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Appealing A Workers’ Compensation Claim Denial

Anyone injured on the job deserves their full workers’ compensation benefits. Unfortunately, recovering workers’ compensation benefits can sometimes become a difficult task. All too often, workers’ compensation benefits are wrongly denied and an appeal becomes necessary. If you have been injured while on the job in Illinois, and your workers’ compensation benefits claim was denied, do not hesitate to contact an experienced workers’ compensation attorney to discuss your legal options. Your case is not lost.


Workers’ Compensation Claim Denied


It is extremely frustrating to have your workers’ compensation claim denied. Claims can be denied for a variety of reasons; sometimes a claim is correctly denied, but too often Illinois workers’ compensation claims are unfairly denied. The first thing you need to do is to determine exactly why your claim has been denied. The three most common reasons for denial are because the employer claims the injury happened away from the work, the employer believes that the injury was simply not that bad, or the employer believes that a claim was filed too late. Your employer has a legal obligation to send you a detailed written explanation of the claim denial. You should seek the professional services of an experienced attorney, if your workers’ compensation claim was denied and, any of the following apply to your case:


  • No explanation was ever given for why benefits were denied;
  • A denial letter was received, but you do not understand the reasoning; or
  • A denial letter was received but it contains inaccurate information.


How to Fight Back


  • Hire an attorney – Fighting a denied workers’ compensation claim is a never easy. An experienced Illinois work injury attorney can help you prepare your appeal and protect your legal rights. The appeal process is critical and a sloppy or ill informed appeal can doom your case.
  • File your official appeal – You will need to file your appeal with the Illinois Workers’ Compensation Commission; this is necessary to get chance to present your case in front of a neutral arbitrator.
  • Get a medical evaluation – In many cases, a claim is denied because your employer disputes the extent of your injuries. Illinois law gives both parties the right to request an independent medical evaluation. Oftentimes, employers will try to pick medical professionals who are not truly independent. Your attorney is critical to make sure that this process remains independent and fair.
  • Arbitration – Workers’ compensation denial appeals are heard by a neutral arbitrator in a setting that is essentially a mini trial. The arbitrator will let both sides present their cases and will encourage a compromise if one is possible. If no compromise can be made, the arbitrator will make a decision.
  • Appeal the arbitrator – The arbitrator does not get the final word in these cases. If your arbitrator made an unfair decision, there is room for another appeal. This second appeal would be heard by a panel of three Illinois workers’ compensation commission board members. In fact, in a limited number of cases, their decision can be appealed as well.


Contact An Experienced Workers’ Compensation Attorney


Injured workers deserve immediate workers’ compensation benefits. But, if your claim is denied there is still hope. Many claim denials are overturned on appeal. An experienced Chicago workers’ compensation attorney can help you work through the appeals process and make sure that your case is being made effectively so that you get the workers’ compensation benefits that you rightfully deserve.

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