Understanding Current Workers' Compensation Wage Caps
June 10, 2022
According to the Illinois Workers’ Compensation Commission (IWCC) in its latest report, covering the fiscal year 2020, the state averages about 250,000 workers’ compensation claims per year. Of these, about 50,000 cover injuries that result in at least three days lost from work.
In 2020, the City of Chicago had 14,817 cases of lost work time from an accident at work, according to the IWCC. The rest of the state had 18,522 such cases. Both numbers were down from previous years due to the pandemic restrictions and business lockdowns.
The Illinois workers’ compensation system was established in 1911 as one of the first in the nation. At the time, cases were handled by courts, but that option quickly became unwieldy, so the Illinois Workers’ Compensation Commission was established.
Workers’ compensation is a no-fault system, which prevents employees from civilly suing employers for injuries and diseases suffered at work and employers from suing workers. The system also provides much quicker compensation to workers to cover their medical expenses and lost wages if they have to miss time at work. In contrast, a civil lawsuit could take months or years.
When it comes to compensation for lost wages, however, the system imposes caps on how much anyone can receive. Typically a worker is entitled to 2/3 of his average weekly wage when off work. However, for high-wage earners, this can be problematic, as there is a cap and the sum may not even cover their normal expenses.
If you’re a high-wage earner in or around Naperville, Illinois, who is going on workers’ compensation and will need replacement income for lost time at work, contact Marker & Crannell Attorneys at Law. We have more than 35 years of experience in helping others recover compensation for their injuries, and we will help you navigate the workers’ compensation system to get what is due to you as quickly as possible.
Marker & Crannell Attorneys at Law proudly serve clients in Bolingbrook, Plainfield, Joliet, Wheaton, Darien, Woodridge, Aurora, Lisle, and Romeoville, Illinois. We also have full-time staff that speaks Spanish to assist any Spanish-speaking workers. Se Habla Espanol!
How Workers’ Compensation
Works in Illinois
Employers in Illinois are required to have workers’ compensation insurance. Sole proprietors, business partners, corporate officers, and members of limited liability companies (LLCs) may exempt themselves, but not their employees. This is why workers’ compensation cases are really claims against an employer’s worker’s compensation insurance company. Most times, the employer is not even involved.
If a business fails to provide workers’ compensation coverage, it can be fined up to $500 a day for each day of noncompliance, with a minimum fine of $10,000. If an employer fails to have insurance, money collected from fines is deposited into the Injured Workers’ Benefit Fund (IWBF), which uses the money to provide benefits to injured workers whose employers fail to carry workers’ compensation insurance.
Additionally, employers are required to post information about their workers' compensation insurance carrier so that all employees have access to it in case of a work injury. If your employer is not providing you with that information, they are in violation of Illinois State law.
If you’re injured or fall ill due to a work-related cause, you must seek medical help and report the accident, injury, or illness to your employer as promptly as possible. Under Illinois law, you have 45 days from the date of the injury to notify your employer of an injury, however; the longer you wait the more likely the insurance company will scrutinize your claim. We recommend you notify your employer immediately in writing (via email or text) so that you have proof of the same. If it is an injury or illness from a toxic substance, the clock starts ticking from when you became aware of the injury or illness. Similarly, if your injury results from repetitive stress, you have 45 days from either the date you became aware of the injury or the date of your first medical treatment with a physician for the injury.
In general, workers’ compensation covers any injury or illness that is work-related, even if it’s an aggravation of a pre-existing condition you have. For instance, you may have once suffered a back injury and now your duties at work – or arising from an accident – aggravate that injury and make it worse. Although workers’ compensation insurance many times tries to deny aggravations of pre-existing conditions, they are nonetheless typically compensable in Illinois. If you find an insurance company is denying your case on this basis, call our offices immediately and we can help you fight the insurance carrier on this issue.
Payment for Lost Time:
How Much and When?
If your injury or illness forces you to miss more than three days of work, workers’ compensation should pay you for lost wages accruing from the fourth day. Once you are out for two weeks, the initial three days will also be paid. Your compensation will cover two-thirds of your average weekly wages, but there is a cap, which currently stands at $1,734.83 a week. High-wage earners face this cap just as do hourly and other workers.
The Illinois Department of Employment Security adjusts the minimum and maximum rates for average weekly workers’ compensation earnings every six months. The current upper cap runs through July 12, 2022, after which the department may adjust the figure.
If your condition persists and you are off work, but you eventually are able to return to work, you will be covered for a Temporary Total Disability (TTD) each week you are off. This is what most employees think of as workers’ compensation payment from the insurance company. If you return to work but earn less than you did before your injury, you qualify for Temporary Partial Disability (TPD). Under TPD, you will receive compensation equaling two-thirds of the difference between your wages earned prior to your injury and the wages you earn on light duty.
If your injury results in a permanent disability that will prevent you from working in any job, you will qualify for Permanent Total Disability (PTD) and can be paid two-thirds of your average weekly wages for the remainder of your life.
If your employer or their insurance provider fails to provide any of these lost-wage or other benefits, you can file with the Illinois Workers’ Compensation Commission by submitting a form called Application for Adjustment of Claim. A hearing will be held by an arbitrator. If the decision does not go your way, you can appeal to the full commission.
Am I Entitled to a Settlement for my Injury?
Nearly 100% of the time the answer is "yes." Your employer can have defenses, but if you sustain a compensable injury on the job, you are entitled to something, even if the injury is minor. Settlements in workers’ compensation are set by statute, which has been in existence since 1911. The statute provides that each body part is worth a set amount of weeks of an employee's wages. Depending on the extent of your injury, you will qualify for a settlement for a percentage of those weeks. Those number of weeks are multiplied by 60% of an employee’s average weekly wage in order to determine the settlement amount.
Settlement ("PPD") = (# of weeks based on body part from statute) x (percentage based on the severity of injury) x (60% of Average Weekly Wage)
Like TTD, the State of Illinois has caps on this settlement rate, which is called a PPD rate. Those maximum caps change every six months. As the Illinois Department of Employment Security is required to publish the statewide average weekly wage (SAWW). The SAWW sets the maximum and minimum weekly benefit levels for workers' compensation. To calculate the SAWW, total wages are divided by the total number of employees in the past six months. Currently, the maximum PPD settlement rate in Illinois for injuries occurring between July 1, 2021, and June 30, 2022, is $937.11.
There are three types of possible settlements in Illinois for a work injury case. First, if you are able to return to work, you are entitled to the percentage loss of use of your body part as summarized above. Second, if you are not able to return to your job and instead are forced to find a job making less, you are entitled to 2/3 of the difference in lost pay up through age 67 or for 5 years, whichever is longer. Third, if you are not able to get back to any job whatsoever and are permanently disabled, you are entitled to 2/3 of your wages for life.
Never accept a settlement with an insurance company without speaking to an attorney to know whether it is a fair offer. Studies done by Marker & Crannell indicate employees who hire attorneys to settle their cases rather than doing so on their own typically obtain 10-20% more (even after paying attorneys fees). If you have questions about what amount of settlement you should be entitled to for your injuries, we offer a free consultation and would be happy to share our opinion with you.
How an Attorney Can Help
If you need to file to have your claim adjusted, even the Workers’ Compensation Commission advises against doing so without the help of an attorney. Better yet, when you first file for workers’ compensation with your employer, have an attorney review everything with you and ensure there is enough medical and other evidence to justify your claim. Be careful not to sign anything or speak to the insurance representative right away as the insurance representative is usually primarily interested in gathering information that can be used against you – no matter how nice they sound.
Marker & Crannell Attorneys at Law will help you receive the full range of benefits to which you are entitled, we will help navigate you through the system to make sure all time off work is paid, all medical is approved and paid, and that you obtain the maximum settlement possible or your injury. Reach out immediately for a free consultation. We serve clients in Naperville, Bolingbrook, Plainfield, Joliet, Wheaton, Darien, Woodridge, Aurora, Lisle, Romeoville, Chicago, and the surrounding areas of Illinois.