By Dan Noll on November 7th, 2023 in
Dealing with a workplace injury is tough. You’re in pain, unable to work, and worried about providing for yourself and your family. On top of that, navigating the workers’ compensation system can be confusing and frustrating. You may wonder why you have not received a check or what to do if your work comp claim has been denied.
The Illinois workers’ compensation lawyers at the Noll Law Office understand your concerns and are here to help. If you haven’t yet received your check or have had your claim denied, continue reading to learn more about your options:
Why Am I Not Getting a Check for My Workers’ Comp Claim?
If you filed a workers’ compensation claim and haven’t received any payments, there may be a few reasons for this delay, including:
- Waiting period – Workers’ compensation wage benefits do not kick in unless an employee misses more than three days of work. After that, wages are calculated at a specific statutory rate while you remain off work.
- Employer dispute – Your employer may dispute the claim, asserting that there is no injury, that you were not injured while working in the scope of your employment, or that you do not require certain types of medical care or other workers’ compensation benefits. This can cause payment delays.
- Incomplete paperwork – Filing errors or missing documentation can lead to delays. You should work with an attorney to ensure that all required forms are accurately completed and submitted.
- Payment processing errors – Sometimes, errors in payment processing can cause temporary delays. Following up with the insurance company to resolve such issues is crucial.
Steps to Take if You Haven’t Received Your Workers’ Comp Payments
If your payment hasn’t arrived, you can take some quick action to help move things along.
- Contact your adjuster – You will want to send the adjuster an email or letter requesting an update on the status of your claim and request a status of payment of insurance benefits. You should specifically request that a written basis of denial be provided within fourteen 14 days.
- File a 19(b) Petition – Your attorney can request an emergency hearing in front of an arbitrator if your workers compensation benefits are not paid, asking the arbitrator to order immediate payment.
- File a petition for penalties – In some cases, there is no good reason to withhold benefits. In that case, your attorney can request penalties and fees, in particular if there has been a vexatious delay in coverage.
What Should I Do if My Workers’ Compensation Claim Is Denied?
If your workers’ compensation claim is denied, it’s important not to panic. Many claims are initially rejected but can be successfully appealed.
Common Reasons for Workers’ Comp Claim Denials
- Late reporting – Under the Illinois Workers’ Compensation Act (820 ILCS 305), you are required to report your injury to your employer within 45 days. Failing to meet this deadline can result in claim denial.
- Insufficient medical documentation – Insufficient medical evidence supporting your claim can be a reason for denial. Make sure to provide detailed records and medical opinions.
- Disputed claim – Your employer or insurer may contest the claim, arguing that the injury isn’t work-related or doesn’t meet the criteria for compensation.
- Non-covered injury – Certain injuries, such as those caused by self-inflicted harm or intoxication, may not be covered under the Illinois Workers’ Compensation Act
Steps To Take if Your Work Comp Claim Is Denied
If your claim was denied, don’t panic. Do these things instead:
- Understand the reason for denial – Review the denial letter and identify the reason the carrier denied your claim. This will help you address the issue at arbitration.
- Gather additional evidence – Collect any additional evidence or documentation to address the denial reason. This might include ordering medical records, subpoena practice, or obtaining physician depositions.
- Request an arbitration hearing – Request a hearing in front of the assigned arbitrator. Your attorney can help you with compiling the correct exhibits, taking depositions, and issuing subpoenas in preparation of the hearing. The arbitrator will review the evidence and decide whether your claim should have been approved for coverage.
Injured at Work in Illinois? Contact The Noll Law Office for Help
The Illinois workers’ compensation attorneys at the Noll Law Office understand that coping with a workplace injury is difficult and dealing with the workers’ compensation system can be overwhelming. That’s why being informed about the process and knowing your rights under Illinois law is crucial.
Don’t lose hope if you’re not receiving workers’ comp payments or your claim has been denied. Be proactive in addressing the issues, gather the necessary documentation, and consider seeking legal assistance from experienced attorneys like those at the Noll Law Office. They could help you navigate the confusing workers’ compensation system and fight for the compensation you deserve. Call them today at (217) 414-8889 for a free initial consultation.