What Does Workers' Compensation Insurance Pay For?
The types of coverage for injured employees in Illinois
on December 13, 2017
Updated on May 17, 2022
Have you been suffered a work-related injury? All state law—including Illinois—requires most employers to provide workers' compensation benefits in such situations. Unlike traditional personal injury claims—which require you to prove someone else was negligent—workers' compensation coverage is a “no-fault” system.
Rich Lenkov, a workers’ compensation attorney in Chicago, says that the most common workers' compensation claim he sees is back injuries, but Illinois workers' comp insurance actually provides several types of benefits. Not every injured employee is eligible for every benefit. For minor workplace injuries, an employee may only be entitled to medical care related to their immediate injuries. But if you miss any time from work, or suffer an impairment that prevents you from returning to your prior job, you may receive additional compensation for those losses.
Post-Injury Medical Treatment
With respect to medical expenses, Illinois workers' compensation law requires the employer to cover any “reasonably necessary” services to “cure and relief” the employee's injury. This includes any necessary medications, devices or appliances. In general, the employee selects his or her own health care provider, who is then reimbursed by the employer. But if the employer has established its own “Preferred Provider Program” (PPP), the employee may be required to select from a choice of two doctors within the network. The employer is required to notify the employee in advance—and in writing—if it has a PPP.
Temporary Total Disability
Temporary total disability (TTD) benefits compensate an injured worker who is medically unable to return to work for a temporary period. Alternatively, an employee may receive temporary disability benefits if he or she is medically cleared to do “light-duty” work but the employer is unable to accommodate such restrictions. After an employee misses 14 days of work, they are entitled to TTD benefits until they can return to work or reach “maximum medical improvement,” as determined by their treating physician.
TTD benefits do not replace 100 percent of an employee's lost wages. Rather, the standard rate is two-thirds of the employee's “average weekly wage” prior to the accident. There are also certain statewide minimum and maximum rates applicable to TTD benefits. A qualified Illinois workers' compensation attorney can advise you of the applicable rates based on when your injury occurred and the number of dependents in your household.
Temporary Permanent Disability
If you are able to return to work on restricted or part-time duty, you can receive temporary permanent disability (TPD) benefits, which help cover the gap between your pre-accident and post-accident wages. Similar to TTD benefits, TPD benefits are paid at two-thirds of the difference in average weekly wages.
Permanent Disabilities and Death
Unfortunately, there are cases where a workplace accident leads to permanent injuries from which the employee will never fully recover. In such circumstances workers' compensation provides both permanent partial disability (PPD) and permanent total disability (PTD) benefits. PPD benefits are paid when the employee suffers “complete or partial loss” of a body part (or the use thereof), or a partial loss of their entire body.
For individual body parts, Illinois workers' compensation law maintains a schedule, which provides a fixed number of weeks of benefits multiplied by 60 percent of the employee's average weekly wage. When there is a partial loss of the whole body, benefits are paid for 500 weeks based on a percentage determined by the employee's doctor.
PTD benefits are paid when an employee is deemed no longer able to perform any kind of meaningful paid work, or has suffered the loss of two major body parts (e.g., both feet, an arm and a leg). Permanent disability of this type entitles the employee to workers' comp benefits for life.
Finally, if an employee is killed due to a workplace accident, the employer must pay a one-time benefit of $8,000 to help pay for funeral and burial expenses. In addition, if the deceased employee had a spouse or dependent children, they may also receive a survivor's benefit equal to 52 weeks pay at the employee's average weekly wage.
For more information, see our overview of social security disability.