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Worker’s Compensation Eligibility: Find Out If You Are Eligible

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A warehouse worker who slips and falls while mopping the floors could be eligible for worker’s compensation. The drug store employee who injures herself while moving merchandise boxes to the appropriate aisle could also be a candidate for worker’s compensation. A businessman who falls down the hotel lobby stairs while on a business trip could also receive worker’s compensation benefits.

What is Worker’s Compensation?

Worker’s compensation protects employees from the financial consequences of workplace injuries. This insurance program covers the employee regardless of who is at fault, whether a colleague, customer, or employer. Limits do apply to receiving worker’s compensation benefits, however.

All of the following factors will determine whether or not one is eligible for worker’s compensation benefits:

Worker's-Compensation-Form

The following factors will determine whether you are eligible for worker’s compensation

1. Employee Status
2. Injured on the Job
3. Commutes
4. Reporting Timeframe
5. Employer Coverage
6. Exceptions

1. Employee Status

An individual must be an employee to be eligible for worker’s compensation. Volunteers, for instance, provide services on a volunteer basis and are not candidates for benefits. Exceptions do exist, however. Volunteer firefighters are sometimes covered by some states’ worker’s compensation programs.

Independent contractors and consultants are not typically eligible for worker’s compensation benefits. Still, the rules vary state by state, and those who signed a 1099 tax form will likely go to court to resolve any disputes.

2. Injured on the Job

To be eligible for worker’s compensation, the employee must have been injured while engaging in work-related activities. The fine line between work-related and non-work-related situations can be illustrated with the following examples:
An employee takes a lunch break and is injured in the cafeteria after slipping on spilled food. This individual is likely to receive worker’s compensation benefits because the injury occurred during work hours and on the company’s premises.

However, an employee who takes a lunch break at the local deli and twists his ankle while at the deli is not eligible for worker’s compensation benefits. This individual’s injury did not occur on workplace premises and is not a work-related incident. However, this employee could receive worker’s compensation benefits if he picked up lunch for his boss from the deli and the injury occurred at the time.

3. Commutes

Commutes to and from work are not considered time on the job and do not entitle an employee to worker’s compensation benefits if injuries occur. However, exceptions to this rule do allow some employees to receive benefits. For instance, an individual driving a company vehicle, an employee running errands for the employer or someone who regularly travels for work can be eligible for worker’s compensation benefits.

4. Reporting Timeframe

Employees who have been injured as a result of work-related activities must report the injury within a specified timeframe, which differs from state to state, in order to be eligible for worker’s compensation. Typically, most states have a 10 to 90-day time period for employees to make a written report for their employer. Once the employer is made aware of the employee’s injury, the employee typically has one to three years to file a worker’s compensation claim.

Different states may allow more time to file a claim. Some states also extend the time limit for filing claims if the individual is unable to file a claim immediately due to such scenarios as falling into a coma, prolonged treatment of the injury (such as burns), or being quarantined due to a contagious condition.

Those with mild work-related injuries should not hesitate to file a claim, since injuries can get worse over time. A claim will simply close in the event that a work-related back condition heals on its own. However, waiting to file a claim for a back injury that grows increasingly severe could lead to becoming ineligible for worker’s compensation benefits.

5. Employer Coverage

The vast majority of employers provide worker’s compensation coverage. While state laws differ, worker’s compensation coverage is usually dependent on the number of employees an employer has, the nature of the business and the type of work employees engage in. Most state laws require an employer to have coverage if they have at least one employee; other states require two to five employees.

Employees of the federal government are protected with a unique federal worker’s compensation system. Federal workers are guided by federal worker’s compensation benefit systems rather than state systems.

6. Exceptions

Domestic workers, such as housekeepers or nannies, are typically not covered by many states’ worker’s compensation programs. Other states exclude these professions if the employees are part time.

Temporary workers, or those hired by staffing agencies, are also covered by worker’s compensation so long as any injury sustained occurred while on the job. The primary challenge in temp workers’ claims is determining who is responsible for the coverage, the temp agency or the company to which the employee was sent to perform work.

Seasonal workers may also be excluded from some states’ worker’s compensation programs. Most states do, however, cover immigrant workers who lack the legal status to work.

Work with an Attorney

As the victim of injury while on the job, your medical bills, lost wages, and time off work are likely to cost you and your family valuable time and expense. You’ll benefit from seeking the services of a worker’s compensation attorney who will handle your case with professionalism and ensure you receive proper compensation. The attorney will discuss with you what is considered eligible under your state’s worker’s compensation laws and find out if your injuries make you eligible for benefits.

In Illinois, workers who have sustained injuries on the job have a two year time limit to file a worker’s compensation claim. When you are ready to discuss your claim, contact Oak Lawn’s most trusted personal injury lawyers. The Berry K. Tucker & Associates, Ltd. legal team is experienced in all facets of personal injury law. Our lawyers’ wealth of experience includes birth injuries, bicycle accidents, car accidents, medical malpractice and wrongful death.

The dedicated team of personal injury lawyers at Berry K. Tucker & Associates, Ltd. will review your case, work with your insurance company, inform you of your legal options and fight for maximum compensation. We also offer an initial consultation to help you get started on resolving your worker’s compensation claim quickly.

Tips for Filing for Worker’s Compensation

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There are many people in Illinois that have jobs in which there is a risk for a work-related injury.  If you get hurt on the job in Illinois, you are entitled to workers’ compensation.  Getting hurt at work is never a pleasant experience because of the pain you go through and the possibility that you may be out of work for a decent amount of time.

Missing that much work due to an injury can put people in a deep financial hole, which is why Illinois requires all employers by law to have workers’ compensation insurance for their employees.How-to-File-for-Workers-Compensation-Illinois

The Process of Filing for Worker’s Compensation

Even though workers in Illinois are entitled to workers’ comp when they are injured on the job, the compensation is not automatic.  You must go through the process of filing your claim and notifying your employer, and your request for workers’ compensation can still be denied for various reasons.  If you need to file a workers’ compensation claim, it is best to hire a personal injury attorney that understands workers’ compensation laws and can help you navigate the claims process.  When you are ready to file your workers’ compensation claim, make sure you follow these tips to ensure that you get the compensation you deserve for your injury.

Workers’ Compensation Benefits in Illinois

In Illinois, there are a variety of benefits that make up workers’ compensation, including coverage for reasonable medical care, temporary total or partial disability, permanent partial or total disability, vocational rehabilitation, and death benefits.  None of these benefits are taxable under Illinois law.

Temporary Disability Benefits

If you are eligible for temporary disability benefits, you can receive 66.6% of your weekly pay as long as it does not exceed the maximum set by the State of Illinois.  The maximum weekly payment for this benefit is $1,440.60 as of July 15, 2017, and this maximum amount is usually updated every 6 months.  You can receive temporary disability benefits after missing three days of work, and if you end up missing more than 14 days of work, you will be compensated the lost wages for the first three days.

Permanent DisabilityDisability-Benefits-Personal-Injury-Attorneys

Permanent disability can be configured in a couple of different ways.  You may receive 66.6% of the difference in your wages before and after the injury, or your pay may be determined by a “schedule of injuries” with predetermined compensation depending on the specific injuries.  Those who have been disfigured may be eligible for 60% of your average weekly wages for up to 162 weeks.

Filing for Workers’ Compensation

When filing a workers’ compensation claim in Illinois, there are two major steps you must complete:

1. Notify your Employer

The first thing you must do if you plan to file for workers’ compensation is notify your employer.  It is best to notify your employer in writing so that it is formal and on record.  Make sure your notification includes the date, time, and place of your accident.  You have 45 days from the time of the accident to notify your employer and still be eligible to receive workers’ compensation benefits.  If you wait for more than 45 days to file, you can lose your right to workers’ compensation benefits.

There are a couple of exceptions to the 45 days rule.  You can file for workers’ comp after 45 days if you have a slow-developing injury or cumulative trauma injury that is work-related and has resulted in a disability.  You must notify your employer immediately once you have discovered the condition.  You have up to 90 days to notify your employer if you have experienced an injury due to radiation exposure on the job.

2. Employer’s ResponseTalk-with-Employer-Workers-Compensation

After your employer has been notified of your injury, they must provide you with a list of medical professionals that you can see for treatment and start the claims process with their insurance provider.  Your employer must accept or deny your claim within 14 days if your injury has caused you to miss more than three days of work.  If your claim is accepted, you should start receiving temporary disability payments.  If your employer denies your claim, they must provide you with a written explanation of why your claim has been denied or delayed.

Once your employer has been notified of your injury, they have 30 days to file an accident report with the Illinois Workers’ Compensation Commission.  However, this report does not result in any actions taken by the Commission.  You are responsible for filing a claim with the Commission if your employer does nothing after your injury report.

Application for Adjustment of Claim

An Application of Adjustment Claim is the paperwork you must file to start your claim with the Illinois Workers’ Compensation Commission.  You must not only provide this application to the Commission, but also proof that you have provided your employer with a copy of your application.  This claim must be filed within 3 years of your injury, or within 2 years of the last time you received a compensation payment.  The following are exceptions to this rule:

  • If you have an injury caused by asbestos, you have 25 years from your last exposure to file a claim.
  • If you have Pneumoconiosis, you have 5 years to file.
  • You have 25 years from your last exposure to file for radiation exposure.
  • If you have a disease caused from inhaling silica dust, you have 3 years to file a claim.

Denied-Workers-Compensation

Many people believe that they only need to file this claim if their employer is not providing them with their workers’ compensation benefits.  However, it is a good idea to always file an Application for Adjustment Claim so that you are ready to deal with any disputes.  It is common for people to hire a personal injury attorney to help them prepare the application for this claim.

If Your Workers’ Compensation is Denied

There are always reasons your workers’ compensation claim can be denied.  Most claims are denied due to failure to notify your employer within 45 days or failure to prove that the injury is work-related.  If you did abide by these rules and your claim was still denied, you can contact the Illinois Workers’ Compensation Commission for a review.  The Commission will decide what to do with your claim after holding a hearing.

Hiring a Personal Injury Attorney

While you can file a workers’ compensation claim without an attorney, it helps to have the assistance of an experienced workers’ compensation attorney.  At Berry K. Tucker & Associates, Ltd. our personal injury lawyers have experience dealing with workers’ compensation cases and we will work to ensure that you get the compensation you deserve.

We can help you correctly file your claim and fight for you if you need a hearing to get your compensation.  Contact Berry K. Tucker, Ltd. to talk to our attorneys about your workers’ compensation claim.

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