If you’re injured at work, you expect compensation to cover medical expenses and lost wages. But what if your workers’ compensation claim is denied? Understanding your rights is essential to getting the benefits you’re entitled to under Illinois law.
Reasons for claim denial
Several reasons can lead to the denial of a workers’ compensation claim. A common reason is failing to report the injury promptly to your employer. In Illinois, you must report an injury within 45 days of the incident. Missing this deadline may result in a denial of your claim.
Another reason for denial involves disputes over the injury’s validity, such as questioning whether it occurred at work or whether pre-existing conditions caused it. In these situations, the insurance company may argue the injury is not work-related, leading to a denial.
What can you do if your claim is denied?
If the insurer denies your claim, review the denial letter to understand the reasons. The letter should outline why the insurance company denied your claim. After reviewing it, take action by filing an appeal with the Illinois Workers’ Compensation Commission (IWCC). The IWCC handles workers’ compensation disputes and can help resolve issues. You must file the appeal within 30 days of receiving the denial letter.
Filing an appeal
To file an appeal, gather all relevant documentation, such as medical records, accident reports, and any communication with your employer or insurance company. The IWCC will likely schedule a hearing where you can present your case. Be prepared with all the evidence to support your claim. If the situation is urgent, you can request an expedited hearing.
Facing a denied claim can be frustrating, but understanding your rights and knowing the next steps can help you secure the benefits you deserve under Illinois law.
