When you’re hurt on the job, you expect that your employer’s workers’ compensation insurance will cover your medical care and lost wages. Unfortunately, that’s not always what happens. We know how frustrating and stressful it is when your claim gets denied. You’re already dealing with pain, appointments, and uncertainty about your recovery—and now you’re told you won’t get the benefits you thought you were entitled to.
A denied claim doesn’t mean you’re out of options. Under Illinois law, you have the right to appeal. The Illinois Workers’ Compensation Act provides a clear process for contesting a denial, and with the right legal guidance, you can still pursue the compensation you deserve. We help injured workers across Antioch and throughout the state fight back when their claims are wrongfully denied.
Before we appeal, we first need to understand why the claim was denied. In Illinois, some of the most common reasons include:
Under 820 ILCS 305, Illinois law requires that injured employees report their injuries to their employer within 45 days. Missing that deadline can give the insurance company a reason to deny the claim. But not every denial is final—and many can be successfully challenged.
If your claim is denied by your employer or their insurance carrier, the next step is to formally file a claim with the Illinois Workers’ Compensation Commission. This is known as filing an Application for Adjustment of Claim. You must submit this application within three years of your injury, or within two years of the last benefit payment—whichever is later, as outlined under 820 ILCS 305/6(d).
Once your claim is filed, your case will be assigned to an arbitrator, who will handle pre-trial matters and conduct a formal hearing if necessary.
The IWCC arbitration process gives both sides a chance to present evidence. This includes medical records, witness statements, accident reports, and your own testimony. We’ll prepare you for this hearing and ensure that your case is properly documented and presented.
The arbitrator will issue a written decision within 60 days of the hearing. If the decision goes against you, you can request a review by a panel of three commissioners.
If you disagree with the arbitrator’s decision, you have 30 days to request a review by the IWCC panel. This process allows us to submit legal arguments explaining why the arbitrator’s ruling was incorrect. If the commission panel upholds the denial, we can take your case to the Illinois Circuit Court, and if needed, to the Illinois Appellate Court.
Each level of appeal becomes more technical, and deadlines matter. That’s why having experienced legal representation is critical throughout the process.
At The Law Offices of Robert T. Edens, P.C., we start by thoroughly reviewing why your claim was denied. Then we gather the medical evidence, employment records, and witness testimony needed to support your case. We work closely with doctors to ensure your injuries are fully documented and clearly tied to your job.
Appeals are often won because we know how to present the facts and challenge the insurance company’s assumptions. Whether it’s a question of timing, coverage, or causation, we take every step to make sure your case is as strong as possible.
There are many reasons why claims get denied. Common reasons include missed deadlines, lack of medical evidence, disputes over whether the injury is work-related, or the employer claiming your actions violated company policy. Insurance companies often deny valid claims to save money, so it’s important to challenge the decision if you believe it’s unfair.
You must file your appeal by submitting an Application for Adjustment of Claim to the Illinois Workers’ Compensation Commission within three years of the injury, or within two years of the last benefit paid—whichever is later. Once you receive an arbitrator’s decision, you have 30 days to request a review by the commission.
You’re required to notify your employer of the injury within 45 days under Illinois law. If you missed that deadline, your claim may be denied, but it’s not always final. There may be exceptions depending on the circumstances. We review the facts to determine if there’s still a way to pursue the claim.
An arbitrator appointed by the IWCC will hear both sides of the case. You’ll have the chance to testify, and we’ll submit supporting evidence including your medical records and employment documents. The insurance company may present its own witnesses. The arbitrator will issue a written decision after the hearing.
While it’s possible to represent yourself, we strongly recommend legal representation. Workers’ compensation appeals involve technical rules, legal arguments, and deadlines. We help ensure your evidence is complete and your arguments are presented in the strongest possible way. We also handle communication with the insurance company and the commission.
No. Illinois law prohibits employers from retaliating against employees for filing or appealing a workers’ compensation claim. If your employer disciplines, demotes, or fires you because of your claim, you may be entitled to additional legal remedies.
The timeline varies depending on the level of appeal and complexity of the case. Arbitration hearings can take several months to schedule. If the case goes to the commission or higher courts, it may take a year or longer. We keep you informed at every stage and work to move your case forward.
Yes. In many cases, a denied claim can still be resolved through a settlement. Once we build a strong case and present it to the other side, they may be more willing to negotiate. Settlements can provide compensation for medical bills, lost wages, and permanent impairment.
Don’t let a denied workers’ compensation claim leave you without the support you need. We’re here to help you fight back and protect your rights. At The Law Offices of Robert T. Edens, P.C., we serve clients throughout Illinois from our offices in Antioch, Waukegan, and Woodstock.
Contact our Illinois workers’ comp lawyers at The Law Offices of Robert T. Edens by calling us at 847-395-2200 to receive your free consultation. We Represent Clients From Our Offices In Antioch (392 Lake St., Antioch, IL 60002), Waukegan (325 Washington St., Waukegan, IL 60085), And Woodstock (1212 North Seminary Unit 1, Woodstock, IL 60098).
The Law Offices of Robert T. Edens, Personal Injury and Workers' Compensation Law Office, have offices in Antioch, Waukegan, Grayslake, Woodstock and Barrington. We represent clients throughout the communities of Antioch, Waukegan, Grayslake, Barrington, Woodstock, Buffalo Grove, Deer Park, Gurnee, Lake Zurich, Round Lake, McHenry, Cary, Crystal Lake, Libertyville, Lincolnshire, Mundelein, Vernon Hills, Wheeling, North Chicago, Zion, Inverness, Palatine, Wauconda, Island Lake, Fox Lake, Barrington Hills, Spring Grove, Lake Bluff, Lakemoor, Long Grove, Lake Villa, Kildeer, Wadsworth, Indian Creek, Fox River Grove, Lindenhurst and other cities within Lake and McHenry Counties Illinois.
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