If you've been injured at work, you may have heard about the Application for Adjustment of Claim. This guide explains what this form is, how and when to file it, and why you should do so right away.
1
First things first
If you were hurt at work, see a doctor and notify your employer. If you want to hire an attorney (we always think this is a good idea) then the sooner the better. Regardless of whether you hire an attorney, the next step is to file an Application for Adjustment of Claim.
2
What it is
The application is the official form that starts a claim with the Illinois Workers' Compensation Commission. It should be filed in every case. While you may start receiving benefits without filing this form, it's recommended that you file it anyway. Down the road, if there is a dispute, it will give you a head start if your case is already in the system.
3
Get a copy of the form
The form you need is produced by the Commission. You can get the form online from their website (see link below). You can call or email the Commission and ask that the form be mailed to you (call 312-814-6633). Forms also are available at the Commission office downtown.
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Fill out the form
The form requires your name and address, your employer's name and address, the location of your injury, and asks for details about your injury. Fill everything out completely and sign at the bottom. Then fill out the Proof of Service page, which is proof that you gave a copy to your employer (this is required). If an attorney doesn't do this for you, then you must get your signature notarized. You can give a copy of the application to your employer in person or by mail.
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Submit the form
Next, you must submit three copies of the signed application to the Commission's office in downtown Chicago. This is the place where all Illinois claims are filed. You can mail the copies or deliver them in person. The address is 100 W. Randolph Street, #8-200, Chicago, IL 60601. Make sure you keep a copy of the forms for yourself. There is no fee for filing the application.
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