Overview
1. What is workers’ compensation?
Workers’ compensation is a system of benefits provided by law to most employees who experience work-related injuries or occupational diseases. Generally, benefits are paid regardless of fault.
2. What is the Illinois Workers’ Compensation Commission?
The Illinois Workers’ Compensation Commission is the State agency that administers the judicial process that resolves disputed workers’ compensation claims between employees and employers.
The Commission acts as an administrative court system for these claims.
As the administrative court system, the Commission must be impartial. Staff explains procedures and basic provisions of the law to members of the public, but cannot provide legal advice or act as an advocate for either the employee or employer.
3. Which employees are covered by the Workers’ Compensation Act?
Most employees who are hired, injured, or whose employment is localized in the State of Illinois are covered by the Act. These employees are covered from the moment they begin their jobs.
4. What injuries and diseases are covered under the law?
The Workers’ Compensation Act provides that accidents that arise out of and in the course of employment are eligible to receive workers’ compensation benefits. This generally means that the
Act covers injuries that result in whole or in part from the employee’s work.
5. What benefits are provided?
The Act provides the following benefit categories:
- Medical care that is reasonably required to cure or relieve the employee of the effects of the
injury; - Temporary total disability (TTD) benefits while the employee is off work, recovering from the
injury; - For injuries that occur on or after February 1, 2006, temporary partial disability (TPD) benefits
while the employee is recovering from the injury but working on light duty for less
compensation; - Vocational rehabilitation/maintenance benefits are provided to an injured employee who is participating in an approved vocational rehabilitation program;
- Permanent partial disability (PPD) benefits for an employee who sustains some permanent disability or disfigurement, but can work;
- Permanent total disability (PTD) benefits for an employee who is rendered permanently unable
to work; - Death benefits for surviving family members.
6. Are workers’ compensation benefits taxable income?
No. Workers’ compensation benefits are not taxable under state or federal law and need not be reported as income on tax returns.
7. Who pays for workers’ compensation benefits?
By law, the employer is responsible for the cost of workers’ compensation benefits. Most employers buy workers’ compensation insurance, and the insurance company pays the benefits on the employer’s behalf. No part of the workers’ compensation insurance premium or benefit can be charged to the employee. Other employers obtain the state’s approval to self-insure, which means that the employer will be responsible for paying its own claims. To identify the party responsible for paying benefits, an employee may check the employer’s workplace notice, check the Commission’s website, or contact the Commission at [email protected] or toll-free at (866) 352-3033.
8. What does the law require of employers?
Employers are obligated to follow the provisions of the Workers’ Compensation Act. Employers must:
- Purchase workers’ compensation insurance or obtain permission to self-insure from the
Commission; - post a notice in the workplace. Employers can obtain this notice at http://www.iwcc.il.gov/forms.htm; and keep records of work-related injuries and report to the Commission those accidents involving
more than three lost workdays.
Employers are prohibited from doing the following:
- Charging the employee for any part of the workers’ compensation insurance premium or
benefits; and - harass, discharge, refuse to rehire, or in any way discriminate against an employee for exercising
his or her rights under the Workers’ Compensation Act.
9. What should an employee do if his or her employer does not have workers' compensation insurance?
The employee should give the employer’s name and address, and the date of injury, to the Commission’s Insurance Compliance Division. The Division can be reached at [email protected] or at 312/814-6611, toll-free 866/352-3033.
10. Is an employer subject to any penalties if they do not purchase workers’ compensation insurance?
Yes. There are various provisions in the Workers’ Compensation Act that address this issue.
Negligent failure to provide workers’ compensation insurance coverage is punishable by a Class A
misdemeanor for each day without coverage (maximum 12 months imprisonment, $2,500 fine).
Knowing failure to provide workers’ compensation insurance coverage is punishable by a Class 4
felony for each day without coverage (maximum 1-3 years imprisonment, $25,000 fine).
An uninsured employer may also be subject to a civil penalty of $500 for every day it lacked
insurance, with a minimum $10,000 fine.
Employers without workers’ compensation insurance may be subject to a citation issued by the Insurance Compliance Division. The citation fine may range from $500 to $2,500.
An uninsured employer loses the protections of the Workers’ Compensation Act for the period of noncompliance. That means an employee who was injured during the period of noncompliance may choose to sue in civil court.
In addition, if the Commission finds that an employer knowingly failed to provide insurance coverage, it may issue a stop-work order and shut the company down until it obtains insurance.
11. Does the Workers’ Compensation Act address workers’ compensation fraud?
Yes. Workers’ compensation fraud falls into many different categories that affect employees, employers, and healthcare providers. The Act prohibits the intentional filing of any fraudulent workers’ compensation claims or making a fraudulent statement to obtain workers’ compensation benefits. Workers’ compensation fraud may also involve making false statements in order to deny workers’ compensation benefits. It is also unlawful to intentionally present a bill or statement for the payment of medical services that were not provided.
Assisting or conspiring in any of these actions may also be considered workers’ compensation fraud.
12. What are the penalties for workers’ compensation fraud?
The penalties for violations of the fraud provisions increase with the value of the property obtained or attempted to be obtained, starting with a Class A Misdemeanor for property valued at $300 or less (maximum 12 months imprisonment and a $2,500 fine), and ranging upwards to a Class 1 felony (maximum 4-15 years imprisonment, $25,000 fine) for property valued at more than $100,000. A convicted party is required to pay complete restitution, as well as court costs and attorney fees.
13. What should I do if I suspect workers’ compensation fraud?
If you wish to report a possibly fraudulent situation, contact the Workers’ Compensation Fraud Unit, Department of Insurance ([email protected]; toll-free 877/923-8648). Anyone who intentionally makes a false report of fraud is subject to a Class A misdemeanor (maximum 12 months imprisonment, $2,500 fine).