Can Employees with Pre-Existing Conditions Still Receive Workers Comp Benefits in Illinois?

The recent debate over budget concerns in Illinois is keeping workers’ compensation reform in the news. This leaves Chicago employees suffering from injuries that were aggravated by activities in the workplace wondering if their workers’ compensation claims will be covered.

In many cases in Illinois, workers can receive benefits if a pre-existing condition is aggravated. In fact, if employment relates at all to an injury, it could be covered. There are however, some important intricacies in the Illinois law that could affect a case, so it is advisable for injured workers in Chicago to seek the advice of a workers’ compensation lawyer.

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Workers’ Compensation in Illinois

The workers’ compensation system in Illinois provides benefits for employees who are injured on the job. These benefits are paid by their employers. All workers’ compensation disputes are resolved by the Illinois Workers’ Compensation Commission. A majority of workers’ compensation disputes in Illinois are resolved through a settlement between employer and employee.

In an effort to reduce fraud and cut costs, a series of new regulations regarding workers’ compensation were enacted by the state of Illinois in 2011. These regulations have significantly tightened the guidelines for proving that an injury is the direct result of something that happened in the workplace.

In Illinois, workers who are injured on-the-job are required to prove that medical expenses were incurred and that they were unable to work as a result of their injury. Employers in the state of Illinois do have the option to provide a modified employment opportunity to an injured worker, even if the pay rate is lower. Benefits may cover the difference between the payment received from modified employment and the original pay rate.

The 2011 reforms enacted in Illinois also added the use of American Medical Association (AMA) Guidelines as one of five factors used to determine permanent partial disability (PPD) benefit awards in workers’ compensation cases. The AMA Guidelines are considered to be highly conservative, which can lead to specific injuries being considered less serious, thus lessening the benefit amounts.

Pre-Existing Conditions

When an injury happens at work, the employee is eligible to seek workers’ compensation benefits, even if they suffer from a pre-existing condition. There are numerous situations and conditions that could lead to the aggravation of a pre-existing condition and each of these could impact a workers’ compensation case. Here are some examples:

  • Re-injury of a body part, hurt in a previous accident, even if workers’ compensation benefits were received for that accident.
  • Injury due to a previous accident which was unrelated to the job which is aggravated by on-the-job tasks like, lifting heavy boxes or frequent kneeling.
  • Complications from asthma caused by environmental factors at work.
  • A slip and fall that aggravates arthritis and prevents an employee from standing for long periods of time.

Worker’s compensation claims that involve pre-existing conditions are not limited to industrial workplaces. Even minor injuries can be greatly impacted by extended standing, a fall, or repeated actions such as typing or cleaning.

Workers’ compensation benefits may also be received in Illinois if an employee experiences a medical condition as the result of a repeated work-related activity. Carpal Tunnel Syndrome is a serious condition that can be directly related to repetitive work.

Proof of a Workplace Related Injury

In Illinois, each workplace injury is considered unique, even when a pre-existing condition is involved. This means that even if an employee has been injured in the same way in the past on-the-job, a re-injury will be considered as a separate case.

While Illinois law does recognize that employees who are injured in the workplace should receive compensation for lost wages and medical expenses, workers are still required to provide medical proof.

Whether or not a pre-existing condition is a factor, employees seeking workers’ compensation must establish that their injury was the direct result of some activity performed while on the job. This could be a one-time incident or a repetitive task.

The state of Illinois has very specific requirements for reporting and establishing proof of a workplace injury. An injury must be reported within 45 days after an employee becomes aware of a workplace cause. A medical examination will be required and employers and insurance are granted the right to request that another examination be performed by a different physician.

Filing a workers’ compensation claim can be a difficult process in any state, but the laws are particularly well-defined in Illinois. Especially when a pre-existing condition is involved, seeking counsel from an attorney is often in their best interest. Employees who are injured in the workplace can receive workers’ compensation awards, but this process can be simplified by hearing the advice of Chicago workers’ compensation lawyer.

Does Your case Have Merit?

When you contact Orzoff Law Offices, you will receive a free initial consultation to answer your questions and focus on your goals. Call 847-564-0285 or send us an email using our quick contact form.

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