If you have never been hurt on the job before and suddenly can not work due to injury, you will likely have a lot questions. Among those can be:

  • How will I pay for my medical care? Under Illinois workers’ compensation law, all of your related medical care is paid for. You do not need health insurance.
  • What is my case worth? It’s too soon to tell and will depend on your recovery and treatment.
  • Is it OK to give the insurance company a recorded statement? We strongly recommend that you do not.

And a lot of people want to know when their first check is going to arrive.

This is a sensible question for a lot of reasons. You will not be getting your regular paycheck, so you need to know when you are going to receive money so you can plan your life. If you live paycheck to paycheck, it is especially important. There are bills to pay and if you go without the money you are entitled to, you could end up homeless, get sued for debts, etc.

Generally speaking, your first check should arrive within two weeks of when you went off of work. The key point is that it must be a doctor who takes you off work, your employer can’t accommodate restrictions if you have any and the insurance company needs to receive a copy of that doctor’s note.

Unfortunately this timeline is not always followed. Just the other day I was called by an injured worker who tore his ACL six weeks ago and still has not been paid.

Why Do Work Comp Insurance Companies Delay Payments?

There can be a variety of reasons why your first TTD check (lost time payment check or temporary total disability) does not arrive in a timely manner. This includes:

  1. There are legitimate questions if you were hurt at work. If your initial statement to your doctor was that you were hurt at home, your case will be denied. If a co-worker or your boss says that you got hurt outside of the job or were drunk, your case will be denied. That does not mean that you will not win your case, but that there is work to be done.
  2. There are legitimate questions as to if your case is covered under the Illinois Workers’ Compensation Act. This can include unexplained falls, injuries traveling to work, fights where you are the aggressor, some mental stress cases and many other reasons. Often an insurance company will say you do not have a case under Illinois law. Do not believe them. Always verify with an experienced Illinois workers’ compensation lawyer.
  3. The insurance company is disorganized and not worried about paying you in a timely manner or have their own policy of waiting just a little bit longer. That sounds nuts, but it happens. When you get hurt, your case gets assigned to a claims adjuster. It won’t get paid until he/she enters it into their system and requests a check. Some of these people are very lazy. Some are cruel. Some quit and you then are waiting on a new adjuster to pick up their caseload and review all of your files. Sometimes that process takes weeks or months. There is a solution to this which I will shortly discuss.
  4. The insurance company is trying to frustrate you. There are some insurance companies that act as third party administrators or TPA’s for big companies. Those big companies are self insured and hire TPA’s like Sedgwick, Gallagher Bassett and others to handle their Illinois work comp cases for them. There is pressure to keep those costs down, otherwise they could lose that big, lucrative business. So in some cases, insurance companies as a strategy will just not pay without reason. Their hope is to frustrate you enough that you will give up.

The solution to all of these delay issues is to formally file a case with the Illinois Workers’ Compensation Commission. This is the first thing an attorney does when you hire them. What this does is put pressure on the insurance company to respond. It also gives you and your lawyer the ability to force action.

We do this by filing what is called a 19(b) petition for immediate hearing and sometimes by filing for penalties and fees against them for an unreasonable delay. What this does is get your case before an Arbitrator and requires the insurance company to disclose the reason why benefits have not been paid. While every case is different, often just filing this motion will get you paid both retroactively and going forward.

It’s not a lawsuit, but it is you and your lawyer going on the offensive to make sure that the law is followed. When people say they want an attorney who is aggressive or who will look out for them, this is the text book example of that.

We have helped tens of thousands of injured Illinois workers and would love to help you. Please contact us any time to speak with a lawyer and get a free case review. We will do whatever we can to help you.