What is Workers' Compensation?
Injuries on-the-job and work-related illnesses requiring medical attention and treatment may entitle you to workers’ compensation benefits. These benefits cover the cost of your medical expenses and lost wages if your injury keeps you from working for five or more days. The agreement does not take into account who is at fault and whether negligence was a factor. Because of this, you cannot collect any money for pain and suffering (as with other personal injury cases), unless someone other than you, the employer, or another employee was at fault. The employer is protected against further lawsuits while your medical costs and lost wages are covered by your employer’s workers’ compensation insurer once your claim is accepted.

What is the Process?
Your employer should contact the insurance company by filing Form 101, Employer’s First Report of Injury. The insurance company will begin temporary payments and continue for up to 14 business days while they investigate your claim and decide whether to accept or deny. This first notice of injury is different from filing an actual claim for lost wages and medical expenses, which you can do by filing Form 110, Employee’s Claim, and sending a copy to both the insurer and the DIA (Department of Industrial Accidents). A “Pay-Without-Prejudice” period means the insurer pays benefits for up to 180 days after receiving your claim while investigating the case. They may stop or reduce payments during this period with seven days notice to you.

If your claim is accepted, the insurance adjustor will send you a card with your claim number, which you will bring to your doctor. This lets the doctor know the insurer is responsible for paying any medical bills. If your claim is denied, you will receive a Notice of Denial from the insurer with the reasons for denial and information about your right to appeal. The dispute process involves a Conciliation, or meeting to work out payments between you and the insurer. If you cannot reach an agreement, your case could progress to an informal conference before a judge, a hearing, and then a review board.

What am I entitled to?
Depending on the type and severity of your injury, you could qualify for several types of workers’ compensation benefits: Temporary Total Incapacity (you are unable to work six or more full or partial work days), Partial Incapacity (you are forced to work less or at a lower pay rate), Permanent and Total Incapacity (you are totally and permanently unable to do any kind of work), Permanent Loss of Function and Disfigurement, Medical Benefits, Survivors’/Spouse’s Benefits, or Burial Expenses. Benefits are based on your average weekly wage. You may also be eligible for social security disability benefits, which are separate from any workers’ compensation benefits.

Visit our Social Security Disability page

Lump sum settlements sometimes replace weekly compensation checks if you, the employer, and the insurer agree to this arrangement, although you would also agree to give up certain rights in the future. Additionally, vocational rehabilitation may help you to return to a job earning as much as you earned before your injury. The DIA defines this rehabilitation as “evaluation of your capabilities, vocational testing, counseling or guidance, workplace modifications, and/or job placement assistance/formal retraining.”

Why do I need an attorney?
As with most personal injury cases, the laws are complicated and there are many opportunities for your voice to go unheard along the way. Our experienced attorneys will handle all contact with the workers’ compensation insurance company, can recover money for your lost wages, medical bills, disfigurement, and vocational training, and help you through the appeal process if needed.

View the complete workers’ compensation guide from the Department of Industrial Accidents (DIA)

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