You’ve been injured at work and someone told you that you should be entitled to workers’ comp benefits. What are the steps to this process, and will it take a long time to start getting benefits? Much of that depends on your employer, your knowledge of the process, and whether you hire a good attorney.
Even a standard workers’ compensation case involves a number of steps. Understanding the process helps you appreciate the time frame involved, and ensures you haven’t missed anything. Most of these steps have a specific time limit, so you will need to keep track of that or hire an attorney to help you.
- Notify your employer of the injury. This notice can be either spoken or written, and should include the approximate date and place of the accident. It has to be done within 45 days of injury. In the special situation of exposure to radiation, you have 90 days after the day that you know or suspect you were exposed.
- At this point, the employer is supposed to provide medical services and inform the worker’s compensation insurance carrier about the claim. If you miss more than 3 days of work due to the injury, payments are to begin or the reason for denial must be given in writing (or a written explanation of what additional information they need from you).
- File a Worker’s Compensation Claim (called an Adjustment of Claim). To start your claim, you must file 3 copies of the claim form (in person, or by mail) to any Illinois Commission. The form (called an Application for Adjustment of Claim) can be obtained from the Illinois Worker’s Compensation Commission website. There is no filing fee.
- The claim is assigned to an arbitrator. Either you or your employer can request a trial. Then, your case will be litigated in front of the arbitrator. If not, it will have status calls every 3 months (and a trial can still be requested at any status call). It is your responsibility (or your attorney’s) to track your case to make sure you don’t miss a status call and to be sure the case is being handled fairly so you get the benefits you are allowed.
- If a trial is requested, the arbitrator will make a decision based on what is presented at the hearing and based on the Illinois Supreme Court Rules of Evidence. This means that the average person would need legal help to gather and present evidence.
- If the decision of the assigned arbitrator is unjust for your case, that decision can then be appealed to Illinois Workers’ Compensation Commission. It will be brought before a panel of three commissioners to review the arbitrator’s decision, the evidence, and the trial transcript. Each side can prepare written arguments to submit before the trial and can prepare a 5 to 10 minute oral argument to present at trial. The commission gives a decision within 60 days. While an appeal is pending, the employer is not required to pay benefits, but if awarded to the employee, interest will be due.
- Following this ruling, if it is still unjust for your case, it can then be appealed to the Illinois circuit court. If you are an employee of the State of Illinois, this is not an option.
- Following the circuit court, the case can go to Illinois appellate court. Of the approximately 40,000 cases that are settled each year in Illinois by the assigned arbitrator, only 250 to 300 have an opinion issued at the circuit court level, and only 100 (0.25%) eventually have an opinion issued by the appellate court (Illinois Workers’ Compensation Commission Fiscal Year 2013 Annual Report, p.14).
- Sometimes a settlement contract (or written agreement of compromise) is drafted and negotiated by both parties. This is to resolve the dispute before it becomes to more lengthy and costly. It is vital to have a competent attorney negotiate terms of a settlement contract. Once an agreement is reached, it is presented for approval to the arbitrator for the case. Usually, settlement contracts solve a case faster than a trial an appeal. However, most settlements aren’t approved until about 2 years after the claim was filed.
As you can see, there are many steps to the process of a Workers’ Compensation Claim and Appeal. It requires knowledge and skill to maneuver through the process to ensure that you get the benefits you’re entitled to. Don’t try to do it on your own.
Contact me for assistance at each step of the claim. You don’t want to miss a step that ends up being a mistake that costs time and money. A competent attorney will protect your interests.