Injured at Work but Employer Won't Pay Worker Compensation Benefits

Extraordinary Remedies Under Workers Compensation Law Sections 19(b-1), 19 (K) and 19 (L) of the Act

What the Illinois Workers Compensation Law Requires

When an employee suffers injury at work and is physically unable to perform his/her work duties, the employer is obligated to pay Temporary Total Disability (“TTD”) benefits equal to 2/3 of the employee's average weekly wage, plus all medical bills for customary and reasonable medical treatment related to the accident. (820 ILCS 305/8(a)(b) and 10; which can be found in full on the website of the Illinois Industrial Commission) TTD payments are to continue until the employee can return to regular or light-duty work, if available. (If unavailable, ttd payments are to continue until the employee can return to full duty work).

Disputes Regarding Return to Work

A dispute may arise between the employee and the employer (or its Workers Compensation insurer) regarding when the employee can return to work. The Workers’ Compensation Act contemplates that medical minds can differ regarding the ability of the injured employee to physically handle the demands of his/her job.

So-Called Emergency Trial When Benefits Have Been Cut Off

An injured employee uses Section 19(b-1) of the Workers’ Compensation Act in order to obtain benefits in an emergency-type situation. If the employer terminates or refuses to provide TTD or medical benefits, the employee can request an emergency hearing, present the disputed issues to an arbitrator and obtain a decision faster than with Section 19(b).

The Workers’ Compensation Act requires the employee to specify the disputed issues in writing and to provide 15 days notice to the employer of this hearing request. The employer has 15 days to respond. If the employer fails to respond to the employee’s Section 19(b)-1 petition the employer will be prohibited from producing their own evidence (i.e. their own doctor’s opinion) at the hearing.

Permanency is not an issue under this section as and the nature and extent of the employee’s injury will be determined at a later time via settlement or final hearing after the employee completes treatment. The Illinois Workers’ Compensation Act states that the final decision of the Workers’ Compensation Commission (the first appeal) shall be made within 150 days of the date the request for emergency hearing is filed by the injured employee. (820 ILCS 305/19(b)(1).

Penalties Against the Employer for Unreasonable Refusal to Pay Worker Compensation Benefits

The Workers Compensation Act provides the injured employee with a measure of protection from an employer who refuses to pay benefits–penalties under Sections 19(k) and 19(l). Section 19(k) states that an employer who denies benefits unreasonably, ie. without a good faith basis, can be penalized in an amount of up to 50% of the employee’s award. Section 19(l) provides that an employer that unreasonably denies or withholds Temporary Total Disability from an injured employee may be penalized of $30 per day up to $10,000 for doing so. The arbitrator or the Workers’ Compensation Commission, when issuing the award, makes the determination of whether or not penalties are warranted under either or both Sections 19(k) and 19(l). 820 ILCS 305/19(k)(l).

Employers Prevented from Unjustifiably Revoking Benefits

An injured employee who has had his/her benefits denied stands in a precarious predicament. Absent steady income, the employee cannot meet necessary financial needs. Absent medical treatment, the employee cannot get better and return to work. The legal remedies stated above are not absolutes- courts must decide disputes, and may not agree that an injured worker is entitled to Temporary Total Disability or medical benefits- but provide a measure of protection for a worker to prevent employers from unjustifiably revoking benefits.