How Long Does Workers’ Comp Last in Bloomington

What You Should Know About Workers’ Comp

In Illinois, most employers must maintain workers' compensation insurance. Under the Illinois Workers' Compensation Act, employees must be insured from the moment they are hired. There is no required waiting period for coverage.

If you're injured on the job or contract an occupational illness in Illinois, you can file a workers' comp claim for benefits that will cover certain expenses that are directly related to your injury or illness. According to the Illinois Workers’ Compensation Act, you must file your claim within three years from the date of your injury or illness, or two years from the date of your last benefit payment, whichever comes later.

How Workers’ Compensation Benefits Work

When you suffer a workplace injury or illness, seek medical attention and report the incident to your employer as soon as possible. Your employer should provide you with a claim form to fill out, or you can download the form from the Illinois Workers’ Compensation Commission’s website. Make sure you fill out the form accurately and completely, sign it, and submit a copy of the completed form to your employer or their workers’ compensation insurance provider. Keep a copy of the form for your records.

Your employer is responsible for reporting the injury or illness to the Illinois Workers' Compensation Commission. If you don't report your injury or illness within 45 days of the accident, you can lose your right to receive workers' compensation benefits.

Once your claim has been submitted, the workers' compensation insurance provider will review it and decide whether to accept it or deny it. If your claim is approved, you will receive workers' comp benefits. If your claim is denied, you can work with a workers' compensation lawyer who can help you file an appeal with the Illinois Workers’ Compensation Commission. Your lawyer can also explain the overall process of workers' comp claims, the reasons for denied claims, and what workers' comp benefits cover.

Types of Workers' Compensation Benefits

In Illinois, employees who suffer work-related injuries or illnesses can recover different types of wage replacement benefits based on the extent of their disability. Workers' comp benefits are based on the type of disability for which the worker qualifies. The types of benefits that are available to you may include one or more of the following.

• Temporary Partial disability (TPD) — If a worker receives TPD benefits, this means he/she is capable of working on a part-time or full-time basis, but in a lesser capacity than his/her previous job. TPD coverage pays 66.6% of the difference between what the worker earned before the injury or illness and what is earned after the injury or illness. Typically, these benefits replace a portion of the worker’s lost wages and are paid until the worker is able to return to his/her pre-injury or pre-illness job.
• Temporary Total Disability (TTD) — A worker will qualify for TTD benefits if he/she is entirely unable to work for a certain period of time. Temporary total disability benefits cover a specific percentage—66.6% of lost wages, only this percentage covers a portion of the worker’s average weekly earnings. Typically, these benefits replace a portion of the worker’s lost wages and are paid until the worker is able to return to work or reaches maximum medical improvement.
• Permanent Partial Disability (PPD) — Permanent partial disability benefits are paid to injured workers who have suffered a permanent impairment but are still able to work. The amount of the benefit is determined by the degree of impairment and the worker’s pre-injury wages. There are two main kinds of PPD benefits: initial compensation and increased benefits. Initial compensation equals the worker’s disability multiplied by 450 weeks. Additionally, workers may recover increased benefits if they have either not returned to work or they are working and earning less than what they earned from an employer before the injury. However, if a worker quits his/her job for any reason that is not related to injury or illness, increased benefits will not be available.
• Permanent Total Disability (PTD) — Workers who sustain permanent total disabilities are unable to return to work due to their injury or illness. Permanent total disability benefits are paid to injured workers who are permanently and totally disabled. PTD benefits cover 66.6% of the worker's average weekly earnings, but how long does workers' comp last? In permanent total disability cases, workers are usually eligible to receive workers' comp benefits for the remainder of their lives.
• Medical Treatment Benefits — All necessary medical treatment costs related to your work injury are covered by workers' compensation insurance. This includes ambulance transport, emergency room care, doctor visits, surgeries, follow-up care, physical therapy, medical equipment, medications, and more. If you need to see a mental health professional after your accident, that's covered too.

Termination of Workers' Compensation Benefits in Bloomington, IL

Insurance providers use various reasons to terminate or reduce workers' comp benefits for injured workers. However, there are established procedures that must be followed when terminating benefits. It's fairly common and easy for insurance companies to terminate workers’ compensation benefits during the first 180 days of payment if they have a valid reason. However, they must notify the worker in writing of their intent to stop benefits at least 7 days in advance. Common reasons for terminating benefits include:

• Failure to Follow Medical Treatment – If you receive workers’ comp benefits, you are expected to see a physician on a regular basis and to strictly adhere to your medical treatment plan. Missing a few appointments may not be significant, but failure to follow treatment plans can result in the termination of your benefits.
• Refusing Light or Limited Duty – If you can't perform your normal work duties because of your injury, your doctor might indicate that you can perform light or limited duties. If your employer offers you such duties, and you refuse them, it can lead to the termination of your workers’ comp benefits.
• Findings of a Private Investigation – Insurance companies are always suspicious of fraudulent actions by injured or ill workers. If a fraudulent workers' comp claim is suspected, insurers often hire private investigators to look into the claim. It's important to know about workers' comp investigations and what they look for in Illinois.

Can You Appeal the Termination of Benefits?

If you suspect that your workers' comp benefits were wrongfully terminated, you can work with a Bloomington work injury lawyer to file an appeal. However, it's important to act quickly, since there are often strict deadlines for filing an appeal. You can expect to attend a hearing before an administrative law judge. During this hearing, your lawyer will have the opportunity to present evidence and argue your case for the reinstatement of your benefits.

What Are the Criteria for Determining Readiness to Return to Work?

Determining readiness to return to work (RTW) after a workplace injury is a collaborative process involving several factors.

Medical Clearance

To determine whether an employee is ready to return to work, a licensed physician must assess the injured or ill worker and make sure he/she has received appropriate medical treatment.

The physician must also review the requirements and demands of the patient's job. These include the physical demands (musculoskeletal strength and cardiopulmonary endurance), the mental and psychological demands (concentration, memory, stress), the potential hazardous exposures (chemical, biological, radiation, extreme heat or cold), and the requirements for the use of personal protective equipment. The doctor may ask the patient questions about his/her specific job duties or contact the patient's employer directly.

Your doctor must certify that your injury has healed sufficiently, and you are physically able to perform the essential functions of your job, with or without reasonable accommodations.

Functional Capacity Evaluation (FCE)

This physical assessment, often conducted by a therapist, evaluates your ability to perform specific job tasks, including lifting, bending, reaching, and stamina. It helps determine if modifications are needed to your work environment or duties.

Pain Management

Your pain level should be manageable through medication or therapy, ensuring it won't significantly hinder your job performance or safety.

Psychological Readiness

Your mental well-being is crucial. You should feel emotionally prepared to return to work, having addressed any anxieties or fears related to the injury or work environment.

If your work injury benefits were terminated too soon, or to find out more about how long your workers’ compensation benefits should last, contact our work accident lawyers at Strong Law Offices in Bloomington, IL. We offer free, no obligation consultations, and we won’t charge you any attorney fees unless we recover compensation on your behalf.