If you suffer an injury at work, you will likely be eligible to obtain workers’ compensation benefit payments. How can you avoid a denial of your claim for benefits? What steps can you take if your claim is rejected? In Illinois, let a Chicago workers’ compensation attorney help.
Determining if a worker is eligible for worker’s comp benefits is often complicated. Many working people in the greater Chicago area do not know if they qualify for benefits. If they do, they may not understand what steps they will need to take to receive benefit payments.
Workers’ comp is an insurance system created by state lawmakers and regulated by the Illinois Workers’ Compensation Commission. Employers purchase insurance for their employees. If someone is injured on the job, he or she may submit a claim and seek to obtain benefit payments.
However, even if you qualify for workers’ comp benefits and know how to apply, workers’ comp insurance companies may reject legitimate claims. Injury victims sometimes need an attorney’s help to acquire benefits they’re entitled to, need, and deserve.
Why Would a Workers’ Compensation Claim Be Denied?
Why are legitimate workers’ compensation claims sometimes rejected? If you’ll keep reading, you will learn that answer – and more about your rights if you are injured on the job in Chicago or anywhere else in Illinois.
Although a workers’ comp insurance company may reject a claim for a variety of reasons, the five reasons listed here reflect frequent mistakes that you need to avoid making if you apply for benefit payments.
1. You didn’t report your injury immediately.
2. The accident report isn’t consistent with the medical findings.
3. Alcohol or drugs were found in your bloodstream during your medical examination.
4. A pre-existing injury or medical condition was discovered.
5. You were laid off or fired before you applied for workers’ compensation benefits.
What Are the Causes of Workplace Accidents?
The Illinois Workers’ Compensation Commission lists the following as the leading reasons for work-related accidents and injuries in Illinois:
1. overexertion
2. slip-and-fall accidents
3. traffic accidents
4. workplace violence
5. exposure to dangerous substances or working conditions
If you become aware of a hazardous situation at your place of work, report it. In a general sense, workplace safety is everyone’s responsibility, but employers are specifically obligated to maintain a reasonably safe and hazard-free workplace.
Mistake #1: You Didn’t Report Your Injury Immediately
If you do not report a job-related accident and injury immediately, your employer’s workers’ comp insurance company may assume that you weren’t actually injured or seriously injured.
To receive worker’s compensation benefits in Illinois, you have 45 days to report a work-related injury in writing to your employer. Failing to satisfy that deadline disqualifies you for benefits. Do not wait 45 days. Report the accident and your injury to the employer at once.
Prompt reporting and prompt completion of any required paperwork keeps you in compliance with the workers’ compensation rules and works to your benefit if a question about your injury or claim arises.
Mistake #2: The Accident Report Isn’t Consistent With the Medical Findings
If your statements regarding a job-related accident are not consistent, or should you claim that your injury occurred one way and the medical exam indicates it happened some other way – or indicates that your injury isn’t very serious – your claim for benefits may be denied.
Explain what happened simply, plainly, and truthfully, without exaggeration or emotion, when you speak to your employer and your healthcare providers. Keep your story consistent. Beyond that, you shouldn’t discuss the details of your case except with your workers’ comp lawyer.
Mistake #3: Your Medical Exam Indicated Drug or Alcohol Use
When accidents happen at work, and employees are injured, they should always seek medical attention immediately. However, if medical test results indicate that you were impaired by alcohol and/or drugs when the accident occurred, you may not receive workers’ comp benefits.
In addition, if you were hurt while engaging in horseplay or a practical joke that you instigated, you probably cannot qualify for benefit payments.
Mistake #4: You Had a Pre-Existing Injury Or Medical Condition
A workers’ compensation insurance company may challenge your claim quite aggressively if you already suffered from a pre-existing illness or injury when a workplace accident happened – especially if that illness or injury is linked in any way to the injury you sustained at work.
Pre-existing conditions complicate workers’ compensation claims. If your workers’ comp claim is rejected due to a pre-existing illness or injury, let your Illinois workers’ compensation lawyer arrange for an independent medical examination and a second opinion.
The right Chicago workers’ compensation attorney will appeal the denial of your claim and fight for the benefit payments that are rightfully yours under Illinois law. Don’t accept a denial of your claim. Challenge the denial with your attorney’s help.
Mistake #5: You Sought Workers’ Comp Benefits After a Lay-Off or Termination
When injured workers don’t immediately file for workers’ compensation benefits after an at-work injury, they may be laid off or fired in the interim. Workers’ compensation claims filed after a lay-off or termination are always scrutinized and viewed with suspicion.
Insurance companies usually assume that post-layoff and post-termination workers’ compensation claims are false and are motivated by revenge or anger against the ex-employer. This is another reason for reporting an injury and filing a claim immediately after an accident.
If it’s possible, you must undergo a medical exam within 24 hours after a workplace injury, or you may be unable to show that your injury was the result of a particular workplace accident. Without a prompt exam, an insurance company may claim you weren’t injured very seriously.
How Will a Workers’ Compensation Attorney Work on Your Behalf?
Workers’ comp lawyers routinely deal with complicated cases, but if your claim is legitimate and you are entitled to benefits, your lawyer will use every available tool to prove it.
If you’re injured, you’re unable to work, and your bills are mounting, take your workers’ comp case to an Illinois workers’ compensation attorney who can offer the help you need to acquire the benefits that you are entitled to under the law.
In fact, after any job-related injury in Illinois, arrange to speak with a workers’ comp attorney as quickly as you can. Your attorney will help you submit your claim and will see that no misunderstandings or mistakes delay your benefit payments.
If you’ve been injured on the job, good legal help is available now, and the law in Illinois is on your side.
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