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Understanding why a claim may be denied and advice moving forward

Workplace accidents are unfortunately a common occurrence, and in many cases, they run the risk of ending in severe occupational injuries. If you have suffered an injury on the job, you might be experiencing numerous challenges following such a stressful and daunting incident.

Perhaps your injuries are forcing you to take an extended leave from work, and when coupled with extensive medical expenses, the financial struggles that may follow could be challenging to overcome. You could choose to pursue relief through workers' compensation, but what happens if your claim is denied?

Reasons your claim may result in a denial

Expecting to receive benefits, only to receive a denial, could be devastating. However, you may be able to appeal the decision, and understanding the potential reasons for a denial could help you prepare for the road ahead. Some of the more prevalent reasons for a denial for workers' compensation benefits could include the following:

  • Presence of compensable injury: To receive benefits, you must prove that a compensable injury is present, and the types of injuries workers' compensation covers may vary depending on the state in which you reside.
  • Timing of report/claim: There is a time frame in which you must report the injury, along with a set period in which to file a claim for benefits, and allowing either to pass by could prove detrimental.
  • Time/place of injury: In some cases, an employer may oppose your claim on grounds that the injury isn't work related, and showing that your injury took place while on the job is a necessary component.
  • Lack of treatment: You may also have to show that you have undergone medical treatment for your injuries, as a lack of documentation of treatment may result in a denial.

Knowing why may only be half the equation, and appealing a denied claim can be complex. However, you don't have to proceed alone, and seeking guidance from someone with experience in this area could help you prepare for what comes next.

Assistance for the road ahead

While you could be feeling somewhat intimidated and overwhelmed by the process, you might be in serious need of financial relief. You could speak with someone who has extensive knowledge in Illinois state workers' compensation laws for assistance throughout this challenging life event. Obtaining guidance and assistance for the appeals process may place you in a better position to pursue the compensation you deserve and help you shift your focus toward recovery.

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