An injured worker naturally expects their employer to cover the costs of medical treatment and lost wages. After all, workers’ compensation is the law. However, sometimes an employer refuses to pay workers’ comp. What should workers do at that point?
How the Workers’ Comp Process Works
Employees need to notify their employers after an injury or the diagnosis of an occupational disease. The employer notifies the workers’ compensation insurance company. The insurer is supposed to pay the injured worker’s medical bills.
Before approving the claim, the insurance company may require medical examinations to confirm the injury. The insurer may also review the employee’s medical records.
Sometimes the employer or its insurer will dispute the workers’ compensation claim and refuse to pay anything. The insurer may also approve benefits, but for less than the employee feels is appropriate.
If the claim is denied, the employer has to notify the employee in writing. The denial letter should explain why a claim has been rejected. After carefully reading the denial letter, the employee should turn it over to his or her attorney as soon as possible. The attorney and employee then will decide whether to continue pursuing a claim for workers’ compensation benefits.
What Comes Next
An employee whose workers’ comp claim has been denied does not have to give up. Instead, the worker may file an Application for Adjustment of Claim with the Illinois Workers’ Compensation Commission (the “Commission”).
The Commission will assign your case to an arbitrator. Your lawyer and the arbitrator may have hearings and status phone calls regarding your claim. When you are ready, your attorney will request a hearing on your appeal. The arbitrator will hear evidence from the employer and employee.
In a workers’ compensation case, the employee has the burden of proof. In other words, the employee has to prove his or her workers’ compensation claim. The employer does not have to prove that the injury is not valid.
If the arbitrator denies the claim, the employee can file a petition for review. Three Commissioners will review the case and make a decision, usually within 60 days.
If the Commissioners also deny the claim, the employee can ask the local Circuit Court to review the workers’ compensation case.
You Do Have Options if Your Employer Refuses to Pay Workers’ Comp
Talk to an Illinois workers’ compensation attorney immediately.
Osvaldo Rodriguez has more than 20 years’ experience helping people like you. Schedule a free initial consultation or ask a question by calling us at 708-716-3441 or by completing the Contact form on our website.
Mr. Rodriguez is fluent in both Spanish and English.
We represent clients throughout the state of Illinois, including Chicago, Addison, Bellwood, Bensenville, Berwyn, Chicago, Cicero, Elmwood Park, Franklin Park, Maywood, Melrose Park, Northlake, and all of Cook County, Lake County, Kane County, Dupage County and Will County.