When Do Workers’ Compensation Benefits End?

when do workers' compensation benefits end

After a workplace accident, victims may wonder, “when do workers’ compensation benefits end?” The amount of time workers’ compensation benefits last depends on a couple of key factors, including the type of injury you sustained and its disability category. Understanding the different types of injuries and their corresponding disability categories can help you gauge how long your benefits will last.

How Long Do Workers’ Comp Benefits Last in Illinois?

The length of time workers’ comp benefits last in Illinois varies according to rehabilitation time and the type of disability category that applies to your injury. There are four main types of disability, including Permanent Partial Disability, Permanent Total Disability, Temporary Partial Disability, and Temporary Total Disability.

The following is a breakdown of each of these categories and how they affect the length of Illinois workers’ comp benefits.

Permanent Partial Disability

If a person has a Permanent Partial Disability (PPD), it means that either he or she is unable to use individual body parts, or he or she has sustained injuries that prevent him or her from preforming job duties. For example, a worker may sustain a leg injury that renders him or her unable to bend the leg fully, which may prevent the worker from performing the type of manual work he or she performed before the injury.

Illinois provides four main kinds of PPD, depending on the extent of the disability. You may qualify for one of these, but you will not be able to receive more than one at a time. The different types of awards are as follows:

  • Scheduled Injury Awards — These awards enable injured workers to receive PPD benefits on a weekly basis that cover around 60% of the worker’s prior average weekly income. These benefits will last for a limited period according to the type of injury. The Office of Workers’ Compensation Programs (OWCP) lists certain body parts that count toward scheduled injury awards. Qualifying body parts on this list include arms, hands, fingers, legs, feet, skin, eyes, and others.
  • Nonscheduled Awards — If you suffer an injury that doesn’t affect a body part appearing in the OWCP list, you may still be able to recover nonscheduled awards. Like scheduled awards, these benefits cover 60% of your average weekly income before the accident, but they cannot exceed 500 weeks. The length of time these benefits last depends on the severity of the individual’s disability.
  • Wage Differential Benefits — If you sustain an injury that renders you unable to work in the same capacity as, before the accident, you may qualify for wage differential benefits. These benefits award injured workers two-thirds of the difference between the worker’s pay before the accident and the new income amount in a “light duty” position. Workers can receive these benefits until they reach the age of 67 or after a period of five years, depending on which is greater. For instance, a 52-year-old worker might be able to receive these benefits for 15 years until he or she turns 67.
  • Disfigurement Benefits — Sometimes workers sustain injuries that lead to permanent disfigurement. In these cases, disfigured workers could qualify for disfigurement benefits that cover 60% of the workers’ average weekly earnings for a maximum of 162 weeks. The length of time these benefits last depends on the degree of disfigurement resulting from the injury.

Permanent Total Disability

Your injury may fall under the Permanent Total Disability (PTD) category if it makes you incapable of returning to work in any capacity or permanently disables two critical body parts. Individuals who qualify for these benefits will be able to receive them for the rest of their life due to the debilitating nature of their injuries.

For example, a worker may be unable to use both arms following an accident, rendering him or her permanently unable to perform the same type of work performed before the accident.

Temporary Partial Disability

If you can fully recover from your injuries and return to work in the same capacity as before the injury, you may be able to receive Temporary Partial Disability (TPD) benefits. With TPD, you’ll receive a percentage of the difference between your previous earnings before the accident and your wages while recovering and working in a lesser capacity. You’ll be able to receive these until a medical professional determines that you have reached maximum medical improvement (MMI), which is when you’ve recovered as much as possible following an injury. 

Temporary Total Disability

In some cases, workers sustain injuries that make them entirely unable to work while recovering. Workers in this condition may be able to receive Temporary Total Disability (TTD) benefits that compensate for lost wages until they’ve made a full recovery or reached MMI. 

Reasons Workers’ Comp Benefits End

There are several reasons workers’ compensation benefits may end. The following are some of these reasons:

You Fail to Get a Medical Examination

In Illinois, you must get an independent medical examination (IME), which you will find with an independent medical professional. This exam objectively assesses injuries to gauge their severity and diagnose them properly. Failure to get this IME could prevent you from receiving benefits.

You Believe You’ve Made a Full Recovery When You Still Qualify for Benefits

Workers may voluntarily sign a final receipt that prevents them from receiving benefits in the future. Even if the worker hasn’t made a full recovery and still qualifies for benefits, he or she can sign this and officially stop benefits. This potential issue and others are why you may need a workers’ comp attorney to help guide you through the claims process.

You Don’t Adhere to a Treatment Plan

Medical professionals will recommend treatment to help you recover from your injuries. If you don’t follow your doctor’s advice and take steps to recover from your injury, benefits may end sooner than they should.

Judges Suspend Benefits

A judge may review a claim and suspend workers’ comp benefits. This would result in the loss of compensation for both medical expenses and lost income.

Can Workers’ Compensation Benefits Stop Without Notice?

Workers’ compensation insurance companies must notify you of a decision to stop paying benefits. Companies should also disclose the specific reason for terminating these benefits. Notices will also include the date when benefits will end.

Time Limits for Filing Workers’ Comp Claims

You have a limited time to file a workers’ comp claim, known as a statute of limitations. In Illinois, the statute of limitations in these cases is either three years from the time of the work-related incident, or two years starting on the date when you last received benefits. Depending on the nature of the case, you may want to consult with a workers’ compensation lawyer before filing.

In some cases, this time limit may not apply, according to the new decision on the statute of limitations in Illinois. A recent case involving an injured worker and a Cook County circuit court judge resulted in a decision that prevented the statute of limitations from affecting the plaintiff’s ability to recover benefits.

Knowing when workers’ compensation benefits end and the reason for their cessation can help you determine how long you qualify for benefits.

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