man with a workplace injury using computer

What to Do if Your Workers’ Compensation Claim Is Denied

Most workplace injuries are covered by workers’ compensation insurance. Workers’ compensation insurance provides wage and medical benefits to people who are injured or become ill at work. Unfortunately, not all workers’ compensation claims are successful. In this article, we explain what to do if your workers’ compensation claim is denied. 

Determine the Reason for the Denial

If your workers’ compensation claim is denied, the first thing you should do is determine the reason why. That information should be contained in a denial letter that you will receive from your employer. Common reasons that workers’ compensation claims are denied include: 

  • Failure to report the injury in time: Illinois law requires that an injured employee report his or her injury to the employer within 45 days of the injury. 
  • Failure to file a claim in time: Generally, in Illinois, an employee must file a claim for benefits within three years of the date of a workplace injury.
  • The employer disputes the claim: A workers’ compensation claim will be denied if it is disputed by the injured worker’s employer. For example, an employer might dispute that the alleged injury occurred in the course of the employee’s employment with the  employer. 
  • Failure to obtain medical treatment: In most cases, an employee’s workers’ compensation claim will be denied if he or she has failed to obtain medical treatment for his or her injuries.
  • Insufficient evidence: A lack of evidence that an injury occurred at work will usually result in a workers’ compensation claim denial. 

Appeal the Decision

Following a workers’ compensation claim denial, you may appeal the decision. Your denial letter should include a deadline for filing your appeal. Appealing a workers’ compensation claim denial is a complicated legal process. Therefore, you should seek the assistance of an experienced workers’ compensation attorney immediately upon receiving a claim denial. In Illinois, all workers’ compensation appeals are filed with the Illinois Workers’ Compensation Commission. During your appeal, you’ll be provided with an opportunity to present your case and provide evidence to prove your claim. Your attorney will help you compile the necessary documentation for your appeal, including your medical records, time sheets demonstrating that you were working at the time of the injury, and other relevant evidence. 

Hire an Experienced Workers’ Compensation Attorney 

As noted above, if your workers’ compensation claim has been denied, you should contact an experienced workers’ compensation attorney as soon as possible. At Foote, Mielke, Chavez & O’Neil, LLC, our experienced workers’ compensation attorneys are here to help you with your workers’ compensation claim denial. When you come to us for assistance, we will represent your legal interests to the greatest extent possible, and with the resolute goal of securing you compensation for your workplace injuries. In addition to ensuring that all required documents are submitted in a timely manner, our experienced attorneys will gather evidence, negotiate on your behalf, and draft a settlement agreement if applicable. Please contact us today to schedule a consultation.