Most employees in Illinois who are injured at work or have a job-related illness are eligible for workers’ compensation benefits. Illinois requires most employers to carry workers’ compensation insurance. Covered employees include full-time, part-time, and seasonal workers. To qualify for benefits, the employee must work for an employer legally required to carry workers’ compensation insurance, and the injury or illness must be job-related.
Those are general requirements, but several other factors determine who qualifies for workers’ comp in Illinois. Whether you are eligible is based on the specific circumstances of your case.
What Factors Determine Workers' Comp Eligibility in Illinois?
Injured workers in Illinois submit claims to their employer’s workers’ compensation insurer, which decides whether the worker receives benefits. The Illinois Workers’ Compensation Commission, or IWCC, oversees the system and adjudicates disputes between employees and employers in workers’ compensation claims.
Insurers and the commission consider several Illinois workers’ compensation requirements when determining whether you can collect monthly benefits for your injuries or illness.
Employment Status
Illinois workers’ compensation insurance covers most individuals from the minute they start their jobs, if they are hired or injured in Illinois, or primarily perform their duties in the state. This includes employees who work in Illinois for a company based in another state.
There are some exceptions based on the employer’s status. Business partners, sole proprietors, corporate officers, and members of limited liability companies may opt for an Illinois workers’ comp exemption. The IWCC estimates that the state’s workers’ compensation laws cover 91 percent of Illinois employees.
The Nature of the Injury or Illness
Employees only qualify for workers’ comp in Illinois for work-related injuries. These include pre-existing conditions made worse by work tasks. In most cases, it does not matter who caused the incident that led to injury, as Illinois workers’ comp is a no-fault system.
Time and Place of the Injury
Where you were and what you were doing matter in determining Illinois workers’ compensation eligibility. For example, workers’ comp doesn’t cover your injuries while commuting or if you voluntarily leave work to get lunch and are in a car accident.
However, the law protects you if your supervisor tells you to get lunch or if doing so is part of your duties. Similarly, you are not covered at an after-hours company event unless attendance is mandatory.
Employer Coverage
Most employers must have workers’ compensation insurance or obtain permission from the Workers’ Compensation Commission to self-insure. Illinois requires employers to post workers’ compensation notices that include steps for injured employees to take and the insurer’s name and contact information.
Workers' Comp Eligibility Examples
Workers get hurt on the job every day in Illinois and may be eligible for monthly compensation for their injuries and inability to work. Examples of employees who likely qualify for workers’ compensation include:
- A warehouse worker who injures their back while lifting boxes
- An employee delivery driver who is hurt in an accident while on a route
- An office worker who slips and falls on a wet floor at work
- A worker exposed to asbestos or chemicals who develops a related illness
Who Might Not Be Covered by Workers' Comp?
There are some gray areas in Illinois workers’ compensation eligibility determinations. Not everyone can receive benefits after being hurt on the job, including the following:
- Independent contractors who are not employees under the law
- Volunteers, though there is an exception for some volunteers, including firefighters, police, and civil defense members or trainees
- Certain business owners or partners, unless they opt in to workers’ comp
- Federal employees who have federal workers’ compensation coverage
- Employees whose intoxication or misconduct was the primary cause of their injuries
If your employer claims you’re not eligible for workers’ compensation, follow the process of applying for benefits anyway. If your employer’s insurer denies your claim, you can file an appeal with the IWCC through its CompFile portal. If your employer misclassifies you and denies your benefits, seek assistance from an experienced workers’ compensation lawyer.
What Types of Injuries and Illnesses Qualify?
The Workers’ Compensation Act and the Workers’ Occupational Diseases Act govern workers’ comp in Illinois. These laws cover employees with job-related injuries, including:
- Physical injuries, such as falls, equipment accidents, repetitive strain, lifting injuries, and vehicle accidents
- Occupational diseases and illnesses, such as respiratory issues, skin conditions, musculoskeletal disorders, infectious diseases, and hearing loss
- Mental health harm, such as PTSD, depression, anxiety disorder, or stress-related conditions, stemming from their job duties
- Injuries from occupational exposure to asbestos, chemicals, and other hazardous materials
Think You Qualify? Here's What To Do Next
Illinois law protects you if you were hurt or became ill due to your job-related duties. Take steps to pursue workers’ compensation benefits, including:
- Report your injury to your employer within 45 days, or within 90 days of receiving a suspected excessive radiation dose. If you are claiming an occupational illness, you must notify your employer as soon as possible after your diagnosis. Illinois workers’ compensation statute of limitations generally requires you to file a formal claim within three years of the injury or diagnosis.
- Seek medical treatment and document every visit. You must keep up with your treatment plan or risk denial or loss of benefits.
- Consult an Illinois workers’ compensation attorney to understand your rights and options.
- File a claim with the IWCC if your employer denies your benefits.
Determine if You Need an Attorney
You can file a claim with IWCC without a lawyer, but the commission will hold you to the same standard as an attorney. You must understand the Workers’ Compensation Act and the 129-page Rules Governing Practice Before the Commission. You must also properly file your documents, make all appearances, and present evidence proving your eligibility.
Mistakes in applications and appeals can mean significant delays or denials that affect your financial future. Don’t take on the workers’ comp process and your employer’s insurer alone when you are already dealing with your injury or illness.
The Illinois Hammer Injury Attorneys have been helping injured workers in Illinois for over 30 years, and we take cases on a contingency fee basis—we don’t get paid unless you do. Call 888-742-6637 or complete our online contact form for a free case evaluation.
