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Restoring Dignity & Control After An Injury 

Why was your workers’ compensation claim denied?

On Behalf of | Jul 9, 2024 | Workers' Compensation |

An important detail to remember about workers’ compensation is that your injuries must have happened while you were working. If you are injured outside of work, you may be denied benefits.

There are other reasons why you may be denied medical coverage and lost wage payments through a workers’ comp claim. Learn here before applying for benefits:

You missed a crucial deadline

Meeting Illinois’ statute of limitations is crucial for a successful workers’ comp claim. If you miss any deadline after a workplace injury, you could be denied benefits. The first deadline is reporting your injuries to your employer. You have 45 days to do so from the day of your injury. The next deadline is making a benefits claim within 3 years of the injury.

You did not seek medical help

Supporting documentation is typically required for a successful workers’ comp claim. A medical report can show how your injury is affecting your ability to work and the kind of benefits you may need. If you do not get a medical report, your claim could be denied until you seek help from a medical practitioner. 

Your injury is not qualified

Not all injuries are eligible for workers’ comp benefits. While a head or spine injury may make you unable to work and, thus, make you eligible for benefits, a cut or bruise may not. It is crucial to know what injuries can qualify you for benefits. 

Your injuries were self-inflicted 

Workers’ comp is a no-fault system, meaning you can receive benefits no matter who is at fault for an accident. However, self-inflicted wounds made to get workers’ comp benefits typically do not make workers eligible for benefits.

Your injuries were caused by substance use or aggression

Like self-inflicted wounds, an accident caused by substance use can prevent you from receiving benefits. Starting a fight, aggressive behavior or roughhousing that led to your injuries typically leads to denied claims. 

How can you appeal a claim denial?

If your claim is denied, you can reach out for legal help for assistance. Legal guidance can help you appeal a denial so you can recover from your injuries.  

 

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