Frequently Asked Questions About Workers' Compensation Defense in Illinois

FAQs Answered by Professional Attorneys

Are Illinois employers required to provide workers' compensation insurance for employees?

In most cases, yes. Regardless of the size of your company, whether you have just one part-time employee or thousands that work for you full-time, you are required to provide workers' compensation insurance for everyone you hire; unless they are corporate officers, members of an LLC, sole proprietors, or business partners. Companies may purchase workers' compensation insurance through an insurance carrier, or they may obtain permission to self-insure or join a group of self-insured employers.

Are out of state companies required to carry workers' compensation insurance in Illinois?

If an out of state company has employees who perform work or conduct business in Illinois, the company is required to carry workers' compensation insurance (or self-insurance) that includes Illinois in its coverage.

What benefits can employees receive under workers' compensation insurance?

The workers' compensation system makes the following benefits to employees who qualify:

• Reasonable payments for medical expenses including doctor visits, hospital stays, surgeries, and prescriptions.
• Partial or total temporary disability.
• Partial or total permanent disability.
• Vocational training and rehabilitation benefits.
• Death benefits.

If an employee lodges a workers' compensation claim, what are my responsibilities as an employer?

When an employee suffers an injury or illness in the workplace, the employer has certain obligations, including:

• Seek immediate medical treatment for an employee who suffers a serious on-the-job injury.
• Complete a First Report of Injury form and file it with your insurance carrier or the Illinois Workers' Compensation Commission (IWCC). Failure to file this report may result in a fine.
• Fully comply with investigations and requests for information by opposing attorneys, your insurer or the IWCC.
• Do not engage in discrimination or in a retaliatory action against an employee who has filed a workers' compensation claim.

When is a Medicare/Medicaid Set Aside necessary in a workers' compensation claim?

Medicare/Medicaid Set Asides (MSAs) are accounts that are created in which a portion of the workers' compensation benefits is set aside for future medical payments. MSAs are overseen by the Centers for Medicare and Medicaid Services (CMS) and are required when a claimant is currently a Medicare recipient and the settlement amount is in excess of $25,000, or when there is a reasonable expectation that a claimant will be eligible for Medicare within 30 months and the settlement amount is expected to exceed $250,000.

If a third party is responsible for a workplace injury, can I recover workers' compensation costs from the responsible party?

When a third party is at fault for a workplace injury, it may be possible to recover most (or all) of the benefits the employee received through a workers' compensation subrogation claim. Subrogation is a complex process, and it is important to get started as quickly as possible after the injury to increase the chances of successful recovery.

How is a workers' compensation dispute between an employer and employee resolved in Illinois?

Workers' compensation disputes are initially resolved through an arbitration hearing before the IWCC. If either party is dissatisfied with the decision, the case may be appealed to a panel of IWCC Commissioners and the Illinois court system.

Is an employee allowed to sue an employer outside of workers' compensation for a workplace injury?

In most cases, the answer is no. The general principle behind workers' compensation insurance is that it pays benefits for work-related injuries regardless of who is at fault, in exchange for the employee giving up his/her right to bring a personal injury lawsuit against the employer. There are two major exceptions to this rule, however. Employees are allowed to sue employers when:

• The employer takes an action that intentionally harms the employee.
• The employer carries insufficient workers' compensation insurance or no insurance at all.

What is the best legal strategy to minimize costs resulting from a workers' compensation claim?

Experience has shown us that the major key to securing a favorable resolution for employers and insurers is swift action. Our firm includes numerous attorneys, many all of whom are members of the Workers' Compensation Lawyers Association (WCLA). We have the capacity and in-depth knowledge to move quickly and thoroughly; building a rock solid case often before the plaintiff is ready. The majority of workers' compensation cases settle without the need for litigation. A swiftly and thoroughly prepared case gives our clients major leverage and puts them in a position to settle the case sooner and at minimal cost.

Do you have additional questions? For answers to your questions and/or to schedule a personalized consultation, contact BCM Law, P.C. today at 312-425-3131. From our offices in Chicago and Bloomington/Normal, we provide skilled representation for clients in Illinois, Missouri, Wisconsin, and throughout the country.