms, if you are hurt at work in Illinois, your employer has to be for your time off of work and 100% of your medical care. No co-pays, nothing out of pocket. The only way around that is if they have a defense to your case of some sort. If they deny benefits without good reason, an Arbitrator can hit them with huge financial penalties.
While a lot of people who call me have worries about getting the medical care they need or compensation for time off work, by far the most common question I get is, “What is my case worth?” Some people also want to know if they will get a settlement at all.
Under IL law, the insurance company isn’t required to offer you a settlement. Some employers, like the state of Illinois, very rarely offer one at all. Most will though because the way insurance companies work is they like to deal with known numbers. By that I mean, once you settle, your case is done and they can close your file. This takes away any chance that your condition will turn for the worse and they’ll have to pay out more money for medical treatment.
So why wouldn’t they offer a settlement? There are a few reasons:
- If you have a history of bringing a lot of work injury cases, they want to make it difficult on you to discourage you from doing it again.
- You have a likely chance of re-injury when you return to work, especially if it’s your back, shoulder, or neck. By waiting, they will reduce the total payout in the end as they’ll only have to settle on one case, not two.
- You are a pain in their butt. Some injured workers get understandably emotional. I’ve seen a few take that emotion too far and be abusive to insurance adjusters. That’s a bad idea and some of them will retaliate by not offering a settlement.
- They honestly believe they have a good defense to your case.
- They want a reputation as being difficult to deal with. This happens more in minor car accident cases than workers comp, but some insurance companies want to be so difficult that good attorneys will decide it’s not worth their time to get involved in cases against them because it will be too much work.
So does this mean you are at the mercy of the insurance company if you want to get paid? Not at all. Sometimes they will make you a settlement offer, although it’s almost always a low ball one. Usually, when an attorney gets involved, an offer will come and it will be much fairer.
But if there’s no offer at all, your attorney can get you the right compensation by taking your case to trial. After an arbitration, you will get an award that will pay you out whatever the Judge thinks the case is worth. Trials aren’t usually expensive and don’t take a ton of time. And quite honestly, when the insurance company knows the case might go to trial, that is how you get their best offer.
So don’t despair. You almost always will get something and there are easy ways to make sure that you get the most money possible in the end.