5 Valid Reasons An Employer Can Deny A Workers’ Compensation Claim In Illinois

After suffering a work-related injury, you can file a workers’ compensation claim and recover compensation. However, not every worker who suffers an injury while on the job and files a workers’ compensation is entitled to recover compensation. The truth is that there are several valid reasons for workers’ compensation claims denial.

That said, it is crucial to note that most workers’ compensation claims are denied for invalid reasons. If your workers’ compensation claim was denied, speak to a qualified attorney to determine if your claim was denied for valid or invalid reasons.

It is possible to fight the decision through an appeal if your claim was denied for invalid reasons. Remember, you have limited time from your denial to appeal the decision, so the sooner you reach out to an attorney, the better.

Submitting a Late Claim

In Illinois, an injured employee is required to file a workers’ compensation claim within three years from the date of their accident. If you miss this three-year window, your employer’s insurer might have a valid reason for denying your claim. Late applications are a common reason insurers deny workers’ compensation claims. If you suffered a work-related injury, ensure you file your workers’ compensation claim on time.

Incorrect Information on Claim Forms

It is crucial that you submit accurate information when filing a workers’ compensation claim. Ensure you have an attorney review your claim forms before you submit them. If you submit claim forms containing discrepancies, your employer’s insurance company might have a valid reason to deny your claim.

Failing To Provide Medical Records

Your employer’s insurance company has the right to look at the medical records related to the accident. While the insurance company does not have the right to look at your whole life, they have the right to know about things such as pre-existing conditions that may affect your claim. If you do not provide the medical records required by the insurance company, the insurance company may have a valid reason for denying your workers’ compensation claim.

The Employee Did Something Wrong

An employee is entitled to recover workers’ compensation benefits even if their work-related accident was their fault. This is because the workers’ compensation system is a no-fault system. However, there are some circumstances when an injured employee may be unable to recover workers’ compensation benefits. For example, suppose you suffered your injury while committing a criminal offense. In such a case, your employer might have a valid reason to deny your worker’s compensation claim.

Insufficient Evidence

According to the Illinois Workers’ Compensation Act, after filing a workers’ compensation claim, the burden of proof is on the injured employee to show that they suffered their injury in the course of their employment.

To show this, you need evidence. If you cannot present enough evidence to show by a preponderance of the evidence that you sustained your injuries in the course of your employment, your employer’s insurer may have a valid reason to deny your workers’ compensation claim.

Contact a Chicago Workers’ Compensation Lawyer

If you need help filing a workers’ compensation claim or appealing a claim denial, contact our Chicago workers’ compensation lawyer at Connolly Injury Law.

Source:

ilga.gov/legislation/ilcs/ilcs3.asp?ActID=2430&ChapterID=68