The workers’ compensation system prevents injured employees from suing compliant employers after a workplace accident. Employers in Illinois are mandated to provide employees with workers’ compensation insurance. Workers’ compensation is designed to ensure injured workers can pay for their medical bills and living expenses during recovery. Workers’ compensation insurance is a no-fault system. This indicates that regardless of who was at fault for an injury, the worker qualifies for workers’ compensation coverage.
Employees file a claim for workers’ compensation against their employer’s insurance policy. This system was developed to be simple, but loopholes and dishonest practices allow insurance companies to minimize work injury claims. In some circumstances, workers’ compensation insurance companies avoid paying work injury claims completely.
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What Is Workers’ Compensation?
When employees are injured on the job, they may be left unable to work. They may also face significant medical treatment costs that they are unable to pay. The workers’ compensation program is intended to protect employees from the financial hardship that follows a workplace accident.
Being eligible for workers’ compensation benefits allows victims to receive compensation for medical bills, lost wages, and rehabilitation. If a victim perishes from a work-related injury, his or her surviving family may be eligible to recover workers’ compensation death benefits.
Does Workers’ Comp Prevent You From Suing Your Employer?
The nature of the workers’ compensation system in Illinois rarely grants employees the right to file a civil lawsuit against their employer. Employers are, however, legally forbidden from punishing their employees for filing a work injury claim. This behavior includes demoting, withholding promotions, and firing employees for seeking compensation for their work-related injuries or illnesses.
The majority of situations do not allow Illinois workers to sue their employers directly. Some circumstances have exceptions, like filing a third-party claim. A third-party claim is filed by injured workers when another person or entity contributes to their accident. These victims may have been injured by careless subcontractors, defective products, faulty equipment, and negligent drivers. Injured employees may qualify for filing a lawsuit against the at-fault third party to receive larger settlements. A workers’ compensation lawyer can help determine what parties played a part in a victim’s injuries.
Civil personal injury lawsuits may apply to an employee’s unique case. Grounds for lawsuits may include third-party claims, intentional torts, and intentional harm. Exceptions can also be made if an employer had knowledge of dangerous conditions or if an employer does not carry a workers’ compensation policy. Employers may also be at risk for a civil lawsuit for a wrongful termination of workers’ compensation benefits. Limitations include any violation of the company’s policy. Violating a company’s policy can include being intoxicated or under the influence at the time of the injury. Violating the company’s policy will more than likely lead to the denial of the employee’s claim.
When Can You Sue Your Employer?
Workers’ compensation coverage is required by law, and employers who do not maintain the proper coverage can have a civil personal injury lawsuit filed against them. Employers are responsible for staying current and knowledgeable of workplace conditions. Employer negligence is covered by workers’ compensation insurance. For a civil lawsuit to be valid, the employer must have been heinous and negligent, refusing to acknowledge workplace hazards, or have failed to provide the required coverage.
If an injured employee believes his or her employer intentionally caused him or her harm, he or she could file a civil suit for intentional torts against the company. Tort injuries include both physical harm and non-physical injuries, like emotional distress. The most common intentional torts filed against employers are assault, battery, conversion, defamation, false imprisonment, fraud, intentional infliction of emotional distress, invasion of privacy, and trespassing.
Assault is attempted battery on the employee or the threat to commit battery against him or her. Battery includes intentional injury to the employee. Conversion happens when employers or their representatives take an employee’s property and make it their own. Defamation occurs when harm is caused to an employee due to slander within the workplace. False imprisonment is the act of an employee being held against his or her will without legal authority. Fraud transpires when an employer’s lies have led to the injury of an employee. Intentional infliction of emotional distress happens when an employee has been emotionally traumatized by workplace behaviors. Invasion of privacy includes four main behaviors, but typically applies to the employee’s private information or photographs being revealed to an audience. Employees experience trespassing if their employer enters or uses their property without their consent.
What Does Workers’ Comp Cover?
To qualify for workers’ compensation benefits, two conditions must be present. The first condition is that an injured victim must be classified as an employee. Victims who are independent contractors or volunteers will not have their injury covered by the employer’s insurance. The second requirement is that a victim’s injuries must have been the result of his or her employment duties.
The primary benefits awarded through workers’ comp are medical, lost wages, vocational rehabilitation, and death benefits. There are four types of wage replacement benefits for injured workers: temporary partial, temporary total, permanent partial, and permanent total disability.
Workers’ Compensation Wage Benefits
Temporary Partial Disability
Temporary Partial Disability benefits are awarded to injured employees who are capable of returning to work, but unable to deliver the same tasks they could pre-injury. They are intended to cover the difference between what an employee can earn currently and what he or she was earning before the injuries sustained. Workers who have Temporary Partial Disability may need to work part-time while they recover. The injured employee may also be given light workloads if available. The doctor handling the disability claim determines when the benefits end.
Permanent Partial Disability
A Permanent Partial Disability prevents victims from working in the same capacity as before their work-related injury. The injury usually leaves an employee with a partial loss of his or her body or whole body. A wage differential may be awarded to victims who can go back to work with a lower wage. Permanent Partial Disability can extend up to 5 years, or until the employee reaches the age of 67.
Temporary Total Disability
Injured workers who are completely unable to return to their job temporarily due to their work-related injuries will be compensated with Temporary Total Disability. Once employees have recovered enough from their injuries and can return to work, their benefits will end.
Permanent Total Disability
Permanent Total Disability is considered the most severe work injury category. Victims who receive Permanent Total Disability have experienced a work-related injury that has left them permanently unable to work. These injuries may include the victim’s loss of the function of both arms, hands, eyes, feet, legs, or any other variety of two body regions. If a doctor determines a worker’s injury has caused Permanent Total Disability, the injured employee may be eligible to collect full benefits for the remainder of his or her lifetime.
Medical Coverage
Compensation is in place to cover an injured worker’s medical bills after suffering a workplace accident. This type of workers’ comp benefit will cover initial and long term treatment costs, as well as costs for medical equipment and prescriptions. Any other associated medical expenses are compensable as well.
Vocational Rehabilitation
If an injured worker must pursue a new career path following a workplace injury, he or she may qualify for vocational rehabilitation benefits. These benefits cover the costs of pursuing new licensure, training, schooling, or certification that are required for the victim to return to a reasonably employable state.
Death Benefits
If a victim perishes in a fatal workplace accident, his or her surviving dependents may qualify for workers’ compensation death benefits. These benefits reimburse a victim’s family for lost income and medical expenses, as well as funeral and burial costs.
Do I Need a Lawyer for a Workers’ Comp Claim in Illinois?
Insurance companies rarely represent an injured victim’s best interests. In an effort to reduce costs for their employer, workers’ comp insurance adjusters frequently undervalue and unfairly deny claims. Victims pursuing a workers’ comp claim without representation are at risk of falling prey to bad faith tactics like unreasonable claim delays, wrongful denials, and unfair settlement amounts.
Without proper legal assistance, a victim’s wages may be miscalculated, medical costs can be overlooked, and third-party claims may go unrecognized. Work accident victims deserve to maximize their compensation to improve their path to recovery. Taking the appropriate steps can help victims secure fair settlements. A workers’ compensation lawyer can guide victims through the claims process, collect sufficient evidence to build a strong case, and fight insurance company disputes. If the insurance company resists offering a fair settlement, an attorney can help victims pursue a lawsuit against the entity.
