Who Decides If You Qualify for Workers’ Compensation?

Who Decides If You Qualify for Workers’ Compensation?

Worker's CompensationAll businesses operating in Illinois with employees are required to sign up for worker’s compensation insurance. This also includes businesses that only hire part-time employees. According to Illinois law, employers have to purchase a policy from an insurance company or get permission to self-insure.

What Does Workers’ Compensation Cover?

Worker’s compensation, also known as worker’s comp, only covers job-related injuries, such as:

  • Injury caused by the repetitive or continuous use of a body part at work
  • Heart attack caused by work
  • Stroke caused by work
  • Other physical harm caused by work
  • Pre-existing conditions aggravated by work

Some injuries not covered in worker’s compensation are:

  • Injuries at non-mandatory recreation events, such as softball games or company picnics.
  • Accidents during an alcohol or drug rehabilitation program.

Who Decides If You Qualify for Workers’ Compensation?

After you have filed for a worker’s comp claim, an arbitrator will be allocated to your case, and you will be given a case number. Once this happens, your case will be re-examined every 60 days in a status call.

When you receive a status call, you can either ask for a hearing or inform the arbitrator that you are negotiating a settlement with the insurance company. If you request a hearing, the arbitrator will set a trial date within 30 days of your request.

During the hearing, the arbitrator will listen as you and your employer state your case regarding why you should or shouldn’t get worker’s comp benefits. After the arbitrator has heard both sides of the story, he/she will communicate the decision to you within 60 days.

Thus, it is essentially the arbitrator who decides if you qualify for worker’s compensation or not.

Last Few Words

Getting injured at work isn’t just physically painful, but financially burdensome as well. The cost of surgeries, operations, medications, and visits to the doctor can take up a fair share of your hard-earned savings. Moreover, the travel expenses to and from a medical facility to receive treatment can also be exorbitantly high.

Thus, you need to make sure you timely file for a worker’s comp claim and receive the benefits you are entitled to.

Personal Injury Attorney

If you need any assistance in filing a worker’s comp claim, get in touch with us at the Law Offices of Robert T. Edens for a consultation today. We can represent you in court and ensure you receive a fair amount of damages. We aim to lower your monetary burden and ensure that you stay financially stable. See more on our Illinois Workers’ Compensation FAQs page.


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