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Grupo MedLegal® > Blog > Workers Compensation > How Is Compensation Calculated for a Work Accident?

How Is Compensation Calculated for a Work Accident?

Workers’ Compensation law in the state of Illinois governs the type of compensation a worker is entitled to if he or she is injured while working. The vast majority of workers qualify under this law, with the exception of independent contractors. These benefits are calculated according to the type of injury sustained and the time and/or severity of the injury.

Medical Payments Incurred in Treatment and Continuity of Treatment for Your Injuries

You have the right to receive payment for any type of treatment received as a result of the injury or wound you sustained at work. In many cases, your employer is part of the Preferred Provider Program (PPP) approved by the insurance department. If you wish to be treated by a physician who is not part of this program, you must be referred and approved by someone from the PPP and your employer must be aware of this.

Benefits for Time Lost

The days missed due to your injury or wound do not have to be consecutive. The calculation of benefits for time lost is very simple. First, it must be determined if you had an additional or second job that your boss was aware of. In this case, the weekly pay from your second job is added to your regular weekly pay and mandatory overtime pay. The time period that is considered is the last 52 weeks that you received complete pay before the accident. The total weekly amount of the 2 types of pay (regular and mandatory overtime, besides the second job in some cases) is divided by 52 weeks. So, you have the right to receive 2/3 of this calculated average.

Right to Continuity of Payments for a Different Position with Less Salary

Once your doctor has approved your return to work, but in a different capacity, and your employer accommodates you but with less salary, you still have the right to receive compensation under partial disability benefits. In this case the average amount of pay you received over the last 52 weeks before the accident is obtained, and the weekly pay average without deductions is added to what you are receiving in your new position. In this case, you have the right to receive 2/3 of that average. For example, if you earned an average of $1,000 per week before the accident, and you now earn a net of $500 per week, the weekly average is $750 and 2/3 of this is $562. However, the state of Illinois has minimum and maximum rates that limit the compensation you are entitled to, which are updated every 6 months.

Additional Compensation

You have the right to additional compensation if you suffered disfigurement, amputation, or significantly noticeable scars in key areas such as the face, arms, legs below the knee and on the upper part of the chest.

Permanent Partial Disability or Total Permanent Disability

In this case, doctors need to provide a detailed report of your injuries, and your prognosis. From there, your medical problems will be quantified and the payment you are entitled to will be determined. Another factor that enters the equation is your earning capacity before and after the accident. The law establishes that for labor accidents occurring after September 1, 2011, payments received in this category are for a period of 5 years or until the employee reaches age 67. In the case of permanent disability, you have the right to receive payments for life. It is a complex formula that takes into account how many years of work you had left, weekly amount, and medical expenses, among other things. For accidents occurring after September 1, 2011, your weekly lifetime payments cannot exceed $500,000 or more than 25 years of compensation.

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