The process of appealing a workers’ compensation denial

Even when a workers’ compensation claim is legitimate, it might not be accepted. When a worker in Illinois receives a denial for a workers’ compensation claim, they can appeal the decision.

Understanding this process can help individuals secure deserved benefits.

Understanding the grounds for denial

The first step in the appeal process is to understand why the claim was denied. Common reasons include claims that the injury is not work-related or that the proper procedure for filing was not followed. One must address these specific reasons in the appeal.

Filing the appeal

To start the appeal, the worker must file a claim with the Illinois Workers’ Compensation Commission. This must occur within a specific time frame after receiving the denial. The claim should include all relevant medical records, a detailed description of the incident and any additional evidence that supports the claim of the injury being work-related.

The hearing process

After filing, the case will go to a trial before an arbitrator. During this hearing, both the employee and the employer can present evidence and argue their case. The worker must present a well-organized case. Given the complexities of workers’ compensation laws and the stakes involved in appeal cases, individuals may need the help of an attorney who understands workers’ compensation.

Decision and further appeals

The arbitrator will make a decision after the hearing. If the decision is unfavorable, the worker can appeal to a panel of three commissioners at the Workers’ Compensation Commission. Further appeals can go to the circuit court and potentially to higher courts if necessary.

Understanding and following the correct procedures can significantly impact the success of an appeal in a workers’ compensation case in Illinois. Workers must act promptly and seek the necessary support to challenge a denial effectively.