When a workers' compensation claim is denied, it can be quite shocking, but the good news is that it is not the end of the road. A Waukegan workers' compensation attorney can walk you through the appeal case but before that, make sure that your claim was denied without reason.
Why workers' Compensation Claims are Denied
If you are denied workers' comp benefits, your employer is obligated to send you a written explanation of the reasons behind it. If that hasn’t happened, approach your employer yourself for an explanation. While each case is unique, most claims are denied because of the following reasons
Incomplete Report Or Lacking Records
If your report is incomplete or missing vital details, your claim may be denied. This is nothing that a quick revision cannot fix.
A Pre-existing Condition
An employer may try to deny benefits by claiming your injury was a pre-existing condition. However, even in this case, you may be able to get compensation especially if the condition worsened because of your job.
The Accident Occurred Off-Site
As per Illinois law, your injury has to arise from your employment for you to be eligible for compensation. However, you can still claim benefits even if it happens offsite while you were working for the employer. If your employer is denying you compensation because of this, you should hire a Waukegan workers' compensation attorney to dispute the decision.
The Injury Isn’t Covered
Certain injuries may not be covered by your workers' Compensation such as mental health. If that is the case, even if you work in a stressful environment, your claim for psychiatric care may be denied.
Lack of Cooperation
If you fail to cooperate with the insurance company when they call you to ask about your claim, it may be denied. This can happen if you refuse to give a recorded statement. While you have the legal right to not do so, your claim can still be denied. In this case, you should hire an attorney to dispute the denial.
Workers’ Compensation Appeal
You have the right to appeal a denial of your workers' compensation claim. There are several ways to do this. You can bring your case to an arbitrator who is appointed by the Illinois workers' Compensation Commission (IWCC). If the decision is unsatisfactory for you, you can go ahead and appeal to IWCC commissioners.
If you are still denied benefits, you can appeal the case to the Appellate and Circuit Court. If that is unsuccessful as well, you can ask your Waukegan workers’ compensation attorney to take your case to the Supreme Court. In this case, you may end up with more compensation than you anticipated because of the hardships you had to endure due to denial of the claim.
See more on our Illinois Workers' Compensation FAQs page.
The Law Offices of Robert Edens have been fighting for the rights of injured workers for two decades and can help you as well. If you or someone you know is being denied benefits by their employers, get in touch with us for a consultation today. We have experienced attorneys who can handle your case and ensure you get the compensation you deserve.
