Injuries on the job happen, but Illinois law requires employers to carry workers’ compensation insurance. A Springfield workers’ compensation attorney could help you pursue the benefits that you are entitled to receive.
Unfortunately, some workers’ comp claims are denied. A lawyer could help you understand why your claim may have been denied and what your options are for proceeding.
What is workers’ compensation?
Workers’ compensation is a form of insurance that provides medical treatment and wage replacement for employees who suffer work-related injuries or illnesses. It also pays death benefits to the dependents of deceased workers.
Injured workers are eligible to receive two-thirds of their average weekly wages if they are unable to return to their job due to their injury or illness. It also covers medical expenses, medication, and retraining to find another suitable position.
Workers’ comp laws are meant to balance the interests of employers and injured workers. In exchange for receiving workers’ compensation, employees agree to waive the right to sue their employer for negligence in certain circumstances. An experienced workers’ compensation attorney can help clients understand how the law applies to their situation. For example, they can explain how pre-existing conditions may affect a claim. They can also provide assistance with submitting appropriate paperwork and communicating with medical providers. In addition, they can conduct discovery and participate in depositions, oral arguments, trial preparation, and mediations to ensure that their client’s rights are protected.
How do I qualify for workers’ compensation?
If you were injured or contracted an illness at work, you may be eligible to receive workers’ compensation benefits. Most states have a system that provides you with compensation for medical bills and some lost wages. In exchange, you give up your right to sue your employer for damages in most situations.
The first step in the process is to seek a medical examination, even if you feel fine and believe your injury or illness is minor. A medical exam can reveal latent injuries or illnesses that you were unaware of. This can prevent you from missing time-sensitive deadlines in the claims process.
It is also crucial to notify your employer of any workplace injury or illness immediately. There are typically specific deadlines for this, which vary from state to state. In addition, your employer must file a report with the insurer or face penalties. Having an attorney who understands the complex laws of your state can help you stay on top of these requirements.
What if my claim is denied?
Most injuries and illnesses incurred while at work are covered under the workers’ comp system. However, not all claims are approved, and insurance companies often deny legitimate cases for many reasons. Those reasons may include that the injury was not sustained at work (but only if the injury occurred on company property) or that the worker failed to report their injury in a timely manner.
Other common reasons for claim denials include that the injury was caused by a preexisting condition (although this can be challenged with medical documentation) or that the injury is not severe enough to warrant compensation. In the event your claim is denied, a skilled Springfield workers’ compensation lawyer could help you appeal the ruling. Appeals typically involve a hearing before an administrative law judge and submission of certain paperwork to initiate the process. Depending on your state, there may also be additional levels of appeal that you can pursue. The timelines for these appeals are short and strict, so you should have an attorney on your side from the start.
Can I still pursue a claim?
Insurers often deny workers’ comp claims, even if they are legitimate, for a variety of reasons. Many injured employees become frustrated and give up or try to navigate the complex system on their own. A top workers’ comp attorney knows how to tilt the scales in favor of his or her client.
A good worker’s comp lawyer will understand how to develop medical evidence that proves your claim, structure a settlement agreement based on future medical expenses and lost wages, and defend you in a trial. The attorney will also have superior negotiation skills backed by an accurate assessment of what your case is honestly worth—no pipe dreams or inflated figures.
Most workers’ comp attorneys accept clients on a contingency basis, meaning that you do not pay any fee upfront and the lawyer is paid after the conclusion of proceedings or a successful resolution to your claim. This arrangement is particularly beneficial for injured workers who need financial help and cannot afford to hire a workers’ compensation attorney on an hourly basis or demand a large down payment for their services.