How is Workers’ Compensation in Illinois Calculated?

Job injuries can be both physically and emotionally crippling. In most cases, they can also be financially crippling as well. Most families have less than $1,000 in savings, and many families have nothing at all. Injured workers may not only be unable to pay everyday bills but they also may have to sit and watch the medical bills pile up. Typically, group health insurance companies refuse to pay these expenses.

An Illinois workers’ compensation lawyer addresses both these needs. No-fault benefits are available which replace lost wages and pay medical bills. The exact nature of these benefits usually depends on the nature and extent of the disability. Furthermore, insurance company lawyers work hard to reduce or deny compensation. Victims need an equally committed attorney to level the playing field.

Temporary Total Disabilities

Most trauma injuries, such as falls, are TTD injuries. These victims cannot work until their injuries completely heal.

So, Illinois workers’ compensation usually pays two-thirds of the victim’s average weekly wage for the duration of that temporary disability. Lawyers usually need more than a calendar and a calculator to determine the AWW. This calculation must also account for future lost wages. If Phyllis is hurt during her probationary period, her AWW must include the automatic pay raise that she will miss.

The medical expenses in all disability claims are much the same. Workers’ compensation covers all reasonably necessary medical expenses, such as:

• Transportation costs
• Emergency care
• Follow-up care
• Prescription drugs
• Medical devices
• Physical or occupational therapy

Generally, the workers’ compensation insurance company pays these bills directly. Injured workers are not financially responsible for any unpaid bills.

Temporary Partial Disability

Occasionally, victims move from the TTD category to the TPD category. They can work during late-stage physical therapy. But they must reduce their hours or accept a light-duty assignment, such as a parking lot attendant.

The same basic rules apply. Workers’ compensation usually pays two-thirds of the difference between the old and new incomes. Furthermore, even though the victim can work again, the insurance company is still financially responsible for all the aforementioned reasonable medical expenses.

Permanent Partial Disability

Frequently, victims in physical therapy reach their MMI (Maximum Medical Improvement) before their illnesses or injuries are completely healed. In other words, in the therapist’s opinion, further sessions would do no good. At this point, victims are usually eligible for PPD compensation. Typically, workers’ compensation pays a lump sum based on the nature and extent of the disability. This sum represents future lost wages and future medical expenses.

Controversies sometimes arise if workers’ compensation benefits run out and the victim has not reached MMI. Usually, an Illinois workers’ compensation lawyer obtains a second opinion in these situations. MMI, like any other medical diagnosis, is quite subjective.

Permanent Total Disability

Sometimes, the work-related illness or injury is so intense that the victim is permanently and totally disabled. The D-word is not just a medical term. A disability also has economic, vocational, educational, and other implications. For example, a severed hand might not be disabling for a college professor, but it is probably disabling for a landscaper.

Pre-existing conditions sometimes come into play here. Generally, insurance companies cannot use genetic predisposition, a prior injury, or any other such weakness as an excuse to reduce or deny compensation in these situations.

Team Up with an Assertive Winnebago County Attorney

Accident victims are usually entitled to substantial compensation. For a free consultation with an experienced Illinois workers’ compensation lawyer, contact Fisk & Monteleone, Ltd. by going online or calling 815-315-0574. We do not charge upfront legal fees in these matters.