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What Disqualifies You From Workers’ Comp in Illinois?

Posted on November 17, 2021

In general, individuals will be able to recover compensation after sustaining an on-the-job injury in Illinois. The workers’ compensation system in this state is considered “no-fault,” which means individuals can typically recover compensation regardless of who caused the injury. However, there are certain circumstances where individuals can be disqualified from recovering workers’ compensation. We want to discuss these exceptions here.

1. Failure to Notify Employer

Any person who sustains an injury at work should be entitled to workers’ compensation coverage, but they have to report the injury to their supervisor or employer within a certain amount of time. Under the law in Illinois, work injuries must be reported to the employer within 45 days after they occur, from when a person receives a diagnosis, or realizes they have sustained an injury or illness caused by the workplace.

2. Horseplaying

Workers’ compensation is considered a no-fault system in Illinois. This means that an individual should be able to receive coverage regardless of who caused the injury. Even if a worker is responsible for causing their own injury, they will receive workers’ compensation coverage, but there are some exceptions. If a worker was playing around on the job and this led to the injury occurring, it is very likely that the insurance carrier or the employer will deny the claim.

3. Drug or Alcohol Impairment

Individuals should not be impaired by alcohol or drugs at work. Inebriation will likely result in the insurance carrier or the employer denying the workers’ compensation plan. It is not uncommon for workers to have to go right to the doctor’s office to take a drug or alcohol test after sustaining a workplace injury. This is particularly true for those who operate around heavy machinery, in the kitchen, or those who drive motor vehicles as part of their job requirements.

4. Injury Didn’t Happen at Work

Any injury that happened outside of the scope of employment will not be covered by workers’ compensation insurance. For example, if an individual sustains an injury during their commute to or from work or during their unpaid break or mealtimes, it is very likely that the insurance carrier or employer will deny the claim. However, just because an injury did not happen in the actual workplace does not mean that a person will not receive coverage at all. If an individual was performing job-related duties outside of the workplace, they will likely receive coverage.

5. Pre-Existing Injuries

Workers’ compensation insurance carriers and employers regularly deny claims if they discover that a worker had a pre-existing injury or illness. However, the existence of a pre-existing injury or illness does not mean that the employee will receive no workers’ compensation coverage. Even if a worker sustains an injury in the exact same spot as a pre-existing injury, they should be able to receive coverage for their current injury if it happened in the workplace.

Secure Legal Assistance for a Workplace Injury

If you or somebody you love has sustained an injury in the workplace, you need to seek legal assistance immediately. An Illinois workers’ compensation attorney can examine every aspect of your case, gather evidence to prove what happened, and vigorously negotiate with insurance carriers and employers to help you recover full compensation for your losses.