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How are workers’ compensation claims for disfigurement handled?

On Behalf of | Jul 13, 2023 | Workers' Compensation |

It can be distressing for most people to have a highly visible scar. Scars don’t just mar a person’s appearance but can also serve as a grim reminder of the incident that caused the injury. What can a worker do about a scar they got from a work-related accident?

Fortunately, Illinois’ workers’ compensation laws allow coverage for disfigurement if a work-related illness or injury caused it.

State rules on work-related disfigurement coverage

According to the Illinois Workers’ Compensation Commission (IWCC), an employee who suffers a severe and permanent disfigurement to their head, face, neck, chest, arms or hands, or some form of disfigurement above the armpits or leg below the knee is entitled to permanent partial disability (PPD) benefits. A disfigured employee’s maximum benefit is equal to 162 weeks adjusted for the PPD rate, multiplied by 60% of the employee’s average weekly wage.

The types of disfigurements typically covered are scars from lacerations and burns.

Employees can also claim for disfigurement caused by an occupational disease or a disease that worsened due to work-related exposure. The Commission noted that if an employee files a claim for occupational disease-related disfigurement, they’re entitled to the same benefits and subject to the same terms as if they had suffered an accidental injury.

While disfigurements can be visible for anyone to see and cause much distress for the affected employee, there’s no guarantee that an employer or the claims administrator handling the company’s workers’ compensation insurance would approve a disfigurement claim.

Workers whose disfigurement claims were denied can request a hearing with the IWCC. However, the IWCC requires workers to allow six months before requesting a hearing for their scar to heal. And once the hearing process begins, an employer could try to fight their way out of having to cover the claim. Workers should consider discussing their claims with a lawyer to determine if they can successfully appeal a denial.