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Determining how to calculate workers compensation claims in Illinois can be complex. This guide demystifies the elements involved—from evaluating medical costs to lost wages and disability benefits—ensuring that you can make a precise computation of what you’re owed according to Illinois law.
For some foundational information about how Workers’ Compensation works in Illinois, check out: Illinois Workers’ Compensation Explained.
The first big factor is whether the work-related injury resulted in death.
- Illinois requires workers' compensation insurance, covering medical care, lost wages, disabilities, and death benefits, rates adjust biannually.
- Workers' comp claim calculations depend on medical costs, lost income, and disability, capped by average weekly wages, injury severity, and earnings.
- Managing claims involves knowing Permanent Partial Disability, Temporary Disabilities, Maximum Medical Improvement, and key influencing factors.
Illinois Workers’ Compensation and injuries resulting in death
The amount of compensation which shall be paid for an accidental injury to the employee resulting in death depends on who survives the deceased employee. In the event a deceased employee is survived by a widow, widower, or any child or children (absent a child or children who are physically or mentally incapacitated), payments shall be made to the widow or widower until the later of the following:
- The death of the widow or widower; or
- The youngest surviving child reaches the age of 18.
- However, if the child, upon reaching the age of 18, is enrolled as a full-time student in any accredited educational institution, the payments shall continue until the child has attained the age of 25. 820 ILCS 305/7(a).
Under the Illinois Workers’ Compensation Act, a “child,” for purposes of determining compensation payouts means any of the following:
- A natural child of the deceased;
- A posthumous child;
- Any child legally adopted by the deceased and widow(er);
- Child(ren) to whom the deceased employee owes a legal obligation to support;
- Child(ren) to whom the deceased employee stood in loco parentis (meaning the deceased employee was “in the place of a parent” in relation to the child(ren))
Additionally, to any child who, at the time of the deceased employee’s death, is under the age of 18 and entitled to compensation, the compensation payments shall continue for a period of not less than six years. Essentially, if a child is 15 or 16 and entitled to compensation, those payments will be continue until the child reaches 21 or 22 years of age.
Similar to the termination of maintenance (alimony) in dissolution of marriage matters, the weekly compensation payments to a widow or widower are subject to termination upon the remarriage of the widow or widower. However, unlike maintenance (alimony) issues, in workers’ compensation claims, the remarried widow or widower will be paid a lump sum amount equal to 2 years compensation benefits and any further rights of the widow or widower to compensation are terminated.
As an additional payout, not subject to any weekly payment to surviving spouses or children, the sum of $8,000 for burial expenses shall be paid by the employer to the widow or widower, other dependent, next of kin or to the person or persons incurring the expense of burial. 820 ILCS 305/7(f).
Illinois Workers’ compensation and Non-Fatal Injuries
Employers are responsible to pay compensation to injured workers according to state-wide accepted schedules. Employers are also responsible to pay any treatment, instruction, and training necessary for the physical, mental, and vocational rehabilitation of the employee, including any and all maintenance costs and expenses.
As an incentive to injured employees, the Workers’ Compensation Act allows the employee to secure their own physician, surgeon, hospital services, etc at the expense of the employer. Many employers, with the approval of the Illinois Workers’ Compensation Commission, maintain what is called a “Panel of Physicians” (physicians approved by the employer and IWCC for use by the employee) that is accessible to all employees.
As we will see below, the amount of compensation depends on the extent of employees injuries.
Permanent Partial Disability Benefits in Illinois Workers’ Compensation
Permanent partial disability benefits are available when an employee (1) loses the full use of a body part; (2) loses partial use of a body part; or (3) loses partial use of their body as a whole (meaning they can no longer perform tasks that they could prior to the injury).
In the event an employee experiences an amputation of an arm, hand, leg or foot, loss of an eye, or any natural teeth, the employer is responsible for obtaining an artificial replacement of the lost member. Any bracings/cases/etc for any necessary artificial replacements. Additionally, the employer shall, when necessary, maintain in good repair, refit or replace the artificial limbs during the lifetime of the employee. 820 ILCS 305/8(a)(4)(C).
Disability Compensation Rate:
1. Scheduled injury:
- Illinois has set a maximum number of weeks for compensation for several body parts. A full list of scheduled injuries can be found here.
- Under this method, the employee will determine weekly compensation by multiplying 60% of their average weekly wages (AWW) by the number of weeks assigned to a particular body part.
- For example, the chart linked to above lists the loss of a thumb as 76 weeks of compensation. If the employee’s AWW was $500, 60% of that equals $300. The employee then multiplied $300 by 76 weeks and is entitled to $22,800.
2. Loss of Percentage of Person as Whole
- If the employee loses the ability to perform a task that, but for the injury, he or she would normally be able to perform, they determine compensation as follows:
- Percentage of loss x 500 = number of weeks employee is compensated
- As above, the next step is to multiply the determined number of weeks by 60% of the employees AWW.
3. Wage Differential
- If an injury forces an employee to accept a new form of employment for less income, the employee may be entitled to two-thirds (66.67%) of the difference between the old job and the new job.
- This differential is not to exceed the State Average Weekly Wage (SAWW)
- If an employee becomes disfigured (defined as a serious, permanent change to their appearance) from a work-related injury or surgical scars, they may be entitled to compensation.
- Typically, the employer and employee work together to determine the total weekly compensation to be paid (not to exceed 162 weeks). This number is then multiplied by 60% of the employee’s AWW to determine total compensation.
Temporary Total Disability
- If the employee is temporarily totally disabled (meaning they can’t perform any work functions) for a period of more than 3 working days, weekly compensation begins on the 4th day of the disability and continues as long as the disability lasts. 820 ILCS 305/8(b)
- If the disability last more than 14 days, compensation begins from the day after the accident.
- Compensation is determined by multiplying 66.67% of the AWW by 40 hours.
- The percentage increases 10% for each spouse and child.
Permanent Total Disability
- An employee is considered permanently totally disabled if the employee is injured in a work-related activity that results in their being completely unable to work, permanently, or having lost the use of both (or a combination of two or more of) of their eyes, legs, feet, arms or hands.
- Employees suffering from a permanent total disability will be entitled to receive lifetime weekly permanent disability benefit of two-thirds the employees AWW (subject to a maximum of 133.33% of the SAWW.
Death Benefits and Dependent Compensation
The unfortunate reality of work-related injuries is that they can sometimes lead to the death of an employee. In such cases, Illinois workers’ compensation provides death benefits that are paid for 25 years or until a total of $500,000 has been paid out, whichever is greater. These death benefits are determined based on the deceased employee’s average weekly wage, considering the number of dependents, such as a spouse and/or children.
When it comes to dependent compensation, different rules apply. For instance, upon remarriage, a surviving spouse without minor children receives a final lump sum payment equivalent to two years of benefits, after which the regular death benefits cease. Minor children may receive death benefits until they reach the age of 18 or 21 to 22 if the child is a student. Understanding these rules is crucial for dependents in securing their financial future after the loss of a loved one.