You are the primary witness in your workers’ compensation case and the only necessary witness in many cases. In Illinois, you are not required to prove that anyone was negligent in order to receive workers’ compensation benefits. The arbitrator or court that is deciding your case needs to know that your injury occurred during the course of your work or as a consequence of your work duties. You may need other witnesses if your employer is casting doubt on the cause or extent of your injury. However, live testimony may be unnecessary even in these cases.

Expert Witnesses

Every workers’ compensation case should include records of all of your medical treatments and diagnosis of your physical condition. You can also call your physicians or a vocational expert as witnesses to testify during your case about:

• The severity of your injuries;
• Disabilities that resulted from your injuries; and
• How your injury or disability will affect your ability to work.

Expert witnesses will often charge large fees in order to testify for a case. You should determine whether live testimony is necessary before you pay for an expert witness. Detailed reports from these experts may contain all of the information you need to establish your medical condition and future work limitations.

Suffering a permanent disability from a workplace injury may prevent you from resuming your previous job duties because of your physical limitations. Vocational rehabilitation trains you in new job skills that will qualify you for a job with more technical or interpersonal duties. An employer is required to offer you vocational rehabilitation when appropriate, and your workers’ compensation claim can give you maintenance during your rehabilitation that is equal in value to your Temporary Total Disability benefits. However, your employer may deny your maintenance if it disagrees with you about whether it must provide vocational rehabilitation.

Recent Case

In the case of Beverage v. Illinois Workers’ Compensation Commission, the claimant and his former employer disputed whether the employer was required to provide vocational rehabilitation and pay maintenance. The claimant had developed a degenerative disc disease that prevented him from performing a job that required him to lift cases of beer that could weigh as much as 50 pounds. The claimant requested vocational rehabilitation, but the employer instead invited him to apply for a warehouse manager position. The claimant did not apply because he did not believe he was qualified for the position. As part of his workers’ compensation benefits, an arbitrator awarded the claimant nearly 163 weeks of maintenance that started after his TTD benefits ended. A trial court nullified that decision because the claimant had not participated in a vocational rehabilitation program or searched for a job during that period.

Qualifications

The claimant stated that his former employer violated Illinois law by denying his request for vocational rehabilitation. The court responded that vocational rehabilitation was not necessary in this case because:

What will happen to your workers’ compensation claim if your employer goes out of business? This scenario does happen and leaves claimants worried about whether they will receive the benefits they need while they recover and look for a new job. Fortunately, the status of your employer will not affect your workers’ compensation claim in most cases. The process could take a little longer, but the end result should still cover your medical expenses and lost income.

Insurance Coverage

Most employers provide workers’ compensation insurance through a third-party insurance company, who is responsible for paying your benefits. Your employer going out of business does not change the insurer’s ability to cover you in the event of a successful workers’ compensation claim. However, the process can be slower if your employer is unable to help its insurer with the case. There may be no one left in your employer’s human resources department to:

• Assist the insurer with investigating your injury; or
• Give the insurer your wage records.

You can provide paycheck stubs or other pay records to help move the process along. In some situations, your employer being closed can help with your workers’ compensation claim. The insurer likely wants to close your case quickly because your employer is no longer a paying client. A prolonged court battle may not be worth the cost to them.

There is an ongoing debate in the workers’ compensation insurance industry about whether more insurers should adopt a value-based care model for paying claims. VBC proponents in the industry cite the potential to provide treatment that is more effective in cost and outcome for the patient. How would a VBC system change workers’ compensation for claimants? It may benefit them in theory, but there are still questions about how the system would actually work.

Value-Based Care vs. Fee for Service

Workers’ compensation insurers use a fee-for-service payment model, in which the insurer pays the healthcare provider for each visit or procedure that it performs. Critics of fee for service say that it puts a greater incentive on the number of visits than the quality of care provided. A VBC payment system compensates healthcare providers based on the nature of the injury and the recovery of the patient. There are several payment models for VBC, including:

• Pay for performance;
• Bundled payments; and
• Outcomes-based payments.

VBC proponents call this a more holistic and patient-centered approach to workers’ compensation. The doctor’s financial incentive is to help a worker reach maximum recovery as soon as possible, which could result in injured employees returning to work more quickly. Of course, insurers could also benefit from more predictable pricing and shorter periods of disability payments.

Typically around one-third of Illinois’ workers’ compensation claims during the winter are from injuries caused by slips and falls. Snow and ice present a hazard for any employees who must walk from their vehicles to their place of employment. Normally, a workers’ compensation injury must occur when an employee is on the clock or performing a work-related task. However, Illinois has a parking lot exception that allows employees to receive compensation if injured from a slip or fall in an employer’s parking lot.

Parking Lot Exception

Illinois courts have ruled that an employer must cover worker injuries that occur in a parking lot because it is an extension of the employer’s premises. It does not matter whether the employer owns the parking lot as long as it is the designated area where employees are expected to park. The court will also consider whether the employee is exposed to a risk of injury that is different from what a member of the general public would normally experience. For instance, a court once rejected a woman’s workers’ compensation claim because she parked in a lot that was meant for both employees and customers of a store. However, the court may have accepted her claim if the store had required its employees to park in a designated area.

Safety Measures

Employers are not required to clear their parking lots of snow and ice, but their negligence would increase the risk of employees being injured and filing for workers’ compensation. Attentive employers will have a contract with a professional snow removal company, as well as salt and sand on site to create safer walkways. They will also instruct employees about safe walking practices, such as: