Getting hurt on the job can flip your life upside down. Medical bills, lost wages, and uncertainty about your future add to the stress. Workers’ compensation benefits are supposed to help—but what happens when your workers’ comp claim is denied?
If you’ve received a denial letter from your employer’s insurer, don’t panic. Denials are common in work injury cases in Illinois, and you have options.
Contact our Naperville workers’ compensation lawyers at Chute, O’Malley, Knobloch & Turcy to learn your legal options. In the meantime, here’s what you should know.
Common Reasons Workers’ Comp Claims Get Denied
Workers’ compensation insurance companies don’t hand out benefits without a fight. Even though the no-fault system is supposed to be a surefire way for injured employees to get medical treatment and financial relief, denials are common. Some of the most common reasons for claims denials include:
1. Missed Deadlines
You must report your injury to your employer within a certain timeframe—usually within 45 days in Illinois. Waiting too long to notify your employer can result in an automatic denial.
2. Lack of Medical Evidence
If your injury isn’t well documented or your doctor doesn’t clearly connect it to your job duties, your claim could be rejected.
3. Disputes Over How the Injury Happened
Employers and insurers may argue that your injury didn’t happen at work or was caused by something outside of your job responsibilities.
4. Pre-Existing Conditions
If the insurance company believes your injury was due to a pre-existing condition, they may try to deny your claim—even if the job aggravated the issue.
What to Do After a Workers’ Comp Claim Denial
A work injury claim denial doesn’t mean the end of the road. Here’s what you should do if your Illinois workers’ comp claim is denied:
Review the Denial Letter Carefully
Your denial letter will explain why your claim was rejected. Understanding the reason will help you determine your next steps.
Gather Additional Evidence
You may need more medical records, statements from witnesses, or expert opinions to strengthen your case. An experienced workers’ comp lawyer can help you build a stronger file.
Contact a Workers’ Comp Lawyer in Naperville
The appeals process can be complex and intimidating. Our local work injury attorneys understand Illinois workers’ comp laws, and we can represent your interests and protect your rights.
How to Appeal a Denied Workers’ Comp Claim in Illinois
You have the right to appeal a denial through the Illinois Workers’ Compensation Commission (IWCC). The process includes multiple steps:
File an Application for Adjustment of Claim
This form notifies the IWCC that you’re contesting the denial. It must be filed within three years of the injury or within two years of the last benefits paid—whichever is later.
Attend a Hearing Before an Arbitrator
Once your application is filed, your case will be assigned to an arbitrator. You may be required to attend status hearings and eventually a trial-like hearing where evidence is presented.
Further Appeals
If the arbitrator’s decision isn’t in your favor, you can appeal to a panel of commissioners, and then potentially to the Illinois courts.
How an Experienced Workers’ Comp Attorney Can Help
A workers’ comp denial can feel like hitting a wall. With the right legal support, however, you can still get the benefits you deserve. At Chute, O’Malley, Knobloch & Turcy, our team helps injured workers in Naperville and throughout Illinois fight denied claims and get their work injury benefits.
We Can Help You:
- Determine why your claim was denied
- Collect and present compelling medical evidence
- Handle negotiations with insurance companies
- Represent you at hearings before the IWCC
We understand the tactics insurers use to avoid paying, and we won’t let them take advantage of you.
Don’t Give Up—Get Legal Help With Your Workers’ Comp Claim Denial Today
You worked hard for your employer. When you were hurt on the job, you deserved fair compensation—not red tape and runaround. Our law firm can help make things right.
If your workers’ comp claim was denied, call 312-775-0042 for our Naperville attorneys at Chute, O’Malley, Knobloch & Turcy. Consults are free.