What If Your Illinois Workers’ Compensation Claim is Denied?
You expect to recover the benefits you are owed when you file a workers’ compensation claim against your employer because you suffered an injury while on the job. However, this is not always the case. Too many workers’ compensation claims are denied. And while some workers’ compensation claims are denied for legitimate reasons, many claim denials are unfair. However, the good news is you can appeal a denied workers’ compensation claim. Read on to learn about appealing a denied workers’ compensation claim in Illinois.
Common Reasons Workers’ Compensation Claims Are Denied
Workers’ compensation claims are denied for a lot of reasons. And as already mentioned, some workers’ compensation claims are denied for legitimate reasons, but most are denied unfairly.
Some of the common reasons for a workers’ compensation claim denial include the following;
- An injury is not work-related
- An injury is pre-existing
- Failure to follow through with medical treatment
- Failure to submit a timely claim
- Failure to provide medical records
- Your injury does not warrant medical treatment
- Failure to submit correct documents
Some of the reasons mentioned above may be genuine, while others may be used as an excuse to deny your claim unfairly.
Steps to Take if Your Workers’ Comp Claim is Denied in Illinois?
If your Illinois workers’ compensation claim is denied, you have the right to appeal the decision. Here are some steps you can take if your claim is denied:
- Review the decision: Review the notice of denial to understand the reason for the denial and whether there are any errors or omissions in the decision.
- Gather evidence: If you believe the denial is incorrect, gather any additional evidence that may support your claim, such as medical records, witness statements, or other documentation.
- File an appeal: If you want to challenge the denial, you must file an appeal within a certain time frame (usually 30 days). You can file an appeal by submitting a written request to the Illinois Workers’ Compensation Commission (IWCC).
- Attend a hearing: If your appeal is accepted, you may be required to attend a hearing in front of an arbitrator or a panel of commissioners. At the hearing, you and your lawyer (if you have one) will present your case and the evidence you have gathered to support your claim.
- Wait for a decision: After the hearing, the arbitrator or panel of commissioners will make a decision about your claim. If the decision is in your favor, you will receive the benefits you are seeking. If the decision is not in your favor, you may be able to appeal the decision again or seek legal remedies.
Overall, if your Illinois workers’ compensation claim is denied, you have the right to appeal the decision and present your case to the IWCC. It is often helpful to have the assistance of a lawyer who is familiar with the workers’ compensation process and can help you navigate the appeal process.
Most rewarding part about being a personal injury lawyer
As a language model, I do not have personal experience as a personal injury lawyer, so I cannot speak to the most rewarding part of this profession. However, I can imagine that there are several rewarding aspects of being a personal injury lawyer. Some possible reasons why a personal injury lawyer might find their work rewarding include:
- Helping people: Personal injury lawyers may find it rewarding to be able to help people who have been injured due to the negligence or wrongdoing of others.
- Making a difference: Personal injury lawyers may feel a sense of accomplishment and fulfillment when they are able to make a difference in the lives of their clients by securing compensation and justice for them.
- Advocating for clients: Personal injury lawyers may find it rewarding to be able to advocate for their clients and stand up for their rights in the face of powerful insurance companies or other adversaries.
- Solving problems: Personal injury cases often involve complex legal and factual issues that require careful analysis and problem-solving skills. Lawyers who enjoy this type of work may find it rewarding to be able to use their skills and expertise to help their clients.
Overall, there are likely many rewarding aspects of being a personal injury lawyer, including the opportunity to help people, make a difference, advocate for clients, and solve problems.
How Do You Appeal a Denied Workers’ Compensation Claim in Illinois?
If your employer’s insurance company denies your workers’ compensation claim, you can try to resolve the issue by challenging the denial directly with the insurance company. An attorney can prepare an appeals letter for you, which you can then present to your employer’s insurance company. If that fails, you can appeal the denial with the Illinois Workers’ Compensation Commission (IWCC).
To appeal a workers’ compensation denial with the IWCC, you need to file an Application for Adjustment of Claim with the Commission. After filing this form, an arbitrator will be assigned to your case. The arbitrator’s work is to review the specifics of your case and decide whether or not the insurance company was right to deny your claim.
If the arbitrator sides with your employer’s insurer, you can appeal the arbitrator’s decision and try to overturn it. To request an appeal, you will need to file a Petition for Review with the IWCC within thirty days of the arbitrator denying your claim. For this reason, it is crucial that you reach out to an attorney as soon as possible after learning that your workers’ compensation claim has been denied.
After filing the petition for review, the IWCC will review the petition to determine if the arbitrator made a mistake. After you send your petition, you will receive a notice within a few days, and in the notice, you will find a hearing date. Before your hearing date, you are free to submit your argument to the Commission in writing and during your hearing, you have up to ten minutes to present your argument. The Commission will then render a decision within sixty days of the hearing.
If the IWCC upholds the arbitrator’s denial, you can appeal the decision to the Circuit Court, Appellate Court, and even the Supreme Court. But these appeals can be extremely difficult. You will need the help of an experienced attorney past the initial petition for review.
Contact a Chicago Workers’ Compensation Lawyer
If you need help pursuing a workers’ compensation claim or appealing a denied workers’ compensation claim in Illinois, contact our experienced Chicago workers’ compensation lawyer at Connolly Injury Law.
