Workers' compensation insurance is a system of benefits provided by law to most workers who have job-related injuries or illnesses. Workers' compensation benefits are provided by licensed insurance companies, self-insured employers approved by the Illinois Workers' Compensation Commission, or group self-insurers who have pooled their liabilities. Generally, the Illinois Workers' Compensation Commission is the agency that handles problems involving workers' compensation. The Illinois Division of Insurance has limited involvement. This fact sheet provides an over-view of workers' compensation insurance in Illinois.
The Illinois Workers' Compensation Act requires all employers to post a notice in the workplace that explains workers' rights and lists the name and address of the workers' compensation insurance carrier or, if the employer is self-insured, the name and address of the company that services compensation payments. Harassment, discharge, refusal to hire, or discrimination against an employee for exercising his/her workers' compensation rights is prohibited by law.
It is the employer's responsibility to pay for reasonable medical care for an employee's work-related injury or disease.
The medical treatments that should be covered by the employer include
The employer is also required to pay for necessary physical, mental, and vocational rehabilitation treatment programs that assist in the employee's recovery and return to work. The employee, however, must cooperate in reasonable treatment programs.
The Division of Insurance may be able to assist you in these situations:
A balance billing problem - If you have a legitimate workers' compensation claim, you should not be financially responsible for any covered bills. However, if the workers' compensation carrier pays less than 100% of the billed charges (for example, reductions taken due to usual and customary fees), the medical provider might bill you for the unpaid balance. If you are experiencing balance billing problems, you should contact the Division of Insurance for assistance. However, we are only able to assist when the workers' compensation carrier is an insurance company. We cannot assist if a self-insured employer is offering the workers' compensation benefits.
A work comp audit dispute - Increased premiums can cause a dispute between the employer and the insurance company. If you are an employer who needs assistance in this situation, you can file a complaint with the Division of Insurance. We will conduct an investigation to make sure the insurance company is operating in compliance with the laws we govern.
An insurance company dispute - If the Illinois Workers' Compensation Commission makes a ruling on your workers' compensation claim, but the insurance company doesn't comply with the ruling, contact the Division of Insurance for assistance.
If you would like the Division of Insurance to assist you with one of the problems explained above, you can file a complaint electronically or obtain a complaint form by calling one of the numbers listed at the bottom of this fact sheet.
Note: These are the only workers' compensation situations we can investigate. All other problems regarding workers' compensation claims, including claim delays, claim disputes, or claim denials, should be directed to the Illinois Workers' Compensation Commission.
For further assistance with workers' compensation problems, you should contact the Illinois Workers' Compensation Commission via their web site http://www.iwcc.il.gov/, or at one of the following numbers:
| Chicago | 312/814-6611 |
| Peoria | 309/671-3019 |
| Rockford | 815/987-7292 |
| Collinsville | 618/346-3450 |
| Springfield | 217/785-7087 |
| TDD | 312/814-2959 |
Each regional office can explain the Illinois Workers' Compensation Commission's procedures and provide materials to assist with workers' compensation claim problems.
National Concrete Masonry Association
National Roofing Contractors Association
American Nursery and Landscaping Association
National Electrical Contractors Association
Associated Builders and Contractors
The Associated General Contractors of America
Mechanical Contractors Association of America
Plumbing-Heating-Cooling Contractors Association
National Utility Contractors Association
Independent Electrical Contractors
Air Conditioning Contractors of America
American Subcontractors Association
Insulation Contractors Association of America
Sheet Metal and Air Conditioning Contractors National Association
Professional Lawn Care Association of America
Associated Landscape Contractors of America
American Concrete Contractors Association
Mason Contractors Association of America
National Fire Sprinkler Association
Artisan Contractor Association of America
Pipeline Contractors Association
Construction Contractors Association
Water Proofing Contractors Association
Painting and Decorating Contractors Association of America
National Demolition Association