Managing disputed workers’ comp claims

Facing the prospect of filing a workers’ compensation insurance claim to recover benefits is one of those things that can elicit a heavy sigh. No matter how solid you believe your claim to be, you may feel you will have to fight for every bit of compensation you get. In the end, questions may linger about whether you lost out on any benefits because you just didn’t know the system.

Dispelling those anxieties is one of the major benefits of working with an experienced workers’ compensation attorney. Insurance companies have teams of attorneys who take advantage of the nuances of the law. By enlisting an attorney’s help on your behalf, you level the playing field.

Your rights in disputes

Workers’ compensation claims do get denied. When that happens and a case is filed with the Illinois Workers’ Compensation Commission, it’s useful to know how the state expects the matter to progress.

A claim starts by a worker notifying his or her employer when an injury occurs. The law requires employer notification as soon as practicable, but definitely within 45 days of the incident. If the injury involves radiation, the time frame is 90 days from the date of suspected exposure. Occupational illnesses, such as hearing loss or musculoskeletal disorders, need to be reported as soon as practicable after discovery.

Step two obliges employers to:

  • Ensure delivery of first aid and other medical services required.
  • Report the relevant workers’ compensation administrator about the matter.

If your injury warrants you missing work for more than three days, temporary total disability benefits should start. Your employer can request more information from you, delaying payments. Alternatively, TTD benefits could be denied.

Employee’s options

If direct reporting and communication don’t result in benefits, you can turn to the Workers’ Compensation Commission, but a request for a hearing using the appropriate form is required. The case goes to an arbitrator. If no satisfactory resolution is reached, an appeal to a panel of commissioners is possible.

If you aren’t a state government worker, you have a right to appeal an unsatisfactory commission decision to a circuit court, the appeals court and possibly to the state Supreme Court.

Clearly, the legal rules are complicated. One misstep could jeopardize the benefits essential for your wellbeing and that of your family.