Appealing a Denied Workers' Comp Claim
Believe it or not, it’s not uncommon for workers’ comp insurance
companies to deny a legitimate claim. After all, these businesses make
money by collecting premiums, not distributing compensation. Insurance
companies will use any excuse to keep from covering your injury. However,
you do have another course of action—filing an appeal.
In the state of Illinois, you have a right to appeal the denial of your
claim. In order to do so, you must show evidence countering the reasons
for the denial. The process can be quite complicated, which is why you
need the assistance of an excellent Chicago workers’ compensation
attorney. A good lawyer will not only know what papers to file and where
to send them, but they will know the deadlines for each one. Every state
has a statute of limitations that puts a restriction on the amount of
time you have to file a workers’ comp claim; however, there are
also deadlines for the appeals process.
What Is Needed to File an Appeal?
In order to begin, you must submit an application for "adjustment
of claim." This must be submitted with proof that the employer has
been served with a copy of the application. Then, you must request a hearing
with the arbitrator working with the Illinois Workers’ Compensation
Commission. This hearing is your opportunity to present evidence that
the denial was a mistake.
If you have sufficient evidence, the next step is requesting a trial. The
arbitrator will seek to resolve the dispute during the trial and will
issue his or her decision within 60 days of its conclusion. Having a good
attorney on your side will allow you to present your case in an orderly
and well-argued way. Lawyers have extensive training in presenting and
explaining evidence in a court of law, including the legal terminology
necessary to present a well-argued case.
What If My Appeal Was Denied?
If your claim is still denied, you can appeal the arbitrator’s decision
with a Petition for Review with the Workers’ Compensation Commission
within 30 days. A panel of 3 commissioners will then review the petition
and make a decision within 60 days regarding your case. Another denial
can be appealed via the Circuit Court, Appellate Court, or even the Supreme
Court of Illinois.
Each step will become progressively harder and will require the support
of experienced legal counsel. Make sure you are represented by the best.
Our attorneys have handled more than 7,500 claims successfully for injured
workers all over the state. Trust us to advocate for you.
Contact us at
(312) 487-2513 or fill out our online form to schedule a free case consultation. We look
forward to fighting for your rights.
Is Workers’ Comp Taxable Income?
workers’ compensation benefits are not taxable. This includes both the state and federal level. However, there may be
some exceptions to this, including individuals who receive compensation
alongside other benefits such as Social Security Income or Social security
If your combined compensation meets a certain threshold, the Social Security
Administration (SSA) may need to offset the workers' compensation
benefits by reducing other benefits.
The difference between the amounts you get from each income may be taxable. However, most people who receive both SSD and workers’ compensation
typically don’t owe taxes.
Understanding Workers’ Compensation Liens
Section 21 of the Illinois workers' compensation act governs liens
on workers' compensation cases.
As a general rule there are no liens in workers' compensation cases.
However, an exception exists if there is unpaid child support owed. If this is the case and the insurance company or employer is properly
served and notified of the child support lien, it is enforceable against
the injured workers TTD checks and settlement. Recent Illinois case law
has also found enforceable liens against an injured worker’s settlement
by the Illinois Department of Public Aid.
Workers' Comp Penalties Against Employers
Section 19 of the Illinois Workers' Compensation Act governs the award
of penalties against the employer. Two provisions, 19(k) and 19(l) may
become relevant depending on the conduct of the employer in defending
the injured workers claim.
19(l) penalties take the form of late fees for delay in payment of an award after trial
or in paying TTD benefits. 19(l) takes the form of a late penalty against
the employer, computed at $30 a day with a maximum of $10,000.
19(k) penalties require a finding of vexatious conduct on the part of the employer in
defending the claim. These penalties require a finding on the part of
the employer of bad faith. 19(k) penalties are computed at 20% of disputed
medical, 20% of the disputed TTD withheld, and in some rare cases 20%
of the prospective medical not approved by the employer once the costs
of that medical are determined.
Workers’ Compensation Settlements
There is no provision of the Illinois workers' compensation act that
guarantees the injured worker a settlement following the conclusion of
medical treatment. The belief that the insurance company or employer will
offer you a settlement may be a mistake. Often times once medical treatment
has concluded the insurance company or employer will simply close the claim.
The value of a claim depends on the following factors:
- Permanent partial disability sustained
- Ability to return to work full-duty
- Wage loss or earning impairment incurred, if any
- Ability to return to any type of gainful employment
Our Firm Gets Results. Start Today with a Free Consultation.
Leonard Law Group is backed by decades of collective experience in the
field of workers’ compensation. We handle cases for workers of all
industries with professionalism and personal attention. Already with a
firm, but unsure of the quality of your representation? Don’t hesitate
to get a free second opinion from our established workers' compensation
lawyers. We have a reputation throughout Chicago and all of Illinois as
top workers’ compensation attorneys.
Injured on the job? Find out what your legal options are by contacting Leonard Law Group.