When you are hurt on the job in Illinois, you are entitled to have all of your medical care to be paid and 2/3 of your pay, tax-free, for your time off of work. These are really important benefits because if you are injured, immediate medical care can be the difference between a short-term and long-term problem. And of course, if you can’t work and get a paycheck, you need money to live off of.
Insurance companies don’t make money by doing the right thing. They save money by not providing benefits. Lately, we’ve been hearing from a lot of injured workers who have been off work a month or more and haven’t been paid. This has led to multiple questions about how long an insurance company has until they can pay you.
Your medical care should start right away. All bills must be paid unless there is a good faith reason not to. Such a reason could be a failed drug test, an honest belief you weren’t really hurt at work, or the treatment not being related to a work injury. Generally speaking, you don’t need pre-approval to get medical care. If you tell the provider it’s a work-related injury, they will generally treat you.
With your time off work, there can’t be an unreasonable delay. To us, if the insurance company has an off-work slip from your doctor and no defense to your case, you should be paid after being off of work for two weeks and the payments should happen at least twice a month until you are cleared to return to work. We too often are seeing workers who have been off work for 1-2 months and haven’t gotten a penny. The insurance company will claim they are gathering information, investigating the claim, don’t have all the documents they need, etc. It’s almost always bullshit.
If you have a legitimate injury, there should be no delay to medical treatment or paid time off work. If it happens, the only solution is to hire a lawyer and have them file a 19b petition for immediate hearing along with a petition for penalties and fees. This puts the insurance company on the clock and requires them to provide a legitimate reason for the delay or denial of your case. If they don’t have one they will either roll over and pay you or get punished at a trial.
The good news is that 19b trial motions usually get a response that works out. To the insurance company, this is just business or a game. If they deny you, maybe you’ll just go away or go back to work when it’s not healthy to. That’s terrible for you but potentially great for them. It’s gross, but really how the insurance industry operates.
The bottom line is don’t stress, look out for yourself, and know that there are solutions out there. If you want to speak with a lawyer for free or have any questions, contact us at any time.