This is the next post in my series on the handling of temporary total disability (TTD) claims in Peoria, Illinois. My last article discussed how to file for TTD benefits. It is important to understand that if you fail to follow the proper processes then your claim may be denied. Retaining an experienced attorney can help you to make sure that those processes are followed. In this article we will discuss the options you have after your claim is denied. If you or a family member are in need of assistance then contact us online or by telephone today to speak with a workers’ compensation lawyer.
There are a number of reasons why a TTD claim may be denied. These can include the injury not being reported in time or procedures not being followed. Other common reasons for claim denial can include allegations that the injury was, in fact, not work related or a belief that the injury does not prevent the worker from returning to their job. While these reasons for denial may seem straightforward, they can often involve complicated issues which may warrant an appeal. An employer for example, may claim that the injury is not work related due to a pre-existing condition from which the worker suffered. They may also attempt to claim that the injury did not happen at work due to an employee acting out of the scope of their employment. These are the types of issues which can be subject to interpretation and a different decision may be reached on appeal.
The first step in appealing a TTD denial is to file an Application for an Adjust of Claim. The case will be heard by an arbitrator who will consider evidence from both the claimant (the injured worker) and the employer. The arbitrator will then issue a decision. If the arbitrator denies the claim then the worker may begin the appeal process by filing a Petition for Review. This Petition must be filed within thirty days after the arbitrator reaches their decision. The case will then head to the commission where it will be decided. The commission will not consider new evidence, testimony, or arguments. The appeal will be decided solely on the record which was presented to the arbitrator. The commission will typically issue its decision within sixty days of the time at which it hears the case.
Appealing a claim denial can involve both complicated legal and factual issues. If proper procedures are not followed, such as filing your Petition for Review in a timely manner, then the appeal will be denied on procedural grounds. Raising the factual errors made by the arbitrator will involve understanding how the commission may view such claims as well as how other conclusions could possibly have been reached. Given how the process can quickly become complicated, it is strongly suggested that you obtain representation to assist you.
I am a Peoria TTD lawyer who assists those who have been injured on the job. My office believes in protecting the rights of individuals over those of corporations. We pride ourselves on providing quality service and we recognize that this is an important time in your life. We will give your case the attention it deserves. This includes promptly returning your phone calls and making sure you know what to expect as the matter moves forward. If you are in need of assistance then contact us online or by telephone today to speak with a workers’ compensation attorney. My office also serves clients in the Illinois cities of Bloomington, Eureka, Galesburg, Morton, Normal, Pekin, Springfield, and Washington.