Workers’ Compensation in Illinois
Workplace injuries are common, but they come with a lot of other difficulties – including concern about your career stability on top of recovering from a major injury. It can be complicated to navigate what your employer expects with the reality of your coverage and the severity of your injury. At Suburban Orthopaedics, we can help guide you through the arduous process of obtaining quality medical care after an on-the-job injury.
If you have suffered a work related injury we know that you deserve specific and attentive orthopaedic care. At Suburban Orthopaedics our physicians and staff are dedicated to efficiently return you to work by providing an extensive evaluation and treatment plan. We are committed to reducing your time off from work while simultaneously restoring you to your pre-injury status in the most efficient and cost-effective manner. With diagnostic and rehabilitative services located on-site, Suburban Orthopaedics is the perfect choice for management and care of your work related injury.
Worker’s Compensation Injuries
Nobody plans to get injured at work, and we know you’re eager to rejoin your team and get back to your daily life, but workplace injuries can be serious and have a life-long impact if you delay seeking treatment. You need to see a medical provider to be able to file for worker’s compensation, so don’t just “wait and see” if the injury resolves itself. Workplace injuries can include:
- Overexertion Injuries: Overexertion injuries are caused when you’ve pushed your body past your physical capabilities and can result in bulging discs in the spine or abdominal hernias. Back injuries are common worker’s compensation injuries that can occur from pushing the body too far to finish a task.
- Slip and Fall Injuries: Slip and fall injuries are common in the workplace and can result in spinal injuries, fractures, knee, hip, or joint injuries that require medical attention.
- Repetitive Motion Injuries: Repetitive motion injuries are caused by doing the same manual task over and over again, causing wear and tear on joints, tendons, and muscles.
- Reaction Injuries: Reaction injuries are caused by slipping, tripping, falling, or trying to move quickly out of harm’s way. Common reaction injuries include meniscus tears in the knee, fractures from falls, or cuts and lacerations.
These injuries can have life-long side effects that impact your mobility and cause chronic pain. You must seek treatment after a workplace injury to rule out any significant injuries. We know it can be a frustrating process to navigate worker’s compensation, but we’re dedicated to you recovering from your workplace injury so you can get back to the things in your life that matter.
Worker’s Compensation Injuries
Work-related orthopedic injuries are very common, especially for employees in physically demanding professions such as construction, health care, manufacturing, warehouse jobs, first responders, and more. On-the-job injuries can impact your professional and personal life and can cause chronic issues. It’s important to get workplace injuries documented and diagnosed by a medical professional as they can get worse over time or be acutely in need of immediate treatment.
Worker’s Compensation Injury Treatment
Work-related orthopedic injuries are very common, especially for employees in physically demanding professions such as construction, health care, manufacturing, warehouse jobs, first responders, and more. On-the-job injuries can impact your professional and personal life and can cause chronic issues. It’s important to get workplace injuries documented and diagnosed by a medical professional as they can get worse over time or be acutely in need of immediate treatment.
- Employees' Need to Know
- Employee Benefits
- Medical Care and Costs
- Employee and Employer Options
- Personal Injury
- Handbook
Which Employees are Covered by the Law?
Almost each individual who is employed by a company in the state of Illinois is covered by the law from the moment they are hired for certain injuries or diseases that may be caused from their employment or duties required by their job.
What Injuries are Covered by the Law?
In most cases the law will include injuries that are caused, in whole or partially, by the employee’s work. For Example:
- An employee who is injured by the repetitive use of a body part.
- An employee who suffers a stroke, heart attack, or other physical problem caused by work.
- An employee who had a pre-existing condition*
- Injuries accrued by employer sponsored recreational programs (athletic events, parties, picnics, etc.)**
* Patient must be able to show the work aggravated that condition
** Only if the employee is ordered to participate by the employer - Injuries, accidental or otherwise, that incur while participating as a patient in a drug or alcohol rehabilitation program are not covered under the law.
Can an Employee be Fired for Reporting an Accident or Filing a Claim?
It is illegal for an employer to harass, discharge, refuse to rehire, or in any way discriminate against an employee for exercising his or her rights under the law.
What Medical Benefits are Covered Under the Law?
The employer is required to pay for all medical care that is reasonably necessary to cure or relieve the employee from the effect of the injury. These costs include but are not limited to
- First Aid
- Emergency care
- Doctor visits
- Hospital care
- Surgery
- Physical therapy
- Chiropractic treatment
- Pharmaceuticals
- Prosthetic devices
- Prescribed medical devices*.
*Devices such as a shoe lift or wheelchair may be covered.
What Benefits are Provided?
The law states the following benefit categories are provided to the employee:
- Medical Care that is reasonably required to cure or relieve the employee of the effects of the injury
- Temporary total disability (TTD) benefits while the employee is off work, recovering from the injury
- Temporary partial disability (TPD) benefits while the employee is recovering from the injury but working on light duty
- Vocational rehabilitation/maintenance benefits are provided to an injured employee who is participating in an approved vocational rehabilitation program
- Permanent partial disability (PPD) benefits for an employee who sustains a permanent disability or disfigurement , but can work/li>
- Permanent total disability (PTD) benefits for an employee who is rendered permanently unable to work
- Death benefits for surviving family members.
Who Pays for the Benefits?
By law, the employer is responsible for the cost of workers’ compensation. Most employers buy commercial workers’ compensation insurance, and the insurance company pays the benefits on the employer’s behalf. No part of the workers’ compensation insurance premium or benefit can be charged to the employee. Other employers obtain the state’s approval to self-insure.
What are the time limits for notifying the employer?
The employee must notify the employer within 45 days of the accident. Any delay in the notice to the employer can delay the payment of benefits. A delay of more than 45 days may result in the loss of all benefits.
What if the Employer Won’t Pay the Worker Any Benefits?
The employee or the employee’s attorney should contact the employer directly to determine why benefits are not being paid. Poor communication often causes delays and misunderstanding. If the problem persists, the employee should file a claim at the Commission. Please note that an accident report does not trigger any action by the Commission.
Who Pays for the Medical Care?
If the employer does not dispute a medical bill, it will pay the medical provider directly. The employee is not required to pay co-payments or deductibles. If the employer disputes a bill, it must promptly give the employee a written explanation for the refusal. If a case is pending at the Commission, the provider cannot try to collect payment from the employee; once the employee notifies the provider that he or she has filed a claim with the Commission to resolve the dispute. The provider may send the employee reminders of the outstanding bill, and ask for information about the case such as the case number or status of the case. If the employee does not provide the requested information within 90 days of the date of the reminder, the provider may resume efforts to collect payment.
How are Prices for Medical Care Determined?
Most treatments that are covered under the Act and were provided on or after February 1, 2006 are subject to a medical fee schedule. The employer shall pay the lesser of the provider’s actual charge or the amount set by the fee schedule.
Can the Employee Choose the Treating Doctor or Hospital?
Yes, however, there are limits; the state of Illinois cannot direct care to a specific doctor or hospital. The employee, after filing their claim with their employer, typically will see a physician directed by the employer. If the employee chooses to they may go see a physician of their own choice, even if that physician is outside of the employee’s regular insurance network.
Can the Employer Ask for an Evaluation by its own Doctor?
Yes. On occasion an employer may request a full medical exam by the doctor of its choice.
To discuss your injury, address your questions, and set an appointment for consultation with one of our orthopaedic specialists please contact our office at (630) 538-7814, log onto our Patient Portal or email us at info@suburbanortho.com
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