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Illinois Workers’ Compensation Law: Am I Covered for My Workplace Injury?

By Parag P. Bhosale

Everyone has heard about workers’ compensation claims and workplace injuries, but there are several misconceptions about what is and isn’t covered under the Illinois workers’ compensation law.  Under the Illinois Workers’ Compensation Act, an employer is required to provide these benefits to any employee whose injury “arose out of” and “in the course of” his/her employment. Generally, that means you are covered for injuries that occur when you are doing virtually any activity that benefits your employer while at work. You don’t have to prove that your employer was negligent or did something wrong…. it can be 100% your fault and you’ll still be 100% covered.

What does “covered” mean? Well, there are three main benefits that you can receive:

• 100% paid related medical expenses
• 2/3rds of your normal pay, tax-free
• A cash award based on your pay scale and extent of your injury

Examples of situations that ARE covered: falling down the stairs at work while carrying a box of office supplies; getting into a car accident while on your way to a sales meeting away from your normal office location; falling off a ladder while trying to answer your ringing cell phone while at a job site; getting physically attacked by a co-worker; and hip-checking an office vending machine to try to get a co-worker’s soda can out.

Some similar situations that AREN’T covered: falling down stairs empty-handed and without anything being defective with the stairs; getting into a car accident during your normal commute to your normal office location; falling off a ladder after having drunk a beer before work; breaking your nose when you instigated a fight with a co-worker; and hip-checking a vending machine at the drugstore next door to your office.

As you can see, these things aren’t so clear cut. Generally, injuries that occur in situations where the risk of injury is no different than what people encounter on a daily basis, will usually not be covered. Staircases are a good example. As noted above, just going down the stairs and missing a step is not good. But add something more dangerous to the situation….carrying a box….slipping on wet step…tripping on ripped carpet…these all contribute to making those same stairs more dangerous.

Here are some answers to common questions regarding the Illinois workers’ compensation law:

Is my commute to work and/or business travel covered?
Generally your commutes to and from work are not covered. There is an exception for a “traveling” employee….someone whose commute takes them somewhere different from their usual place of business. Business trips will likely be covered for the entire duration of the trip.

Is there anything that can jeopardize my coverage?
Not surprisingly, evidence of any type of intoxicant in your body will prevent you from being covered. You can overcome this by proving that the injury would have occurred regardless of the intoxication, but that can be a tough hurdle to get over.

If I get in a fight with a co-worker, are my injuries covered?
Fights are only covered when the other guy starts it. So don’t be the instigator!

If I injure myself helping a co-worker on the job, am I covered?
Injuries that occur while you are helping out fellow employees can be covered in certain circumstances. Illinois law encourages us to be nice to our co-workers.

Can I claim injury for repetitive action?
Injuries from repetitive actions can be covered but are hard to prove. The most common example is a carpel tunnel injury from repetitive typing. It is very important in these cases that your medical records specifically identify your type of work as causing or aggravating the carpel tunnel.

If the workplace aggravates a pre-existing condition, can I make a claim?
You may have a long history of back problems, but if you aggravate that condition doing a work-related activity, then you’re covered. Conversely, if you injured your back at work and later on aggravate it doing something at home, it’s not going to be covered. If you previously had a workers’ compensation claim and resolved it, but later re-injured that same body part, you can usually make a new claim.

How do I protect myself from denied claims?

Here are some practical steps you should take immediately after an incident:

1. Always report your injury to your employer. Call, text, email, write a letter….do something.  A workplace injury must be reported within at least 45 days of the accident in order to be covered.

2. Always get medical attention. It is illegal for your employer to interfere with your efforts to see a doctor, so drive yourself to the hospital if you have to. Many injuries can start off as a dull ache or soreness and then slowly accumulate into something far more serious, so don’t brush these things off….get it checked out.

3. Don’t be afraid to get an experienced workers’ compensation attorney involved early in the process. The insurance companies that cover these claims employ attorneys that instruct them on exactly how to fight against you, and this happens immediately after you report your claim. There’s no reason why you shouldn’t stand on equal ground and get the same advice.

And remember, most of the time your employer won’t be affected by the claim….their insurance takes care of it all.

Please contact us immediately at Gardi, Haught, Fischer & Bhosale LTD if you are in need of legal advice regarding Illinois workers’ compensation law. We will give you practical, sound advice on whether or not you have a viable workers compensation claim.  And we never charge you anything to meet and discuss your case.

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