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Denial of Workers' Compensation Claims

Chicago Law Firm for Commonwealth Edison Workers

Working for an electric company, whether you work in a sedentary or more active role, carries a range of physical risks. After a job accident, if you are concerned that your employer Commonwealth Edison and its insurer may issue a denial of your workers’ compensation claim, you should call the seasoned Chicago workers’ compensation attorneys of Katz, Friedman, Eisenstein, Johnson, Bareck & Bertuca. For more than sixty years, we’ve fought for full and fair compensation for workers. Several of us have been recognized as Super Lawyers and received other honors. We stand ready to help you.

Denial of Workers’ Compensation Claims

In Illinois, most employees can access workers’ compensation benefits after sustaining job-related injuries. If Commonwealth Edison or its insurer refuses to pay you workers’ compensation benefits after you’ve been injured or made sick on the job, it needs to provide you with a written explanation for the denial. There are various common reasons workers’ compensation claims are denied. In some cases, claims are denied because the insurer is not able to access a complete report or sufficient records. For instance, if Commonwealth Edison fails to provide an incident report to its insurer, or your doctor fails to provide medical records, you could face an unfair denial.

Sometimes an insurer issues a denial because a claimant has a pre-existing condition. This is a tricky situation. You should be aware that you are eligible for workers’ compensation benefits so long as your work for Commonwealth Edison exacerbated or aggravated your pre-existing condition. For example, if you had a herniated disc prior to falling from a ladder at a site where you were installing power lines, but you suffer a ruptured disc that requires surgery because of the fall, you may receive an unfair denial of your claim based on your pre-existing disc herniation. It is important to talk to a lawyer if you think that a work accident could have made a pre-existing condition worse.

Another reason these cases can be complex and susceptible to denial is that there may be no witnesses when workers are injured while out in the field. Under Illinois law, your injury needs to arise from your employment, and insurers may use the fact that an injury occurred offsite as justification for denial

Disputing the Insurer’s Denial

The Illinois Workers’ Compensation Commission (IWCC) oversees the workers’ compensation system and provides dispute resolution mechanisms for injured workers who were denied benefits. If Commonwealth Edison’s insurer denies your claim for benefits, either partially or fully, you can file a claim with the IWCC. It can be critical to have a seasoned lawyer by your side to present your application and ensure that your answers appropriately present your injuries as work-related.

Your appeal of Commonwealth Edison’s denial will be heard by an arbitrator with the IWCC. You and Commonwealth Edison may present evidence and arguments. You will bear the burden of proof to show your health or medical issues are directly job-related. It is important to be honest in any incident report as the information within it could become evidence in your claim at the IWCC.

If we represent you, we will put together strong evidence to show your injuries are job-related and you are entitled to benefits such as reasonable and necessary medical care, disability benefits, and vocational rehabilitation. A decision will be issued by the arbitrator in 60 days. If the denial is upheld, you can have your claim heard in front of a panel of three commissioners at the IWCC. The next step our Chicago attorneys can take, if your claim continues to be denied, is to go before the state’s Circuit Court and Appellate Court to appeal the earlier decision.

Hire a Chicago Commonwealth Edison Claims Law Firm

When you work for Commonwealth Edison, you perform important work that may place you at risk of getting physically injured. Our lawyers represent electrical workers in Champaign, Rockford, Quincy, and Aurora, as well as Sangamon, Winnebago, Kane, Cook, and Adams Counties. Call us at 800-444-1525 or 312-263-6330 or complete our online form.