Workers’ Compensation Claims

If an employee is injured on the job, the employee can file a workers’ compensation claim for benefits, including payment of all related medical expenses and off-work benefits. However, the process of filing a claim can be confusing for many who are unfamiliar with it.

If you have been hurt in a workplace injury, the workers’ comp attorneys at Nelson & Nelson understand the complex process and can help you get the compensation you’re entitled to. From filing a claim to fighting for you at the Commission or Division, our Belleville, Illinois workers’ comp lawyers have plenty of experience from which you can benefit. Our attorneys are licensed to represent workers in Illinois and Missouri. Contact us today to begin the workers’ compensation claim process.

What you need to do to receive workers’ compensation benefits:

• Report your work injury – According to Illinois law, you must notify your employer of the accident and subsequent injuries within 45 days. In Missouri, the notice should be within 30 days and in writing.  However, keep in mind that an insurance company may have its own time period for reporting an accident and injuries, but that will not bar a workers’ compensation claim if notice of the injury is given to a supervisor within 45 days in Illinois or 30 days in writing in Missouri.  Bottom line: report the accident as soon as possible.
• Seek Medical Attention – Once you have reported the accident, your employer should provide you with all the necessary information for you to receive medical treatment.  In Illinois, you should go immediately to your choice of a medical provider (primary care physician or hospital). In Missouri, you must go to the doctor your employer directs you to see. You should provide the doctor with a detailed account of what happened.  This ensures the doctor’s notes include an accurate history that your injuries were the result of an accident at work. Those important notes can help prove the validity of your claim and your need for workers’ comp benefits if the insurance provider tries to deny you.

Your employer will need to contact either their insurance provider or workers’ compensation administrator. If your injury is severe enough to cause you to miss over three consecutive days of work, your employer will need to begin paying temporary disability benefits and report the accident to the Illinois Workers Compensation Commission or the Missouri Division of Workers’ Compensation within 30 days after knowledge of the injury.

When To File a Workers’ Comp Claim?

If there is any dispute or you are denied benefits by your employer’s insurance provider, you must file a claim with the Illinois Workers’ Compensation Commission. While you only have 45 days to report your workplace accident and injuries to your employer, you can file a claim with the Illinois Workers’ Compensation Commission within three years following the accident or the Missouri Division of Workers’ Compensation within two years following the accident. However, it is always best to file your claim as soon as possible. Having our skilled workers’ comp attorneys by your side will help protect your rights throughout the entire claims process and help you reach a favorable settlement.

We will support your claim to full and fair compensation for:

• Medical care
• Temporary total disability (TTD)
• Permanent partial or total disability (PPD or PTD)
• Other compensation depending on the situation

Workers’ Compensation Claims Process

What you can expect when filing a workers’ compensation claim in Illinois:

1. You must file three copies of the Application for the Adjustment of Claim and a Proof of Service (which is on the back of the Application for Adjustment of Claim and indicates you have given a copy of your application to your employer). Your signature must be notarized.
2. Send a copy of the signed application to your employer. Send three copies of the signed application to: Illinois Workers’ Compensation Commission, 100 W. Randolph St. #8-200, Chicago, IL 60601. And keep one copy of the signed application for your records.
3. After you file your application, the Commission will open a case file and mail you and your employer a Notice of Hearing which will include information about the arbitrator assigned to your case and the date of your first status call.
4. After the first status call, your case will automatically be set for a new status call every three months. You will not receive a notice of the next call date, so you must keep track of later status call dates.
5. On your status calls, your arbitrator will discuss your case and will provide any updates or allow you to request a trial, which entails arbitration as opposed to a conventional courtroom trial. It is your responsibility to pursue the course of the trial.
6. Before the arbitrator can make any decision on your case, you will need to reach maximum medical improvement, which means you will need to have healed as much can be expected following the initial injury.
7. Arbitration will only take place if the arbitrator decides the case should continue; otherwise, the case will be dismissed after status calls for a period of up to three years.

What you can expect when filing a workers’ compensation claim in Missouri:

1.   It is highly recommended to immediately report your injury in writing to a supervisor/employer within 30 days of the injury. Follow the instructions on the Report your Workplace Injury/Occupational Disease or Repetitive trauma injury form (WC-280, 03-12). Keep a copy of your written report of injury that you submit to your employer for your records.
2.   After your injury has been reported to your employer, your employer is supposed to submit a separate First Report of Injury to the Missouri Division of Workers’ Compensation, which will generate a case number.
3.   If you are being represented by an attorney, your attorney’s office will complete and electronically file a Claim for Compensation form WC-21-A (06-15) on your behalf, for accidents, injuries, or occupational diseases occurring on or after January 1, 2014.
4.   If you choose to complete and submit a Claim for Compensation form WC-21-A (06-15), you must mail in at least 3 copies of your Claim form to the Missouri Division of Workers’ Compensation, PO Box 58, Jefferson City, Missouri 65102. Follow the instructions on Claim form WC-21-A (06-15) to complete the Claim form. Keep a copy of the completed Claim form for your records.
5.   After your Claim for Compensation form has been filed, the Missouri Division will send out a notice to you, your employer, and your employer’s insurance carrier that the Claim for Compensation has been filed. The notice will also state that your employer has 30 days to timely file an Answer to the Claim for Compensation form WC-22 (06-15).
6.   If you need to try to resolve issues or discuss your case with an Administrative Law Judge, you can submit a Request for Hearing form WC-183 (02-18) to the Missouri Division.
7.   Once the division files your Request for Hearing form, it will generate pre-hearing notices that will go out to you (employee), employer, employer’s insurance carrier, and any attorneys assigned to claim.