The process of applying for workers’ compensation can be difficult. It is often hard to concentrate on the details of an application while recovering from a serious injury. Unfortunately, many applications are turned down every year because of avoidable mistakes. Injured workers can increase their chance of success by learning more about the process.
Denial is a possibility even for legitimately injured workers
According to statistics compiled by the Illinois Workers’ Compensation Commission, approximately 5,000 injured workers in the state are turned down for benefits every year. Every Illinois workers’ compensation attorney is aware that some of these workers are injured in legitimate job-related accidents. Flaws, inaccuracies or outright lies in an application may cause denial of benefits.
Mistakes involving pre-existing conditions
Many workers’ compensation claims do not deal correctly with pre-existing conditions. This is one of the most common causes of denial. If an employee lies about a previous condition, exaggerates it or refuses to document it, the claim may be thrown out. Written testimony from a doctor is required to clear up ambiguity about pre-existing conditions and workers’ compensation.
Lack of employer notification
Some workers do not notify their employers promptly after an accident. They may be embarrassed about the incident or nervous because they were at fault. If the accident is not reported within 90 days, the employee loses the right to compensation.
Improper documentation of medical care
Injured workers need to document the medical care and advice they receive after an accident at work, including information in all of the following categories:
- Emergency treatment at the scene
- Emergency room care after the accident
- Length and circumstances of any hospitalization
- Outpatient visits with doctors
- Physical therapy
- Referrals to medical specialists
If employees cannot produce accurate records of their medical care, they may be unable to obtain benefits, as an Illinois workers’ compensation attorney knows.
Getting it right the first time
According to the IWCC, almost 10 percent of workers’ compensation claims are rejected in the first round. Employees have the right to appeal an IWCC decision, but this process can be tiring and expensive, with no guarantee of success in the end. The best strategy is to make a strong, accurate application and get it right the first time. Employees who have been injured on the job may find it useful to contact an Illinois workers’ compensation attorney about their case.
