What If Your Illinois Workers’ Compensation Claim Is Denied?

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.

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.

By Connolly Injury Law |

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