Restoring Dignity & Control After An Injury 

Why might an insurer deny my workers’ compensation claim?

| Nov 17, 2020 | Workers' Compensation |

Most Illinois employers have workers’ compensation insurance. If you are injured or become ill at work, it will cover lost wages and the costs of treatment. However, if the insurer denies your claim, you could be left unable to work and with medical bills that you cannot pay. Understanding the rules of the system is vital to ensure you do not miss out.

Workers’ compensation claims are not guaranteed to succeed

Just because your employer has insurance coverage does not mean you will receive compensation. You need to file your claim correctly. Otherwise, the insurer may reject it. Here are some reasons they might use to deny your claim:

  • You did not report your injury on time: It is best to report the accident to your employer straight away. It reduces the chance you forget and pass the 45-day reporting deadline. The limit for filing a claim is usually three years.
  • You saw the wrong doctor: An insurer may push you toward one of their doctors who act in their favor. Seeing someone independent is often a better option.
  • You did fill the forms correctly: Like any legal matter, there are ways to do things that you must observe. It is wise to seek legal help to ensure your claim is not delayed or turned down because of administrative errors.
  • The insurer claims it is not work-related: Whether an accident or illness is work-related is not always clear cut. Insurers will try their best to avoid paying out. You may need help to argue your case.

Following the guidance above increases the chance that your claim is approved the first time around. If the insurer denies your initial workers’ compensation claim, you can look at legal options.

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