Why Are Workers Compensation Claims Denied?

 Posted on November 18, 2021 in Workers' Compensation

Suffering a workplace injury is frustrating. You may be unable to work, require intensive medical care, and be left with permanent disabilities. However, the situation is all the more vexing if your workers’ compensation claim is denied.

Injured workers depend on workers’ compensation benefits during their recovery. If a claim is denied, the worker may be left with mounting medical bills and other expenses. Here are three common reasons workers compensation claims are denied:

The Accident Did Not Occur at Work

In order to qualify for benefits, your injury must have occurred during work. However, this does not necessitate a specific physical location. If the injury occurred while you were performing your job duties (e.g., out making deliveries), it qualifies. This is one of the most common justifications for a claim denial. Employers and insurers looking to avoid a payout often try to argue that the worker was not “on the job” when the accident occurred.  

The Statute of Limitation Expired

Like every legal claim, injured workers must file their claims within a certain amount of time from the day of the accident. In the State of Illinois, the Workers Compensation Commission recommends that claims be filed as soon as possible, but no more than 45 days after the day of the injury.

Drug or Alcohol Intoxication 

Illinois is a no-fault workers compensations state. Generally, this means that injured workers qualify for benefits even if they are responsible for their injuries. However, there is an exception to this rule. If the worker was under the influence of drugs or alcohol during the accident that caused their injuries, they do not qualify for workers’ compensation benefits.

Contact a Kane County Workers Compensation Lawyer

Being injured at work is scary. Your job may provide for you and your family. After so many years of being a good employee, you can only hope your employer will be there in a time of need. Unfortunately, it does not always work this way. Employers and their insurance companies frequently deny workers compensation claims without proper justification, leaving their employees in desperate circumstances.

Thankfully, injured workers have rights. An experienced workers’ compensation attorney can help you appeal the denial by filing a Petition for Review with the Workers' Compensation Commission. McNamara Phelan McSteen, LLC has a team of workers’ compensation lawyers that can help you fight a denied claim. They can provide vigorous representation and guidance throughout the workers’ compensation claim process. 

If you need an experienced Kane County workers’ compensation attorney, call McNamara Phelan McSteen, LLC today at 815-727-0100 for a free initial consultation.

Source: 

https://www2.illinois.gov/sites/iwcc/Pages/default.aspx