The aftermath of sustaining an injury in the workplace can be challenging for injured workers in Illinois. Independent of any financial concerns, simply finding, receiving and healing from the proper treatment to an injury can be an all-consuming experience. On top of that, navigating the process of receiving deserved workers’ compensation benefits provides another dimension of stress. This is especially true when an employer refuses to offer workers’ compensation.
(article continues below infographic)
For workers in Illinois who incurred an injury during the course of employment, it is important to understand the process that must take place in order for workers’ compensation benefits to be awarded. Given the possibility of an initial denial of benefits from the employer, such understanding includes the process following a denial.
Steps to avoid denial
The first step in the process is notifying the employer of the injury within 45 days of the workplace accident and filing a claim with the Illinois Workers’ Compensation Commission within three years of the injury. Executing these two steps within their respective deadlines is critical. Failure to do so is likely to result in a denied claim for needed compensation to cover lost wages and medical costs.
Beyond failure to properly and punctually notify the employer and file a claim with the IWCC, there are other non-administrative reasons why a claim for benefits might be denied. Central to those reasons is the failure to present a strong case for the causal relationship between the workplace and injury.
Appealing a denial
If the employer is insured, but refuses to offer workers’ compensation after the injured employee has notified the employer and filed a claim with the IWCC, the claimant may appeal the employer’s denial to the IWCC. Appealing a denial is a complex process, for which claimants who have not already hired a workers’ compensation attorney may wish to do so.
After receiving an appeal from the claimant to the denial of workers’ compensation benefits from the employer, the IWCC will seek to resolve the dispute in the following manner:
- An arbitrator will initially try the case
- A panel of three commissioners may review the arbitrator’s decision
- The case may be appealed to higher courts, in sequence
The IWCC has indicated that most workers’ compensation disputes in Illinois are resolved through settlements outside of court.
An alternative scenario featuring an employer refusing to offer workers’ compensation is the case of an uninsured employer. For these cases, the State of Illinois has established the Injured Workers’ Benefit Fund, which provides funds to injured employees of uninsured employers through penalties imposed on uninsured employers.