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Restoring Dignity & Control After An Injury 

Understanding the workers’ compensation appeal process

On Behalf of | Oct 18, 2023 | Workers' Compensation |

If you are injured at work, you may expect workers’ compensation to provide financial support while you recover. Unfortunately, sometimes claims are denied. 

After a workers’ comp denial, you may feel defeated; however, you have options. One is to appeal the decision. Learn about this process and what to expect here. 

Reasons for denial

There are several reasons your workers’ compensation claim may be denied. The most common include:

  • Late reporting
  • Insufficient medical documentation
  • Disputes over your injury
  • Employer disagreement

Identifying the specific reason for denial is the first step toward building a strong appeal.

Appealing the decision

You can file a formal appeal after determining why your claim was denied. In Illinois, this involves submitting a Request for Hearing to the Illinois Workers’ Compensation Commission (IWCC). The IWCC will then schedule a hearing where both parties can present their cases.

The hearing process

During the hearing, both sides will present evidence, witness testimonies and arguments to demonstrate the validity of your claim. A workers’ comp arbitrator will preside over the hearing and decide based on the evidence presented.

Potential outcomes

After the hearing, several outcomes are possible. The arbitrator may decide in your favor, granting you the benefits you deserve. Alternatively, they might uphold the denial. If dissatisfied with the arbitrator’s decision, you can further appeal to the IWCC’s Review Division and eventually to the Illinois Appellate Court.

Being patient throughout this process is essential, as workers’ comp appeals can be time-consuming. Appealing a denied workers’ comp claim in Illinois is a multifaceted process. With perseverance and the right guidance, you can work towards securing the compensation you deserve.

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