What if your workers’ compensation claim is denied?

If your employer or the insurer denies your workers’ compensation claim, you will need to take swift action to appeal it. There are specific forms to file and steps you need to take in order to settle the dispute, and you have to make sure that you collect enough evidence to justify your claim. Speak with a workers’ compensation attorney for help fighting the denial and obtaining your benefits.

If you reside in Northern Illinois, you are welcome to call our office for a free consultation at 815-923-2107.

appeal denied workers' comp claims

Why do employers or insurers deny workers’ compensation benefits?

There are numerous reasons why employers or insurers deny workers’ compensation claims—some are justified, while others are not. Administrative mistakes constitute a large portion of denied claims. For instance, if you do not inform your employer about your injury within 45 days, or if you fail to submit the correct documents, it can lead to a denial or delay.

Other common reasons that employers or insurers deny claims include the following:

  • Your injury was not work-related or it was pre-existing, i.e., did not arise in the course of your employment.
  • You are not an employee. (Independent contractors and self-employed persons are not eligible.)
  • You have not followed through with your medical treatment.
  • Your injury does not warrant treatment or your doctor says you are able to return to work.

What steps do I take if my employer or the insurer denies my claim?

If your employer or its insurer denied your claim, you can appeal it with the Illinois Workers’ Compensation Commission (IWCC). This provides you with an opportunity to state your case, provide evidence to prove your claim, and hopefully, reverse the denial.

To appeal a denial, file an Application for Adjustment of Claim with the IWCC.

If you are unable to work and need your case heard sooner, you can file a Petition for Immediate Hearing. With this avenue, you will have your final decision within 180 days.

Do I need an attorney to help me with my appeal?

Seek representation from a legal professional to assist you if your employer or the insurer denied your workers’ compensation claim. You owe it to yourself to do whatever you can to secure the benefits you and your family need. For a free case evaluation with a lawyer in Illinois, contact Franks Gerkin McKenna today at 815-923-2107.