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Restoring Dignity & Control After An Injury 

What to know before appealing a workers’ comp claim denial

On Behalf of | May 23, 2024 | Workers' Compensation |

Many injured workers can apply for workers’ compensation benefits to receive medical care and lost wages. However, a claim could also be denied, which can severely harm workers who are seeking to recover from their injuries. 

Injured workers can file an appeal in the hopes of receiving workers’ comp benefits. Here is what you should know:

Why was the claim denied?

It is often important to understand why a workers’ comp claim was denied in the first place before appealing. However, some denials are caused by more complicated matters. A claim could have been denied for the following reasons:

  • Missed statute of limitations
  • Unqualified medical condition or injury
  • The injury happened outside of work
  • The injury was self-inflicted
  • The injury was the result of inebriation or recklessness

The reason why a denial happened in the first place may have been a simple mistake, such as a type or misunderstanding.

How long do you have to appeal the denial in Illinois?

Injured workers have several deadlines they must meet for a successful workers’ comp claim. A worker has 45 days to inform their employee of the injury and 3 years to file a claim. But, if a claim is denied, the injured worker only has 30 days to make an appeal. Missing any of these deadlines could prevent an injured worker from receiving health care benefits.

What steps do you need to take to make an appeal? 

The appeal process for a denied workers’ comp claim often requires proper legal documents, evidence to support an appeal and a hearing before a judge. Filing an appeal so that an injured worker can receive workers’ comp benefits is a complex matter and often requires in-depth knowledge of workers’ comp laws. Workers who are seeking to appeal a denial may need to reach out for legal help for a successful case. 

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