UNDERSTANDING ILLINOIS WORKERS’ COMPENSATION BENEFITS AT

ABC Company

WHAT ARE WORKERS’ COMPENSATION BENEFITS?

For a better idea of workers’ compensation benefits, try to think of workers’ compensation as ‘work accident insurance.’ In simplest terms, if you get hurt at work doing your job, ABC Company probably insures you for any injuries. ABC Company insures you for risks associated with your work. The insurance covers three main areas:

1. Medical treatment due to your injury

2. Money for time off from work due to injury

3. If appropriate, money for permanent disability.

At ABC Company, our primary focus is safety to avoid injuries so that you are safe and healthy while at work. However, if an unforeseen event occurs and you are injured, our next focus is to get you the best possible medical care to minimize your injuries. Next, at ABC Company, we make every effort to return you to work as soon as medically proper which will help you continue to heal and keep you active. Finally, once you’re healthy and back to full work, we provide permanent disability benefits if appropriate. That’s it, in a nutshell.

THAT DOESN’T SEEM THAT TOUGH, DON’T I NEED A LAWYER TO GET WORKERS’ COMPENSATION BENEFITS??

No, you don’t. In fact, this book is designed to give you most of the basic information you need so that you don’t need a lawyer. In fact, getting a lawyer might possibly delay your benefits and cost you money.

We’re not telling you that you can’t get a lawyer. You can talk to a lawyer at any time. You can show the lawyer this booklet and ask him or her if it is inaccurate in any way. All we are asking is that you give ABC Company a chance to provide you with appropriate information and timely benefits before obtaining a lawyer. We have specialists in all areas of workers’ compensation that will help you at any step of the process to carefully explain your benefits and insure you’re getting everything that you are entitled to.

ALL RIGHT, SO I DON’T NEED A LAWYER. WHAT DO I DO TO GET BENEFITS??

Now you’re talking. Remember our primary focus is always to avoid work injuries by working safely. But let’s assume the unforeseen occurs and you suffer a work injury. When that happens, you have to report the work injury to a supervisor. If you don’t report a work injury, it may seriously delay or even cut off your right to benefits. Be sure to report even minor injuries because if you don’t report it, you may not get benefits.

HOW DO I REPORT AN EVENT IF I AM SERIOUSLY INJURED??

Don’t worry about it—if you need emergency medical attention, get it. But be sure a supervisor is made aware of the problem as soon as it is medically safe to do so.

SO I’VE REPORTED AN INJURY,

WHAT’S NEXT??

When you report a work injury to a supervisor, the supervisor will give you the ABC Company report of injury form. You have to work with your supervisor to fill it out completely. It’s a simple form that provides us with some basic information about you and what happened. It’s designed to allow us to prevent similar injuries in the future and make for a safer workplace. It’s also designed to let us predict your medical care and job needs when you get back to good health.

BUT WHAT IF I MAY HAVE CAUSED THE ACCIDENT, DO I STILL GET BENEFITS??

Remember, workers’ compensation is work accident insurance. Workers’ compensation benefits should be paid even if you may have caused the accident. The best bet is to truthfully report every work injury.

ALL RIGHT, I’VE REPORTED THE WORK INJURY AND FILLED OUT THE FORM, NOW WHAT??

You’ve completed the important steps on your side. Now, we will go to work. Based upon the information provided by you and your supervisor, our workers’ compensation specialists will perform an investigation. Barring an unforeseen occurrence, you will get an answer within 24 hours that will clearly tell you that:

1. We accept your claim and will pay all workers’ compensation benefits or

2. We are denying your claim with a written explanation of the basis for denial.

Don’t worry. We accept the majority of claims that are reported timely. If you don’t get an answer within 24 hours, please ask your supervisor to get you updated information on the status of the answer. The correspondence accepting the claim will identify the ABC Company workers’ compensation specialist whom you can contact for information or help at any time regarding your benefits.

SO YOU’VE ACCEPTED MY CLAIM, WHAT ARE THE BENEFITS??

This may be easier than you think. First, when we accept your claim under workers’ compensation, we will pay reasonable medical expenses that are related to your work injury. All you have to do is work with us to get us the bills and information from your doctor regarding the course of treatment.

If we don’t think you’re getting the best possible treatment or if we think a second opinion is necessary, our specialist will discuss it with you. We may want you to go to a medical specialist for an exam. Either way, we will pay the cost.

Our goal at ABC Company is to get all our employees the best possible medical attention when they have been injured at work.

OKAY, I DON’T HAVE TO WORRY ABOUT MEDICAL BILLS BUT HOW DO I EAT WHILE I’M OFF WORK??

Follow this part closely. The second benefit we pay after accepting your claim is ‘temporary disability.’ There is a three-day waiting period that means that you have to be off more than three days to start getting paid temporary disability benefits. If you are off more than two weeks due to your work injury, we will pay you for the first three days. Without getting too technical, the amount you are paid is about two-thirds of what you were making at the time of injury. The money paid for temporary disability is tax-free which means you should get about the same in take-home pay as you were getting while working. You will receive temporary disability throughout the period that the physicians feel that you need to be off work. If you have any questions about the payment of temporary disability or if payment is late, please contact your ABC Company workers’ compensation specialist.

HEY, WHAT ABOUT GETTING MY JOB BACK WHEN I GET HEALTHY??

We’re happy you asked that question. We want all employees to return to work as soon as the physicians clear you to return. It is a goal at ABC Company to have all employees active and working so long as it is medically appropriate to do so. In appropriate cases, we may identify modified positions to suit your special needs when the doctors feel your condition has stabilized and you can again return to medically modified work. We need you to let the doctors know that medically modified duty will be available so that your doctors can advise us with regard to your needs. Once you are back to medically modified duty, we will work with you and the doctors to continue to get you healthy and back to full work.

ALL RIGHT, I’M BACK TO WORK, NOW WHAT??

Whew, well we’re almost through. If all your medical bills are paid and your temporary disability has been paid, in appropriate claims, we will pay permanent disability. Determining permanent disability is a moderately complex process and may be confusing even to accountants and lawyers!! If you feel you are entitled to permanent disability due to a serious work injury, please contact your ABC Company workers’ compensation specialist. The specialist will do their best to carefully explain the process and, in an appropriate claim, make you a written offer of permanent disability for your consideration. We assure all ABC Company employees that we will be fair and provide you with documentation necessary for you to determine that our offer is a good one.

I HEARD DAVE IN PRODUCTION GOT A LAWYER AND HE GOT A GIANT SETTLEMENT, WHAT GIVES??

Well, you hear all kinds of stories. Workers’ compensation benefits are designed to take the uncertainty out of the process. But the amount provided to the injured employee is also limited by the law unlike automobile accidents, etc. If you suffer a work injury and have permanent problems, you are probably entitled to permanent disability benefits. We want to pay you what you’re entitled to. Workers’ compensation benefits don’t provide you with the pot o’ gold which you may have heard some claim. Our goal is to tell you what the fair range is and we’ll provide you with the same guidelines used by the attorneys and arbitrators and make you a fair offer in writing.

IS THAT IT? AREN’T YOU SKIPPING SOMETHING??

Not really. Workers’ compensation isn’t all that complex—we pay your bills, we pay you while you’re off work and we pay something for your permanent loss if appropriate. Like everything in life, there may be nuances here and there. We assure you that your ABC Company workers’ compensation specialist can answer any question you might have. Give them a chance!!!