Free Adobe PDF - Illinois


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Date: October 11, 2005
File Format: PDF
State: Illinois
Category: Workers Compensation
Word Count: 528 Words, 3,291 Characters
Page Size: Letter (8 1/2" x 11")
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http://www.iwcc.il.gov/icpnFORM.pdf

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WORKERS' COMPENSATION
is a system of benefits provided by law to most workers who have job-related injuries or illnesses. Benefits are paid for injuries that are caused, in whole or in part, by an employee's work. This may include the aggravation of a pre-existing condition, injuries brought on by the repetitive use of a part of the body, heart attacks, or any other physical problem caused by work. Benefits are paid regardless of fault.

IF YOU SUFFER FROM A WORK-RELATED INJURY OR ILLNESS, YOU SHOULD TAKE THE FOLLOWING STEPS:
1. GET MEDICAL ASSISTANCE. By law, your employer must pay for all necessary medical services
required to cure or relieve the effects of the injury or illness. The employee may choose two physicians, surgeons, or hospitals. Where necessary, the employer must also pay for physical, mental, or vocational rehabilitation, within prescribed limits.

2. NOTIFY YOUR EMPLOYER. You must notify your employer of the accidental injury or illness within
45 days, either orally or in writing. To avoid possible delays, it is recommended the notice also include your name, address, telephone number, Social Security number, and a brief description of the injury or illness.

3. LEARN YOUR RIGHTS. Your employer is required by law to report accidents that result in more than

three lost work days to the Workers' Compensation Commission. Once the accident is reported, you should receive a handbook that explains the law, benefits, and procedures. If you need a handbook, please call the Commission or go to the Web site. If you must lose time from work to recover from the injury or illness, you may be entitled to receive weekly payments and necessary medical care until you are able to return to work that is reasonably available to you. It is against the law for an employer to harass, discharge, refuse to rehire or in any way discriminate against an employee for exercising his or her rights under the Workers' Compensation or Occupational Diseases Acts. If you file a fraudulent claim, you may be penalized under the law. disablement from an occupational disease, or within two years of the last workers' compensation payment, whichever is later. Claims for pneumoconiosis, radiological exposure, asbestosis, or similar diseases have special requirements. Injured workers have the right to reopen their case within 30 months after an award is made if the disability increases, but cases that are resolved by a lump-sum settlement contract approved by the Commission cannot be reopened. Only settlements approved by the Commission are binding.
Chicago: 312/814-6611 Peoria: 309/671-3019 Springfield: Collinsville: 618/346-3450 Rockford: 815/987-7292 TDD (Deaf):

4. KEEP WITHIN THE TIME LIMITS. Generally, claims must be filed within three years of the injury or

For more information, go to the Illinois Workers' Compensation Commission's Web site or call any office:
Toll-free:866/352-3033 Web site: www.iwcc.il.gov 217/785-7087 312/814-2959

BY LAW, EMPLOYERS MUST DISPLAY THIS NOTICE IN A PROMINENT PLACE IN EACH WORKPLACE AND COMPLETE THE INFORMATION BELOW.
Party handling workers' compensation claims Business address Business phone Effective date Policy number
ICPN 12/04 Printed by the authority of the State of Illinois.

Termination date Employer's FEIN