When a worker’s compensation claim is denied in Chicago, workers’ compensation lawyers typically take several steps to help their clients navigate the situation and secure compensation. Here’s how they typically handle denied claims: For more information please visit Chicago Workers Compensation Lawyer

1. Review the Denial Reason

The first step is to understand the specific reason why the claim was denied. Common reasons for denial include:

  • Lack of sufficient medical evidence proving the injury.
  • Failure to file the claim within the deadline.
  • Pre-existing conditions that may be blamed for the injury.
  • Disputes over whether the injury is work-related.

Lawyers will carefully review the denial letter and all the paperwork involved to identify why the claim was denied.

2. Gather Additional Evidence

Once the reason for the denial is identified, the lawyer will work to strengthen the claim by gathering more evidence, such as:

  • Medical records: Ensuring the medical evidence fully supports the injury claim.
  • Witness testimony: If the injury occurred in the workplace, obtaining statements from co-workers or supervisors can be crucial.
  • Expert testimony: In some cases, hiring medical experts or vocational experts to explain how the injury impacts the worker can be helpful.

3. Appeal the Denial

Illinois law allows workers to appeal denied claims. A workers’ compensation lawyer can guide the client through this process, which may include:

  • Requesting a hearing before the Illinois Workers’ Compensation Commission (IWCC).
  • Filing a Petition for Review with the IWCC to challenge the denial.

4. Negotiation with the Insurance Company

In some cases, lawyers will attempt to negotiate directly with the insurance company. They may seek a settlement or work to resolve the denial without going through a formal hearing. This negotiation process could involve a demand for compensation based on the severity of the injury, lost wages, and medical costs.

5. Litigation

If negotiations fail, the lawyer may pursue litigation. This involves presenting the case before a judge at the Illinois Workers’ Compensation Commission. The lawyer will argue the case in court, presenting evidence and questioning witnesses to demonstrate the validity of the claim.

6. Prepare for Possible Outcomes

A workers’ compensation lawyer will also prepare the client for potential outcomes, including:

  • Compensation being awarded: If the appeal is successful, the worker may receive compensation for medical expenses, lost wages, and permanent disability benefits.
  • Further denial or delay: Sometimes, the process can involve delays or continued denials, but an experienced lawyer will help navigate this.
  • Settlement: Some workers’ compensation cases result in settlements, where the worker agrees to a lump sum in exchange for giving up future claims.

7. Protect the Worker’s Rights

Throughout the entire process, workers’ compensation lawyers work to protect the injured worker’s rights. They make sure all deadlines are met, the right documentation is submitted, and the worker is not taken advantage of by the insurance company.

Conclusion

Handling denied claims involves a combination of investigation, evidence gathering, legal advocacy, and appeals. Workers’ compensation lawyers in Chicago offer invaluable support by guiding their clients through this complex process, fighting for the compensation they deserve.