
After taking the necessary steps to file your workers’ compensation claim, you may feel as though a weight has been lifted from your shoulders. Unfortunately, the filing process can be complex, so submitting the claim can ease your stress. However, when you receive notice that your claim has been denied, you may be unsure of what to do as your medical bills continue to accumulate. If this represents your circumstances, you’ll want to keep reading. The following blog explores what you should know about these difficult matters, including the common reasons for a denial and the importance of working with an Illinois workers’ compensation denials attorney to help you fight for the best possible outcome.
Why Might My Workers’ Compensation Claim Be Denied?
Unfortunately, there are several reasons why the insurance company may have denied your claim for compensation after you’ve sustained an injury at work. One common reason you may find that your claim has been denied is that you failed to seek medical treatment. Even for injuries that can be easily self-diagnosed, like a sprained ankle or pulled back muscle, you must seek care from a provider if you wish to pursue a claim. This is because you’ll need your medical records to file a claim to establish that the injury actually exists. Without these records, you run the risk of the insurance company claiming you are faking the injury.
Another common reason that claims are often denied is that they are filed incorrectly or after the reporting window. Generally, if you make an error when filing a workers’ compensation claim, such as including incorrect information or forgetting to complete a section of the forms, it can result in the denial of your claim. Similarly, if you inform your employer outside of the accepted reporting window, which in Illinois is 45 days from the date on which the injury occurred. Failure to notify your employer can result in the denial of your claim.
Finally, if your employer disputes the claim, it could lead to a denial. Unfortunately, your employer may worry that their insurance premiums will go up as a result of your claim, and they may try to argue that your claim is invalid for any number of reasons.
Can I Appeal This Decision?
In the event your workers’ compensation claim is denied, you may be anxious about how to proceed. Luckily, you are eligible to appeal this decision. Generally, the first step involved in this process is sending an appeal letter to the insurance company explaining why the denial is incorrect and providing additional and supplemental evidence. If the insurer still refuses to change its decision, you can file an appeal with the Illinois Workers’ Compensation Commission.
As you can see, navigating a workers’ compensation denial can be incredibly difficult, especially while healing from the injuries you’ve endured. As such, it is in your best interest to connect with an experienced attorney to assist you through these difficult matters. At the Law Firm of Kevin A. Moore, our dedicated legal team understands the importance of recovering compensation in these instances. That is why we are dedicated to fighting for you and the best possible outcome for your circumstances. Contact us today to learn more.
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