Every state, including the federal government, has workers’ compensation laws that require employers to provide particular types of insurance benefits for their staff who are injured in the course of their employment. While workers’ compensation laws and procedures tend to differ slightly from state to state, we are going to focus on the rules that apply to the likes of St. Clair County, Granite City, Glen Carbon, Maryville, and Collinsville.
Who Is Entitled to Workers’ Compensation Benefits in St Clair County?
To be eligible for workers’ compensation benefits, you should be an employee. However, there are two limited exceptions: interstate railroad workers and crew members on vessels. These employees are not eligible for workers’ compensation benefits. If they are injured on the job, federal law dictates that they must sue their employers as opposed to claiming workers’ compensation benefits. For most other employees, though, whether or not they are eligible for workers’ compensation benefits is typically based on whether they are independent contractors or employees.
What Is the Difference Between an Independent Contractor and an Employee?
An employee is a person who works for another company or person and is not an independent contractor. There are several factors that must be considered when it comes to determining the difference between an employee and an independent contractor, but in general, an employee is a worker or staff member who:
- Uses his or her employer’s tools
- Works under specific control and direction of his or her employer
- Has taxes deducted from their pay by the employer
- Has a long term position with his or her employer
- Performs the employer’s regular business
An independent contractor is the opposite of an employee. An independent contractor uses his or her own tools, can only be hired for one job, does not have taxes deducted out of his or her pay by the employer, if usually highly skilled, and does not necessarily perform an employer’s regular business.
One of the most important distinctions between an employee and an independent contractor is who controls the details of the work performed. Usually, an employer has the authority to tell the employee precisely how to perform every single step of his or her job. On the contrary, the employer does not have any power to tell the independent contractor how to carry out his or her job. A great example of this is an electrician or a plumber. When someone hires an electrician or a plumber, they tell the contractor what they want repairing or replacing, such as fixing wiring or a leak, but not how to fix the issue.
Does an Injury Have to Be the Employer’s Fault in Order to Receive Workers’ Compensation Benefits in St. Clair County?
Fortunately, workers’ compensation does not have anything to do with fault. In fact, you are allowed to claim workers’ compensation if the injury was your fault, your boss’s fault, or nobody’s fault at all, just as long as your injury is related to the job.
Can an Employee Sue The Employer If They Get Hurt in the Workplace?
The answer here is no. The workers’ compensation system is the injured employee’s only remedy against the employer with regards to the injury. Employees may not sue their employer for damages for the injury.
What If the Injury Did Not Occur on the Employer’s Premises?
Simply put, the injury does not have to occur on the employer’s premises. An employee may be entitled to workers’ compensation provided he or she is injured while in the course of employment. In fact, there are many kinds of work-related activities that can take place away from the employer’s factor or office, including:
- Work-related education
- Business meetings
Travelling to and from work-related meetings, and partaking in work-related education are also considered to be in the course of an employee’s employment. Even an injury that occurs at a company recreational event or work-related picnic could be covered by workers’ compensation, depending on the nature of the company event.
Injuries That Are Not Covered by Workers’ Compensation in St. Clair County
If you incur an injury while travelling to and from your regular workplace, the injury is not usually covered under workers’ compensation. Furthermore, not all types of injuries that happen during work-related business travel are covered under workers’ compensation. For instance, if you are injured while on a sightseeing trip or doing some sort of other non-business related activity during a business trip, that kind of injury will not be covered.
What Happens If the Employer Does Not Have Workers’ Compensation Insurance?
All employers in St. Clair County must have workers’ compensation insurance or they must be self-insured. If an employer is not self-insured or does not have insurance coverage, an employee can take one or both of the below actions:
- An employee may sue his or her employer – this is the only exception to the rule that you may not sure an employer for work-related injuries
- An employee can file a workers’ compensation claim with the state’s special fund that is aimed at handling uninsured workers’ compensation claims
If an employee does get hurt at his or her place of work, and the employer is not covered by workers’ compensation insurance, the employee will need to contact a qualified workers’ compensation lawyer.
What Kinds of Benefits Do the Workers’ Compensation Laws Provide?
Typically, workers’ compensation laws in Illinois provide injured employees with the below kinds of benefits:
- Vocational rehabilitation
- Weekly compensation benefits
- Payment of medical treatments
- Permanent impairment benefits
It is worth mentioning that injured employees are not entitled to any type of workers’ compensation benefit for pain and suffering the way they would be in a personal injury lawsuit.
A Closer Look at Different Workers’ Compensation Laws
As we have established, workers’ compensation laws are designed to protect people who are injured on their job. They are designed to make sure that employees who do incur an injury or are disabled on the job are offered fixed monetary awards, in order to eliminate the need to litigate. Further, the laws provide benefits for dependents of workers who are killed as a result of a work-related illness or accident. Some workers’ compensation laws also protect employers and their fellow workers by eliminating the liability of co-workers in most kinds of workplace accidents.
Things are a little different for federal employees. The Federal Employment Compensation Act has been designed to provide workers’ compensation for non-military federal staff. Most of the provisions under the Act are typical of most other workers’ compensation laws. However, awards are mainly limited to death or disability endured during the performance of the workers’ expected duties but not caused intentionally by intoxication or by the employee him or herself. What’s more, the Act covers medical expenses that are incurred as a result of the disability and may require that the employee undergo retraining for the job. Disabled federal employees receive two-thirds of their normal monthly salary during the disability, but they may receive more for permanent physical injuries incurred on the job or if he or she has dependents. The Federal Employment Compensation Act is administered by the Office of Workers’ Compensation Programs.
What the Workers’ Compensation Law Covers in St. Clair County
In St. Clair County, a lot of workers who are injured on the job are typically entitled to payment for their medical bills along with up to 80 percent of their average weekly wage. Here, workers’ compensation is designed to protect the employers from being sued while providing financial reimbursement to workers who are injured on the job. The remuneration from workers’ compensation usually includes medical reimbursements, lost wages, and even vocational rehabilitation services. Survivors of employees who unfortunately died on the job are also entitled to file claims.
St. Clair County required that all public employers are covered with workers’ compensation and that private employers have to provide cover when:
- The continuously employ three or more staff members at a time
- During the previous 52 weeks, the employer has regularly employed at least one staff member for 35 hours or more a week for a period of 13 weeks or longer
While this may seem straight forward enough, it is never quite as simple. Take into account insurance companies and third party claims adjustors, or those wayward employers who attempt to defeat the law, and even the easiest of claims can become drawn out and daunting. Usually, insurance companies have little to no compensation for injured workers and their family. What’s more, insurance companies have monetary as well as other resources that may see the worker or the working family have to ensure financial hardships. That is why it is essential to seek the advice of a workers’ compensation attorney who will create a level playing field that works in the employee’s favor.
Employees are usually entitled to receive workers’ compensation benefits for a broad range of injuries that are sustained at work, especially those that leave them with a permanent disability. A skilled lawyer can help to protect your rights and is essential when:
- You are unable to get medical treatment.
- Your employer denies that you were injured on the job.
- You are not receiving your salary.
- The carrier denies workers’ compensation claims.
- You wish to sue a third party. For example, if you start off representing yourself and you come across someone on the other side who is especially difficult and is doing everything possible to take advantage of your lack of the legal system.
- An attorney for the insurance provider of your employer makes contact with you to take a statement or deposition.
- The adjustor promises care or payment that you never receive.
A Checklist for Claiming Workers’ Compensation Benefits
The below information will prove valuable in taking the proper steps when it comes to interacting with employers, insurance companies, and medical professionals during a workers’ compensation case in St. Clair County. The below outline will help to make life easier as well as help you case.
If you incur a workplace injury, it is imperative that you keep meticulous records:
- Make copies of all paperwork, including documents, accident reports, medical records, letters, and pay stubs.
- Keep a clear record of all your mileage to and from doctor’s appointments including hospital visits, visits to doctor’s offices, physical therapy, and so on. Mileage must be reimbursed at the travel reimbursement rate as set at the time of travel. You should send all your requests for mileage certified mail with a return receipt requested and be sure to keep the signed receipts. Also, keep a copy of your mileage request form.
There is information that you will give to your doctor as well as receive from your doctor that you will need to be aware of:
- When you attend medical examinations that are scheduled by your lawyer’s office, be sure to take along all medical records, MRI films, CT scans, and X-rays.
- Ask your doctor for a disability slip, or a restriction slip, or both, which will be required if you are to continue all disability benefits, including long-term disability, workers’ compensation, short-term disability, and no-fault.
- Be sure to carefully follow the doctor’s medical recommendations and restrictions
- If you incurred your injury as a result of a car accident, ask for a no-fault application for benefits form to fill out.
Information About Your Employer
When it comes to dealing with your employer, keep these points in mind:
- Send a request to the employer, via certified mail, requesting benefits information on the benefits that you are covered for in your employment with the company, as well as benefits regarding accidents, sickness, family medical leave, disability pension, long-term and short-term disability benefits, and wage continuation benefits.
- Make sure you keep a copy of the letter for your records.
- If you do receive a return receipt requested or a certified letter from your employer, you must sign for it. If the letter does not come from your employer, do not sign for it.
- Report the injury to the employer and ask for a copy of Form 100 that the employer should have filed
- If the employer has failed to file a Form 100, you are entitled to file an Employee’s Report of Claim.
Do You Need a Workers’ Compensation Lawyer in St. Clair?
Once you have notified your employer about your injury, he or she must report it to the claims administrator or insurance company. The insurance provider will then determine if you are eligible for benefits. The investigation typically involves:
- Perusing the medical records
- Analyzing your wages, education, and work experience
- Ordering a medical examination
- Sending you for an assessment of your ability to perform your regular work duties
Under Illinois’ laws, the insurance provider has to approve or deny your workers’ compensation benefits timeously. If the claim is approved, you will start to receive your payments, but there are times when insurance providers may deny your claims.
Fortunately, you are not required to file any paperwork unless your initial claim is denied. If you want to appeal a denied claim, you will have to file an application for adjustment of your claim. You will need to do this within three years of your injury occurring, or at least two years from your last medical payment or wage loss – whichever was later.
It is advised that you seek the assistance of a knowledgeable workers’ compensation attorney to help you receive the compensation you deserve.