Business & Work

Workers’ compensation is a system of benefits that:

• Pays for the medical costs of job-related injuries and diseases,
• Covers almost every employee in Illinois, and
• Starts from the moment a job begins.

If you suffer a job-related injury, you can probably get workers’ compensation.

The Illinois Workers’ Compensation Commission (the "Commission") handles workers’ compensation claims. The Commission acts as an impartial court that answers these claims.

Who is eligible for workers’ compensation?

Under the Workers’ Compensation Act (“WCA”) and the Workers’ Occupational Disease Act (“WOD”), workers’ compensation benefits are payable to employees and certain dependent survivors.

Covered workers may include:

• Most state, county, and local government employees (excluding Chicago police and firefighters),
• Employees of private companies and charitable or religious organizations,
• Domestic workers and agricultural workers,
• Landscape workers, and
• Employees injured out of state, where the contract was made in Illinois or the employment is principally located in Illinois.

Covered workers often may not include:

• Workers classified as independent contractors,
• Employees of the federal government,
• Employees of a railroad,
• Longshore, shipyard, and harbor workers, and
• Chicago police and firefighters.

What injuries are covered by workers' compensation?

Workers' compensation only covers job-related injuries, such as:

• Injury caused by the repetitive use of a body part at work,
• Traumatic injuries, such as slip-and-fall accidents,
• Diseases caused by exposure to harmful substances or conditions at work,
• Mental health conditions caused by work-related stress or trauma,
• Other physical problems caused by work, or
• Pre-existing conditions made worse by work.

Some injuries are not covered, including:

• Injuries at recreational events, like company picnics or softball games, unless your employer orders you to go, and
• Accidents during a drug or alcohol rehab program.

What is an employer required to do for injured employees?

The law requires an employer to:

• Buy workers’ compensation insurance or get permission to self-insure,
• Post this notice in the workplace explaining workers' rights, which lists:
  • The insurance provider,
  • Policy number, and
  • Contact information.
• Keep records of work-related injuries,
• Report accidents that cause more than three lost work days, and
• Report any work-related deaths within two days.

Even though an employer is required to report accidents to the Commission, the Commission will not act until the employee files a claim.

If an employer does not have workers’ compensation insurance, the employee should contact the Department of Insurance and provide the employer's name, address, and the date of the injury. The Workers’ Compensation Fraud Division can be reached at [email protected]. 

An employer must not:

• Charge their employee for any part of the workers' compensation insurance premium or benefits, and
• Discriminate against an employee for exercising their rights under the law. This includes harassing, firing, or refusing to rehire the employee because they filed a compensation claim.

An employee can still be disciplined or fired for other valid reasons, even after filing a compensation claim.

What is an injured employee required to do in order to get workers' compensation?

To get workers' compensation, a worker must do the following:

• Get first aid or medical help as soon as possible after the injury,
• Work with the doctors and try to completely heal so the worker can return to work, if possible. A worker can lose benefits if they do not try to get better or if they do things that will make their injury worse,
• Tell the doctors that the treatment is for a work-related condition. This lets the doctors know that the employer should pay the medical bills, and
• Give the employer the name and address of the doctor or hospital they chose. If the employee changes providers, the employee should tell their employer.

The employee must also give the employer all medical records that have to do with the injury or illness. A worker does not have to give anyone free access to his or her doctor or medical records.

The employer is not required to provide benefits if it does not receive the necessary medical information. If the employee's doctor does not send medical records to the employer, benefits may be delayed.

What does an employee have to prove to win their workers' compensation claim?

An employee must file a claim with insurance and file a case with the Illinois Workers’ Compensation Commission (the "Commission"). Workers must report the injury to their employer within 45 days of the incident. A case must be filed with the Commission” within 3 years of the accident. While there are exceptions that would extend the filing period, you should file your case as soon as possible to protect your rights.

When an employee files a claim, it is on the employee to prove to the Commission that they have a good claim. They must prove the following:

• The worker was an employee of the employer on the date of the accident,
• The employee was injured or exposed to a disease because of their employment,
• The injury was caused by or made worse by the incident,
• The employee notified the employer within the correct time limits, and
• If the injury is from everyday activities or movement. Then, the worker was at greater risk of injury than the public.

If the employee proves all of these, they will receive some benefit. But the employer can still argue other things, such as:

• The extent of the injury,
• The average weekly wage amount, or
• The medical necessity of treatment.

Note that there are special rules for some occupations and health conditions. To see if you qualify, you may want to talk to a lawyer.

Claims Resolution 

An arbitrator on the Commission holds a trial. The trial follows Illinois laws, evidentiary rules, governing rules, and precedent from previous workers’ compensation claims.

The process can be quite long. It can often take one to two years from the date of filing the claim. Other than an emergency hearing, arbitrators cannot resolve a workers’ compensation claim until the employee has recovered from their injury to the extent possible. 

Both the employee and the employer have the right to appeal a decision. While an appeal is pending, an employer is not required to pay benefits awarded by an arbitrator. However, if the case is resolved in favor of the employee, interest will be added to the award. 

Commission decisions are final for employees of the state of Illinois. All other workers’ compensation claims can be appealed to the circuit court. 

Most cases, however, are resolved through a settlement contract between the employer and employee.

What else can an injured employee do to get workers' compensation?

An employee can file a lawsuit to get workers' compensation benefits. A workers' compensation contract sometimes gives a time limit for the employee to try to get compensation. For certain employers and certain injuries, you can still file a lawsuit to get your benefits if you go past the time limit.

What should an employer do if an employee reports an injury?

If an employee reports an injury to an employer, the employer should take the following steps:

• Provide the first aid and medical services needed,
• Tell the insurance provider or workers' compensation administrator,
• If the employee cannot work for more than three days because of the injury, the employer must do one of the following:
  • Begin payments of Temporary Total Disability (TTD),
  • Give the employee a written explanation of the additional information the employer needs before it will begin payments, or
  • Give the employee a written explanation of why benefits are being denied.

Need help getting information on workers' compensation?

For more information on getting workers' compensation benefits in Illinois, see the Workers' Compensation and Occupational Diseases Handbook.

You can also visit the Illinois Workers' Compensation Commission website.