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Appealing a workers’ compensation denial in Illinois

On Behalf of | Jun 2, 2023 | Workers' Compensation

Most Illinois employers are required to carry workers’ compensation coverage. When an employee is injured in an on-the-job accident or develops a work-related illness, the benefits this coverage provides pays their medical expenses and helps them to make ends meet until they are able to return to work. Workers’ compensation is no-fault coverage, which means workers are entitled to benefits even when their injuries are their own fault or caused by acts of negligence. However, workers’ compensation claims are often challenged by employers or their insurance providers, and many of them are denied.

Why workers’ compensation claims are denied

Workers’ compensation claims are usually denied for administrative reasons. The most common reasons for denial in Illinois are incomplete claim forms and insufficient supporting evidence. If you are injured in a workplace accident, you should make sure that your workers’ compensation paperwork is completed properly and supported by relevant medical records. Workers’ compensation claims may also be denied because injuries are not considered job-related or were preexisting.

Appealing workers’ compensation denials in Illinois

If you file a workers’ compensation claim in Illinois that is denied, the first thing you should do is file an Application for Adjustment of Claim form with the Illinois Workers’ Compensation Commission. The IWCC will then assign an arbitrator to your case. Once this is done, you can request a hearing. During this hearing, the arbitrator will listen to arguments form both sides before making a decision. If the arbitrator upholds the denial, you will be given 30 days to appeal the decision by filing a Petition for Review form with the IWCC.

Avoiding mistakes

Some workers’ compensation claims are denied because they were contested by employers worried about rising insurance premiums, but many more are rejected because of simple paperwork errors. The IWCC has a procedure in place that gives injured workers an opportunity to appeal denials and fix basic errors, but the process takes time. If you are injured in a workplace accident and would like to avoid these problems, you should notify your employer about your injuries as soon as possible, complete all parts of the workers’ compensation claim paperwork and keep track of your medical treatment and expenses.