Workers’ compensation is a confusing process because it involves many parties. You make a claim when you suffer a work injury to your employer. The employer’s insurance will pay your claim.
However, the state has oversight. So, in some aspects, the state does control the workers’ compensation program.
The state steps in to protect everyone. According to the Illinois Workers’ Compensation Commission, the program is state-mandated, which means the state creates laws to ensure the workers’ compensation system runs properly.
The state requires employers to have workers’ compensation insurance by law. It is also the state that will punish an employer who does not carry insurance when mandated to do so by law.
State law sets the guidelines for benefits, such as how much you will receive in lost wage payments and what medical expenses the employer must cover. It also decides the types of benefits you can receive and how to determine if you can return to work.
The state also ensures the system’s fairness by offering mediators and judges that will hear cases. If you want to appeal, the state is where you appeal.
State law ensures everyone has coverage on day one. Once you start working, you have coverage.
Your employer does control a few of the aspects of the system. The main one is that your employer can choose from where to buy insurance. It will buy it from an independent insurance agency. The state does not provide the insurance.
Your employer can also object to claims, which will begin the appeals process. If your employer or its insurer feels you do not qualify for benefits, then it can deny your claim.
The state manages the program to ensure the fairness and effectiveness of the system. However, it is still a private system in that each employer must pay for the insurance and pay out the benefits.