Common Reasons for a Denied Illinois Workers’ Compensation Claim 

 Posted on March 06, 2024 in Uncategorized

The Illinois workers’ compensation statute was enacted to protect workers if they suffer work-related injuries or develop an occupational disease. Workers’ comp benefits ensure that the injured employee’s medical expenses will all be paid, and they will receive a percentage of their wages while recovering from their injuries.

Unfortunately, far too many employers and their insurance companies deny an injured worker’s claim, leaving that worker in a difficult situation. The following are some of the most common reasons cited for denial. If your claim has been denied, it is important to contact an Illinois workers’ compensation lawyer right away.

Failure to Report Right Away

One of the primary reasons for the denial of a workers’ compensation claim is the failure of the injured worker to report the incident promptly. Illinois has strict deadlines for reporting workplace injuries, in most cases, within 45 days of the incident. The claim may be denied if an employee fails to notify their employer within this timeframe.

Failure to Provide Enough Medical Evidence

Workers' comp claims require medical evidence to support the injury or illness. The claim may be denied if the worker’s medical records do not clearly link the injury and their job duties. This can happen if the employee fails to seek medical treatment promptly after the incident or if the medical documentation is incomplete or inconsistent.

Failure to Prove Pre-Existing Condition Made Worse by Job Injury

The claim may be denied or disputed if an employee has a pre-existing condition contributing to their injury or illness. Insurance carriers may argue that the injury was not solely work-related and may deny coverage for medical treatment and lost wages. However, it is essential to note that aggravation of preexisting conditions is often covered under workers' compensation, so this does not automatically mean your claim should be denied.

Failure to Prove Injury Is Work-Related

There may be disputes over the cause of the injury or illness. Employers or insurance carriers may argue that the injury did not occur during their work duties, making it ineligible for workers' compensation benefits. For example, the claim may be denied if an employee is injured while engaging in horseplay or violating company safety policies.

Contact a Will County, IL Workers’ Comp Lawyer for Legal Help

Workers’ compensation claims involve various deadlines and administrative requirements that must be met to be valid. Do not risk missing deadlines for failing to file paperwork or provide necessary documentation that could result in your claim being denied. Although you may think you should have no problem with your claim, your employer and insurance company may think otherwise. Call Rathbun, Cservenyak & Kozol LLC at 815-730-1977 to schedule a free consultation with one of our skilled Joliet, IL workers’ compensation attorneys to ensure your right to benefits is protected.