What to Do If Your Workers’ Compensation Claim Was Denied

Published on Sep 17, 2021 at 3:12 pm in Workers' Compensation.

Person signing document

After being injured at work, you likely filed a workers’ compensation claim so that you can recover financially for your physical damages. You might have expected your claim to go smoothly and that you would easily get a resolution that you were happy with. However, one of the options for what could happen is that your workers’ comp claim could be denied.

After a denial, you might not know where to turn or what you can do to continue the process. A workers’ compensation lawyer can help you through a claim denial and guide you through what you can do to move forward with your claim even though you feel like this is a dead end. Let’s take a look at your options after a workers’ comp claim denial.

Steps to Take After a Workers’ Comp Claim Denial

When your workers’ compensation claim gets denied, you probably feel like you’re out of options, but that’s not true. If you feel like the denial was the wrong decision and you deserve your claim to be re-evaluated, then there are steps you can take toward reopening your claim to get the answer you want.

One of the first things you’ll need to be sure that you do is file an Application for Adjustment of Claim with the Illinois Workers’ Compensation Commission (IWCC). Even though your employer should have filed a claim with the IWCC, you’ll want to file this form so that you can be sure that your claim is officially filed.

From there, you can request a hearing with the IWCC so that you can attempt to appeal the decision for your workers’ comp claim. After that, will be assigned an arbitrator and get a case number and will go through the process of a hearing to appeal. Depending on your situation, the case could go to trial, so you’ll need to be prepared. This must be filed within three years of the incident.

If getting an answer to your appeal is an emergency, you can file for an emergency hearing through a Petition for Immediate Hearing. You can only file for this hearing if you haven’t returned to work and are owed more than 12 weeks of disability payments. Ideally, these hearings are for when you haven’t been able to return to work, but your employer and their insurance company haven’t paid you for disability benefits.

If your trial through the IWCC also gets denied, you still have one last option to file an appeal. You can file a Petition for Review within 30 days of the IWCC arbitrator’s decision. This will cause your claim to go to the Commission. You’ll get a hearing where you can argue your side for a few minutes and then the Commission will give you a decision within 60 days.

There are still options to continually appeal if you keep getting denials and you don’t believe that’s fair. That’s where having a workers’ comp attorney on your side can help. They’ll help you climb the legal ladder in appealing decisions to higher courts if they feel you haven’t gotten justice for what happened.

Why Was My Claim Denied?

If your claim was denied, then your employer or their insurer must notify you in writing why it was determined that it would be denied. There are a few reasons why your Illinois workers’ comp claim got denied, and while you were likely notified of the reasoning for your denial, you still might be wondering if this is on par with the typical reasons for denial.

Here are some of the most common reasons that a workers’ comp claim is denied:

  • Incomplete Report
  • Insufficient Evidence
  • Poor Record-Keeping
  • Pre-Existing Conditions
  • Accident Wasn’t at Work

Even though you got a written denial that explains one of the reasons listed above, or if it was a completely different reason, you still might be confused and not understand why your claim was denied. Having a workers’ compensation lawyer on your side can help answer all of your questions and guide you through the claim and appeals processes.

Prince Law Firm Will Support You

It can be frustrating enough to go through a workers’ comp claim because you’re dealing with injuries, going against your employer, and trying to recover what you lost from your accident at work. When the process doesn’t go as you expected, or you get a denial, you might be struggling even more with what happened. That’s where a Marion, IL workers’ compensation lawyer comes in.

At Prince Law Firm, we know how vulnerable you feel and how delicate this situation is. That’s why we’re prepared to handle your case with the utmost care and consideration for your peace of mind. We’ll take care of the legal side of things so that you can focus on your physical and emotional healing. Reach out to us today so we can discuss your legal options.



Want to speak to an attorney? Unsure if you have a case? Fill out the form below and we’ll reach out to you as quickly as possible.