BASIC (09-08)

DI 52120.080 Illinois Workers’ Compensation (WC)

A. Types of Illinois WC payments and payment provisions

1. Temporary Total (TT) disability

TT benefits pay 66 2/3 percent of the individual’s average weekly wage. The benefits will pay for the duration of the disability or until the worker has returned to work.

2. Temporary Partial (TP) benefits

The TP benefit is 66 2/3 percent of the difference between the average amount the worker would be able to earn in the pre-injury job(s) and the net amount he or she earns in the light-duty job.

3. Permanent Total (PT) WC

PT pays 66 2/3 percent of the individual’s average weekly wage, subject to minimum and maximum levels. In the State of Illinois, an injured individual may receive lifetime PT benefits.

4. Permanent Partial (PP) disability

There are four types of PP benefits. The maximum and minimum payment amounts vary for each type. See Illinois Workers' Compensation Commission for a complete list of rates.

  • Wage Differential

    Wage Differential PP benefits are paid if the individual returns to employment, but at a lower wage than the pre-injury employment. The payment amount is 66 2/3 percent of the reduction in earnings when comparing the new job with the job held prior to injury.

    NOTE: The receipt of Wage Differential PP WC is an indication that the individual has returned to work and it may be necessary to establish a Work Continuing Disability Review (CDR) to evaluate the work activity.

  • Schedule of Injuries

    The “schedule of injuries” refers to a list that assigns a compensable value for each body part.

  • Non-Scheduled Injuries

    If the condition is not listed on the schedule of injuries, but it imposes certain limitations, the employee may be entitled to a percentage of 500 weeks of benefits, based on the loss of the person as a whole. The individual is paid 60 percent of their average weekly wage for the number of weeks determined.

    NOTE: This language is not adequate to determine lump sum proration. See DI 52120.080A.

  • Disfigurement

    An individual who suffers a serious and permanent disfigurement is entitled to a maximum of 162 weeks of benefits at the PPD rate.

5. Vocational Rehabilitation/Maintenance Benefits

To qualify for Vocational Rehabilitation and Maintenance Benefits, the individual must participate in a rehabilitation program and be unable to return to the pre-injury job. The employer is required to pay for treatment, instruction, and training necessary for the physical, mental, and vocational rehabilitation of the employee. This includes all maintenance costs (money for living expenses) and incidental expenses. The maintenance benefit payment cannot be less than the employee’s calculated TT benefit rate.

6. Illinois Lump Sum (LS) considerations

  • Person as a Whole Awards

    Illinois LS awards may refer to loss of a specific percentage of loss of earnings capacity as loss of use of the person as a whole. Loss of the whole person is limited to 500 weeks of benefits. This language alone cannot be used to determine the amount at which to prorate a lump sum. The order of preference in DI 52150.060D.3. must be applied.

    EXAMPLE:

    An individual is awarded periodic payments of $135.82 per week prior to a lump sum settlement.

    The lump sum settlement papers indicate that the $20,000.00 LS represents a 32.5 percent loss of use of the person as a whole. There is no weekly proration rate given in the award.

    SSA has determined that, rather than multiplying the 500 week limit times 32.5 percent and prorating the lump sum over 162.5 weeks at the resulting $123.08 per week, we must consider the award as not stating any proration amount and use the prior periodic rate.

  • Future Medical Expenses

    There is no provision of the Illinois law specifically addressing the issue of future medical expenses. Conversely, there is nothing in the law which prohibits designating part of a lump sum settlement as being for future medical benefits. Under Illinois WC law, an arbitrator (the individual approving any final settlement) has the option of designating a portion of the LS for future medical expenses. If the settlement specifically identifies money to be used for future medical expenses, then the amount specified should be considered an excludable expense. Standard policies apply when determining if the amounts appear to be excessive. See Excludable Expenses: DI 52150.050B.2.

B. Cost-Of-Living adjustments (COLA)

A COLA is only provided for recipients of PT benefits. To qualify, the individual’s case must have been closed by a decision. Beginning in the second year after the award was issued, the recipient will receive an amount from the Commission’s Rate Adjustment Fund (RAF) that reflects the increase in the State-wide average weekly wage during the preceding year. These payments are made monthly and are payments made separately and in addition to the regular PT benefit. The monthly payments are adjusted July 15th of each year. These payments should be included when calculating offset.

C. Attorney fees

The attorney's fee is typically limited to 20 percent of the compensation recovered. The fee is further capped at to 20 percent of 364 weeks of the maximum TTD benefit, unless a hearing is held and the Commission approves additional fees.

In cases where the employer made a written offer to the employer, the attorney may only charge a fee based upon the amount recovered that is in excess of the initial offer. In these cases, the attorney may charge more than the 20 percent.

D. Retirement Insurance Benefits (RIB) considerations

Illinois does not offset due to the receipt of RIB.

E. Verifying WC

If verification cannot be obtained from the disabled individual, you may need to contact the Illinois Workers’ Compensation Commission. You will likely need authorization from the Number Holder to obtain release of the information.

COMMISSION OFFICES

Toll-free:

within Illinois only

866/352-3033

Chicago:

100 W. Randolph St. #8-200  60601

312/814-6611

Collinsville:

1014 Eastport Plaza Dr. 62234

618/346-3450 

Peoria:

202 N.E. Madison Ave. #201 61602

309/671-3019

Rockford:

200 S. Wyman 61101

815/987-7292

Springfield:

701 S. Second St. 62704

217/785-7087

TDD:

Telecomm. Device for the Deaf

312/814-2959

You can obtain case status information online by visiting: http://www.state.il.us/agency/iic/caseinfo.htm.

You will need a claim number to enter the online system.

F. References

http://www.state.il.us/agency/iic/ - Illinois Workers' Compensation site

DI 52135.080 - Illinois PDB

Illinois Workers' Compensation Commission - Illinois Maximum and Minimum WC rate list

DI 52150.060 - Prorating a WC/PDB Lump Sum Settlement

DI 52150.030 - Considering the RIB Option

DI 52150.050 - Excludable Expenses


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0452120080
DI 52120.080 - Illinois Workers' Compensation (WC) - 12/16/2013
Batch run: 12/16/2013
Rev:12/16/2013