Workplace injuries can be stressful and overwhelming. Workers’ compensation was designed to support workers with financial assistance while they recover from their injuries. Most employers in Illinois are required to carry workers’ compensation insurance.
However, the fact that your employer carries workers’ comp does not guarantee that your claim will be approved. If your workers’ comp claim is denied, all is not lost. You may still be able to appeal a workers’ compensation decision.
Reasons For a Denied Workers’ Compensation Claim?
There may be several reasons why a workers’ compensation claim may be denied. If you are injured at work, you must follow the state’s requirements and deadlines for filing. Here are a few common reasons why a workman’s comp claim may be denied.
- Injuries were not reported right away
- Incomplete, inaccurate, or late paperwork
- Your injuries happened during your lunch break
- You were under the influence
- A fight or horseplay caused your injuries
- Your injury is linked to a pre-existing condition
- Received medical treatment at an unauthorized treatment center
- Employer disputes details of how you were injured
You have every right to dispute if you receive a denial for your workers’ compensation claim. But it’s important that you are able to provide documented proof to support your side.
How to Appeal a Workers’ Compensation Decision in Illinois
The first step in a workers’ comp appeal is often to challenge the denial directly with the insurance company by submitting a well-crafted appeal letter, ideally prepared by an experienced workers’ compensation lawyer.
This letter should include additional evidence supporting your claim. Suppose the insurer refuses to overturn its decision or uses incorrect reasoning. In that case, you can escalate the appeal by filing an Application for Adjustment of Claim with the Illinois Workers’ Compensation Commission (IWCC).
A hearing before an arbitrator will allow you to present your case in detail. The arbitrator will review all evidence, assess the validity of the denial, and issue a ruling to uphold or overturn the insurer’s decision, offering you a fair chance to pursue the compensation you’re entitled to.
Chances of Winning Workers’ Comp Appeal
Approximately 2.5% of workers’ comp claims in Illinois require arbitration. Since every case is different, it’s difficult to determine the chances of winning workers’ compensation appeals.
However, workers’ comp appeals generally have a significant chance of approval. One study found that 67% of denied claims are later approved, many resulting in a higher payout than the original claim.
Hire a Workers’ Compensation Attorney
The best way to improve the odds of your workers’ compensation appeal getting approved is to hire an experienced workers’ compensation attorney. When insurance companies and employers do everything possible to avoid paying workers what they are owed, it’s time to take a stand.
After a denial, insurance companies often count on the claimant wanting to give up. But with our highly effective team at Disparti Law Group, you will have the support you need to put up a fight and win the compensation you are rightfully owed.
For a FREE case review, contact us today at (312) 600-6000 and find out why thousands say… Larry wins! The
