Accident

The Elements of an Illinois Workers' Compensation Claim

Workers on frame

To qualify for Illinois workers’ compensation benefits, an employee must have sustained an accidental injury or been exposed to an occupational disease “arising out of” and “in the course of” their employment.

This basic requirement, which is the subject of many disputed claims, is found in both the Illinois Workers’ Compensation Act and the Occupational Diseases Act:

To obtain compensation under [the Workers’ Compensation] Act, an employee bears the burden of showing, by a preponderance of the evidence, that he or she has sustained accidental injuries arising out of and in the course of the employment.

820 ILCS 305/1(d) Illinois General Assembly | IWCC PDF.

In [Occupational Diseases] Act the term “Occupational Disease” means a disease arising out of and in the course of the employment or which has become aggravated and rendered disabling as a result of the exposure of the employment. Such aggravation shall arise out of a risk peculiar to or increased by the employment and not common to the general public.

A disease shall be deemed to arise out of the employment if there is apparent to the rational mind, upon consideration of all the circumstances, a causal connection between the conditions under which the work is performed and the occupational disease. The disease need not to have been foreseen or expected but after its contraction it must appear to have had its origin or aggravation in a risk connected with the employment and to have flowed from that source as a rational consequence.

An employee shall be conclusively deemed to have been exposed to the hazards of an occupational disease when, for any length of time however short, he or she is employed in an occupation or process in which the hazard of the disease exists

820 ILCS 310/1(d) Illinois General Assembly.

Arising out of Employment

“Arising out of employment” refers to causal connection:

To satisfy this requirement it must be shown that the injury had its origin in some risk connected with, or incidental to, the employment so as to create a causal connection between the employment and the accidental injury. 

Sisbro, Inc. v. Industrial Commission, 207 Ill. 2d 193 (2003) Google Scholar | Illinois Courts.

Three types of risks can lead to an accident at work: (1) employment-related risks ; (2) personal risks; and (3) neutral risks that have no particular employment or personal characteristics. First Cash Financial Services v. Industrial Commission, 367 Ill. App. 3d 102 (2006) Google Scholar | Illinois Courts PDF.

Injuries from employment-related risks are compensable under the Illinois Workers’ Compensation Act. Risks are distinctly associated with employment when:

the employee was performing acts he was instructed to perform by his employer, acts which he had a common law or statutory duty to perform, or acts which the employee might reasonably be expected to perform incident to his assigned duties.

A risk is incidental to the employment where it belongs to or is connected with what an employee has to do in fulfilling his duties.

Caterpillar Tractor Co. v. Industrial Commission, 129 Ill. 2d 52 (1989) Google Scholar.

Injuries from personal risks are not compensable under the Act.

Injuries from neutral risks “are compensable under the Act only where the employee was exposed to the risk to a greater degree than the general public.” “Such an increased risk may be either qualitative, such as some aspect of the employment which contributes to the risk, or quantitative, such as when the employee is exposed to a common risk more frequently than the general public.” Metropolitan Water Reclamation District of Greater Chicago v. Illinois Workers’ Compensation Commission, 407 Ill. App. 3d 1010 (2011) Google Scholar.

“Neutral risks include stray bullets, dog bites, lunatic attacks, lightning strikes, bombing, and hurricanes.” Illinois Institute of Technology Research Institute v. Industrial Commission, 314 Ill. App. 3d 149 (2000) Google Scholar.

Repetitive or Cumulative Trauma

An accident arising out of employment does not necessarily need to be a single event. Workers can also suffer injuries from repetitive or cumulative trauma. “An employee who suffers a repetitive-trauma injury still may apply for benefits under the Act, but must meet the same standard of proof as an employee who suffers a sudden injury.” City of Springfield v. Illinois Workers’ Compensation Commission, 388 Ill. App. 3d 297 (2009) Google Scholar | Illinois Courts PDF.

In the Course of Employment

“In the course of employment” simply “refers to the time, place and circumstances surrounding the injury.” Sisbro, Inc. v. Industrial Commission, 207 Ill. 2d 193 (2003) Google Scholar | Illinois Courts. Generally, this means that the accident must occur during work hours and on work premises.

Accidents that occur while an employee is traveling to and from work are generally not compensable, unless the employee is considered a “traveling employee” – one who is required to travel away the employer’s premises.  The Venture-Newberg-Perini, Stone & Webster v. Illinois Workers’ Compensation Commission, 2013 IL 115728 Google Scholar | Illinois Courts PDF. Traveling employees are deemed to be “in the course of employment” from the time they leave home until they return.

The test whether a traveling employee’s injury arose out of and in the course of employment is the reasonableness of the conduct in which she was engaged at the time of the injury and whether that conduct might have been anticipated or foreseen by the employer.

Mlynarczyk v. Illinois Workers’ Compensation Commission, 2013 IL App (3d) 120411WC Google Scholar | Illinois Courts PDF.

Further reading:

Steak ‘N Shake v. Illinois Workers’ Compensation Commission, 2016 IL App (3d) 150500WC (server injured while wiping down a table was exposed to a risk distinctly associated with employment, for which a neutral-risk analysis was not required to find that the accident arose out of employment) Illinois Courts PDF.

Calumet School District #132 v. Illinois Workers’ Compensation Commission, 2016 IL App (1st) 153034WC (accidental injuries resulting from “voluntary recreational programs” do not arise out of and in the course of employment) Illinois Courts PDF

Adcock v. Workers’ Compensation Commission, 2015 IL App (2d) 130884WC (“where an employee is injured on the job while performing an activity of everyday living (such as bending, stooping, walking, or reaching), a neutral risk analysis governs the employee’s claim, even if he was required to perform the act at issue as part of his employment duties.”) Illinois Courts PDF.

Metropolitan Water Reclamation District of Greater Chicago v. Illinois Workers’ Compensation Commission, 407 Ill. App. 3d 1010 (2011) (under the “street risk” doctrine, if the employee is required to be on the street to perform a duty of employment, the risk is employment-related and accidental injuries sustained while performing  the duty arise out of employment) Google Scholar | Illinois Courts PDF.

Karastamatis v. Industrial Commission, 306 Ill. App. 3d 206 (1999) (“in order for an injury to arise out of one’s employment, the risk must be: (1) a risk to which the public is generally not exposed but that is peculiar to the employee’s work, or (2) a risk to which the general public is exposed but the employee is exposed to a greater degree”) Google Scholar.

Orsini v. Industrial Commission, 117 Ill. 2d 38 (1987) (“For an injury to have arisen out of the employment, the risk of injury must be a risk peculiar to the work or a risk to which the employee is exposed to a greater degree than the general public by reason of his employment.”) Google Scholar.

This article does not provide legal advice and does not create an attorney-client relationship. If you need legal advice, please contact an attorney directly.