• Collinsville, IL Personal Injury: How to appeal a workers’ comp claim denial

    March 25, 2019
  • Denied workers’ comp claim? Here are your next steps…

    workers' comp claim denial

    Have you been injured at work? If so, you’re probably trying to get workers’ compensation payments so you don’t miss valuable income while you’re away from work. However, the process doesn’t always work out so easily. Many times, claims for workers’ compensation are denied due to any number of reasons. When this happens, injured workers may go without essential pay that helps provide for themselves and their families. If you were injured at work and your workers’ comp claim was denied, please read more below about the steps you should be taking to fight for your rights!

    Reasons for Workers’ Comp Claim Denial

    workers' comp claim medical exam

    Unfortunately, there may be completely legitimate reasons why your claim was denied. Whether it was the fault of you or the employer, here is a list of the things that a workers’ comp insurer might claim as a reason that you were denied the benefits that you deserve:

    • Injury did not occur on the job
    • Injury caused by a pre-existing condition
    • A doctor deemed you fit to return to work
    • You did not report the injury in time
    • Your employer did not report the injury in time
    • Your employer did not report the injury at all

    How to Appeal a Denied Workers’ Comp Claim

    workers' comp claim attorney

    Below are the steps you must take to appeal a denied workers’ compensation claim. Before making the decision to appeal, make sure it’s the best decision for you based on legal advice from a qualified workers’ compensation lawyer.

    Step #1: Find the Facts

    Your first job is to figure out why your claim was denied. In the State of Illinois, the insurer must provide a written explanation of why the claim was denied. If you have lost or misplaced that information, you must call the insurer to find out the specific reasons that your claim was denied. This will help determine what options you have for pursuing benefits.

    Step #2: Ask the Insurer to Reconsider

    Once you find out why the claim was denied, it may be as simple as completing some missing forms and asking them to reconsider. If it’s a simple mistake, they may be able to change the outcome of your claim. However, they may also resolve that you do not deserve benefits. In which case, move to step 3.

    Step #3: File a Formal Appeal

    The next step is to file a formal appeal with the proper administrative agency. In the State of Illinois, you’ll want to file your appeal with the Workers’ Compensation Commission.

    Step #4: Hire an Attorney

    Lastly, you’ll need to hire an experienced workers’ compensation attorney that can handle these proceedings for you. You wouldn’t be jumping the gun if talking to an attorney was the first thing that you did. They’ll have helpful tips that will give you insight on the process and how you can go about pursuing benefits.