Many workers who are injured on the job assume that the workers’ compensation program will pick up the tab for their lost wages and medical expenses. While those who have experienced workplace injuries or illnesses might be eligible to receive benefits under Illinois law, the certainty of having their needs met is not a given.
Workers’ compensation laws vary greatly from state to state and there are several nuances in the Illinois laws that make them unique. This is one reason that consulting with a workers’ comp attorney can be particularly beneficial for Illinois workers who have been injured or become ill on the job.
In recent years, there has been uncertainty over the long-term continuation of workers’ compensation benefits in Illinois. As the result of workers’ compensation reform efforts, restrictions were put into place in 2011 which, while designed to prevent fraud, have made it significantly more difficult for many employees to seek benefits following a workplace related injury or illness.
Workers’ compensation has been all over the news in the Chicago area. In the wake of the Illinois budget crisis, workers’ compensation continues to be a hot-button topic and lawmakers are considering even more changes in the coming years.
Proving a Workers’ Compensation Case
One of the major challenges that those injured on the job in Chicago may face is proving their case. This can be a time-consuming and stressful process. Proving that an injury or illness was the result of an event that happened on the job becomes even more difficult when:
- An injury happens while away from the worksite, or while traveling on company business (even in-state)
- An injury happens during a required, employer-sponsored social event, particularly if alcoholic beverages were served
- An injury aggravates a pre-existing condition
Injured parties must also prove that medical expenses resulted, and that they are unable to work as a result. Employers are given the opportunity to provided modified job options to accommodate an injured worker, though payment may be less.
Disputing a Workers’ Compensation Case
In Illinois, the Workers’ Compensation Commission resolves all disputes between employees and their employers as the result of on-the-job injuries. Cases are tried first by an arbitrator, and their decision may then be reviewed by a three-commissioner panel. Though cases can be appealed, up to the Illinois Supreme Court, most disputes are resolved through a settlement.
Recent Changes to Workers’ Compensation Laws
The 2011 changes to the workers’ compensation laws were made in an effort to cut costs and reduce fraud. Though there has been some push-back, Gov. Bruce Rauner is leading the charge for even stricter regulations. As the debate rages on, the future of workers’ compensation benefits in Illinois remains in the air.
Among the significant changes enacted in 2011 are:
- A reduction in the medical fee schedule and the number of hospital and non-hospital regions. This change was made to reduce medical costs in workers’ compensation cases, but could result in fewer treatments for injured employees.
- Requires medical providers to provide billing statements on standardized forms.
- Caps for wage differential awards (to 5 years or age 67, whichever happens first). This can significantly decrease the benefit awarded to injured workers who fall within this category.
- Changes in the calculation of Temporary Partial Disability payments from gross amount earned in the modified job to net amount earned in the modified job. This affects cases where an injured employee is given the opportunity to work, after injury, in a modified position which accommodates the injured party.
- Permanent partial disability must now be established by a licensed physician, using the most current edition of the American Medical Associations (AMA) Guide to the Evaluation of Permanent Impairment. Known for their conservative guidelines, this AMA requirement can result in a lessened account of a workers full injury, leading to a smaller benefit amount.
- Authorization for Utilization Reviews for employers and insurance companies. This allows employers and insurance companies to consult with other doctors before authorizing medical treatment or paying bills for a treatment. While this saves Illinois businesses and insurance companies’ money, it can result in delayed or incomplete treatment for injured workers.
Though these workers compensation regulation changes have been in effect since 2011, the long-term implication for employees suffering from workplace injuries, now and in the future, is still very much in the air.
As expected, the result of these changes has been a drastic reduction in the number and amount of payments made to injured workers throughout Illinois. While this is a great advantage for Illinois employers and insurance providers, it can lead to immense financial and emotional hardship for injured employees.
It is vital, now more than ever, that injured workers in Chicago seek advice and support from an Illinois workers comp attorney. The results of facing a workers compensation case alone can be potentially devastating.