Denied Workers Compensation Claims- What to do

Lawyer in McHenry County, Workers Compensation

The law gives you the right to file for compensation if you have been injured or taken ill at work. These benefits, which insurance companies administer, are sometimes denied. If you have been injured on the job in Illinois and were denied compensation, you may be able to submit an appeal to the Illinois Workers’ Compensation Commission.

Compensation claims are denied for different reasons in various states. Keep reading to understand why your claim may have been denied and the next steps to take in appealing your claim

Why was my Workers’ Compensation Claim Denied?

The reason for denial is usually included in the letter of denial. It could be possible that you did not meet the eligibility requirement, but if you believe you deserve it and were denied by error, you can contest this with an appeal.

Some possible reasons why your claim was denied are;

If your evidence was found unconvincing

You will need to prove that your injury or condition was directly related to work activities. If your evidence was not clear enough, you might need to get extra tests done

If your injury cannot be compensated

Some injuries are not -compensable, depending on the state. An example is stress-related injuries. This is usually because they cannot be proven in court.

If you failed to report your injury to your employer

For a claim to be valid, your employer must be made aware that you suffered an injury on the worksite, and early too. This is expected to be no longer than days after the injury occurred.

If you filed the claim after a long time

Some injuries take a while to manifest. While there are some exemptions to such cases, state laws require that you file compensation claims no later than two years after the injury.

Next Steps After a Workers Compensation Denial

Having ascertained why your claim was denied, you will need to file an appeal. Within the denial letter, you will be informed of a deadline to appeal. Ensure that you follow through.

In some cases, a physical meeting with your employer to discuss the claims might bring a resolution, especially if there was a mere error.

If your employer does not give a favorable response, you will need to find a worker’s compensation attorney to help you with the appeal process. It would help if you spoke with the attorney before this so that your meeting does not result in conversations that may jeopardize your case.

Appeals may go through an arbitrator, the worker’s compensation commission, or a judge, depending on the appeal stage. Another reason to get a lawyer is the various documentation required in this phase of appeal. An attorney is better suited to handle your needs.

Getting denied a claim that is rightfully yours is very distressing, and this is why you need solid legal representation to ensure that your rights are protected. At Franks, Kelly, Matuszewich, and Andrle Attorneys at Law, we can help you contest a compensation denial. Reach out to us today.