Most employers must maintain an adequate workers’ compensation insurance coverage that would ensure that the injured employees receive the necessary medical treatment and compensation while they are unable to work.
What is workers’ compensation? Workers’ compensation is a system of benefits provided by state law to most employees who have job-related injuries. It provides an exclusive remedy to the injured at work employees; generally, the employees may not sue their employers for their work-related injuries.
Employees are entitled to the benefits provided by the workers’ compensation from the moment they begin their jobs. Importantly, workers’ compensation benefits are paid regardless of fault.
What benefits are provided under the workers’ compensation?
Workers’ compensation system provides compensation for all injuries received at work, including injuries received by the repetitive use of a part of the body or even for pre-existing condition, if such condition was aggravated by your work activities. Benefits provided by the Workers’ compensation system can be classified into two categories. The first category or workers’ compensation benefits is temporary benefits, which includes the following:
Medical care that is required to cure or relieve the employee of the effects of the injury;
Temporary total disability benefits while the employee is off work and is receiving medical treatment;
Temporary partial disability benefits while the employee is recovering from the injury but working on light or restricted duty; and
Vocational rehabilitation benefits for the approved vocational programs.
The second category of workers’ compensation benefits is permanent benefits, which includes the following:
Permanent partial disability benefits for an employee who sustains a permanent disability of disfigurement, but can work receiving reduced wages;
Permanent total disability benefits for an employee who is rendered permanently unable to work; and
Death benefits for surviving family member.
Are workers’ compensation benefits taxable?
No. Workers’ compensation benefits are not taxable under the state or federal law and not even reported as income on tax returns.
Who pays for workers’ compensation coverage?
Your employer is responsible for the costs of workers’ compensation insurance. Most employers buy commercial workers’ compensation insurance, and the insurance companies pay the benefits on the employer’s behalf.
Can I verify whether my employer has workers’ compensation coverage?
Yes. To identify which party is responsible for paying your workers’ compensation benefits, you may check your employer’s notice board (usually located in the lunch room or meeting area) or, in Illinois, by calling a toll-free number (866) 352-3033. If your employer does not have workers’ compensation insurance, the employee should give the employer’s name, address, and the date of injury to the commission’s Insurance Compliance Division or call a qualified attorney for help with filing of the complaint.
What happens if your employer does not have workers’ compensation insurance?
There are significant penalties for an employer if it fails to provide the workers’ compensation insurance coverage. Furthermore, an uninsured employer looses the protections of the workers’ compensation act for the period of noncompliance and may be sued in civil court, where there are no limits to awards for injuries. Furthermore, many states, including Illinois and Wisconsin, maintain an injured workers’ benefit fund, which is used to pay to injured employees whose uninsured employers failed to pay benefits.
What happens when an employee is injured at work?
The employee should notify his or her manager or Human Resources Manager as soon as possible. This notice should disclose the date and place of the injury, provide a brief description of the injury, and give the employee’s name, address, and contract phone number. We always recommend that such notice be given in writing, with a copy of the notice saved for future references. Obviously, if an employee is hospitalized or is unable to provide such a notice immediately upon injury, the employee or his or her relatives generally have 45 days within which to provide such a notice. A competent lawyer will help you to properly draft such a notice and give you the necessary guidance to avoid potential mistakes.
Can a worker be fired for reporting an accident or filing a claim? It is illegal for an employer to harass, discharge, or refuse to rehire, or in any way discriminate against an employee for filings a workers’ compensation claim. Such conduct by the employer may give rise to a right to file a separate suit for damages in the circuit court. However, an employee with a pending workers’ compensation claim may still be disciplined or fired for other valid reasons.
What can an employee expect from his or her employer after providing a notice of injury?
Upon receipt of a notice of injury, the employer should promptly take the following steps:
Provide all necessary first aid and medical services;
Inform the insurance carrier or workers’ compensation administrator, even if the employer doubts as to the legitimacy of the employee’s claim;
If the employee is unable to work for more than three days because of the injury, the employer must do one of the following: (i) begin paying the temporary total disability benefits, (ii) give the employee a written explanation of the additional information the employer needs before it will begin making payments, or (iii) give the employee a written explanation of why benefits are being denied.
Generally, the employer is also responsible for reporting the accidents to the workers’ compensation commission on the designated form, “Employer’s First Report of Injury.”
It’s important to contact a workers’ compensation lawyer early in the process so that the employer’s actions are properly documented to protect your interests.
What happens if the employer refuses to pay any benefits?
Your attorney should contact the employer directly to determine why benefits are not being paid. If the situation cannot be resolved amicably, your attorney will file a request for hearing with the workers’ compensation commission. It is important to note that the employer’s accident report does not trigger any action by the workers’ compensation commission. The commission gets involved only if the worker or his or her attorney files a claim and follows the procedures to request a hearing. This is a complicated process, and it should be initiated by an experienced workers compensation attorney.