What Are My Options if My Workers’ Compensation Claim Was Denied?

 Posted on February 25, 2021 in Workers' Compensation

For those who are injured while on the job, workers’ compensation benefits can be crucial. Medical benefits will cover the costs of all treatment related to an employee’s injury, and wage benefits will provide compensation for the loss of income due to a temporary or permanent disability. However, even though employees are eligible to receive these benefits following any work-related injuries, whether they or their employer were at fault, some employers or their insurance companies deny workers’ comp claims. This can cause a great deal of financial difficulty for a person, since they may be unable to pay their medical expenses, especially if they are unable to work while recovering from their injury. Fortunately, employees who have been denied benefits can file a claim through the Illinois Workers’ Compensation Commission (IWCC) and take steps to receive the benefits they deserve.

The IWCC Claims Process

An employee who has been denied workers’ comp benefits can begin the claims process through the IWCC by submitting an Application for Adjustment of Claim. A claim must be filed within three years after an injury occurred or within two years after the employee last received payment for medical bills or Temporary Total Disability (TTD).

After a claim is filed, the IWCC will assign an arbitrator to the case. Every three months, a status call will be scheduled, and either party may ask for a hearing to be held to review the case. In most cases, an employee must reach “maximum medical improvement” before the arbitrator can make a decision, although an emergency hearing may be necessary if an employee needs immediate assistance with medical bills or disability benefits.

During the claims process, an employee will be required to prove that they are eligible to receive benefits, which will include showing that they were employed by their employer at the time of their injury, the injury occurred arose out of the course of their employment, and they notified the employer of their within the applicable time limit, which is 45 days in most cases. An arbitrator may encourage the parties to reach a settlement in which the employee will agree to close the claim in exchange for a monetary payment. If the parties cannot reach a settlement, the arbitrator may make a decision that states whether the employee is entitled to benefits and if so, the amount of benefits they should receive.

Either party can appeal an arbitrator’s decision. Appeals will be heard by a panel of commissioners, who will issue a decision after reviewing the records and transcripts of the hearing, as well as oral and written arguments from both parties. This decision can be appealed in an Illinois circuit court, and further appeals can be pursued before the Illinois Appellate Court and the Illinois Supreme Court.

Contact Our Aurora Workers’ Compensation Claim Attorneys

If you have been denied workers’ comp benefits following a work-related injury, Kinnally Flaherty Krentz Loran Hodge & Masur P.C. can help you file a claim through the IWCC, and we will advocate on your behalf to ensure that you receive the benefits you deserve. To learn more about how we can help with your case, contact our Kane County workers’ comp lawyers at 630-907-0909 and schedule a free consultation today.

Sources:

https://www2.illinois.gov/sites/iwcc/Documents/handbook.pdf