Worker’s Compensation vs. Personal Injury: What is the Difference?

With the Governor of Illinois pressing for significant worker’s compensation “reform,” I have been giving a great deal of thought to the many and varied differences between a worker’s compensation claim and a personal injury claim in Illinois.  Many people, including legislators in Illinois, really do not understand the significant differences between the Illinois Worker’s Compensation Act and a Personal Injury case.  The differences are astonishing in terms of proving a case and the types of damages that are recoverable.  If one understands just how limited and restricted damages are in a worker’s compensation claim, then maybe, just maybe, the Governor and General Assembly will not be so quick to enact additional reforms that further reduce the injured worker’s rights under the Illinois Worker’s Compensation Act.

Let’s look at the Illinois Worker’s Compensation Act.  This Act was enacted as a result of many significant compromises between labor and business.  The main compromise was that business (the employers) agreed that liability would be easier to prove in exchange for labor (employees) agreeing to limit the amount and types of monetary compensation that could be recovered.  Put another way, the employers agreed to lessen the burden on an employee to prove he was entitled to receive compensation.  For this promise, the employees agreed to limit the amount of money they could obtain as compensation.  Business now is looking to change this bargain by making it harder for an injured employee to prove that he is entitled to an award and if he is entitled to an award to further limit the amount of it.

In essence, under the Illinois Worker’s Compensation Act, the employee has to prove that his injury was the result of an on-the-job accident.  The employee does not have to prove “fault” on the part of the employer.  He does not have to prove that the employer caused his injury.  Rather, he has to establish that the injury occurred while he was on-the-job doing what he was supposed to be doing.  With certain exceptions, if an employee can prove this then he is entitled to receive an award under the Illinois Worker’s Compensation Act.  If he cannot prove this, then he is not entitled to make a recovery under the Act.

If an employee can prove his claim under the Worker’s Compensation Act, then he is entitled to receive compensation.  The damages that are currently recoverable under the Act are very narrow and restrictive.  There are three main categories of compensation available to an injured worker:

A.   An injured worker is entitled to have his medical bills paid for.  The amount that worker’s comp is required to pay is significantly reduced by the Medical Fee Schedule.

B.  He is entitled to receive two-thirds of his average weekly salary for so long as his doctor says he is unable to return to his job.  This benefit is referred to as Temporary Total Disability, or TTD.

C.  Finally, an injured worker is entitled to receive an award for Permanent Partial Disability, or PPD.  This benefit is for the degree of permanency that the injured worker will have as a result of the injury.  It is typically restricted to how it will affect an injured worker’s ability to perform his job.  It does NOT include a component for pain, suffering, loss of normal life, or the impact it has on his personal life.  All in all, the damages that are recoverable to compensate for an injury are limited.

A Personal Injury claim, on the other hand, is very different.  By “personal injury claim,” I mean one for an automobile accident, slip and fall, products liability, medical malpractice or any other type of injury that occurs OUTSIDE of the workplace.  In a PI claim, the injured person has to prove “fault,” meaning that you have to show that the at-fault party was “negligent.”  The meaning of negligence has been the subject of an earlier blog article.

In a Personal Injury claim, if the injured person can prove fault, then the array of damages are much more expansive than in a worker’s compensation case.  The basic elements of damages an injured person may be entitled to recover include:

A.  Medical Expenses.  The award is for the FULL amount of the bill, not a reduced amount like in worker’s compensation.

B.  Lost Wages.  The award is for the full amount of the lost wages, not 2/3 like in worker’s compensation.

C.  Past and future pain, suffering and loss of normal life or disability and disfigurement.  These are referred to as non-economic damages.  These damages often make up the largest part of an award.  They are arguably the most important because it helps the injured person to be compensated for losing out on what their life used to be like before a tragic accident.  These types of damages are NOT available under the Illinois Worker’s Compensation Act.

As this very brief analysis points out, there is a significant difference between a worker’s compensation claim and a personal injury claim in Illinois.  The worker’s compensation system severely restricts the types and amounts of damages that an injured worker can recover when compared to a Personal Injury claim.  It is important for us all to know the differences.