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Why was my work injury claim rejected?

6 Common Reasons for Denial of Workers' Compensation Claims

In a just world, employees injured at work while performing their job duties will receive the workers' compensation benefits they are entitled to with minimal pushback from the insurance companies. Sadly, we do not live in a just world. Many legitimate work injury claims are denied by workers' comp insurance providers, causing significant delays in medical treatment and undue financial hardship for injured workers. Below are the most common reasons insurance companies use to deny workers' compensation benefits:

1. You have a pre-existing condition: Insurance companies will claim that they are not responsible for your injury because you had a long-standing chronic condition. Having a pre-existing condition does not disqualify you from workers' compensation benefits even if you injure the exact same body part at work. Under the Illinois Workers' Compensation Act, if the work injury caused an aggravation or worsening of a pre-existing condition you are entitled to workers' compensation benefits.

2. No notice of accident to the employer:You have 45 days to report your work accident to your employer. Notice must be given to your supervisor or someone in a position of authority. Telling your co-worker about a work accident is not proper notice. Even though you have 45 days to report a work accident, it is in your best interest to report the accident to your supervisor immediately, no matter how minor you think the injury is.


Up in Smoke?

Posted on in Workers' Compensation

The effect of recreational marijuana on Illinois Workers' Compensation claims.

As of January 1, 2020, the consumption and sale of marijuana for nonmedicinal purposes became legal. Illinois was the 11th state in the nation to legalize the use of recreational marijuana. The law allows all Illinois adults aged 21 and older to possess up to 30 grams of the cannabis flower or up to 500 milligrams of THC for cannabis-infused products. In addition to the restrictions on the amount an individual can possess, there are clear restrictions on where you can consume it.Any person or business can prohibit the use of marijuana on private property.The use of recreational marijuana is also specifically prohibited:

  • In any public place, such as streets or parks;
  • In a motor vehicle;
  • On school grounds, with the exception of medical users;
  • Near someone under the age of 21; or
  • Near an on-duty school bus driver, police offer, firefighter, or corrections officer.

As stated above, employers can choose to maintain a "drug-free workplace" and restrict all their employees from marijuana (medicinal marijuana and/or recreational marijuana) use. As such, provided that it is applied in a nondiscriminatory manner, employers can require an employee to undergo a drug test following a work injury. If an employee tests positive for drug use or refuses to take the drug test following a work accident, there is a rebuttable presumption that the employee was intoxicated, and that the intoxication was the proximate cause of the injury.

Can I still pursue a workers' compensation claim with a positive drug test?


Most people take for granted the plight of the delivery worker. Especially when, observing the heavy snow or extreme cold, we make that easy phone call to the local pizza parlor so that we can have a nice comfortable and warm dinner at home safe from the treacherous conditions outside.

The people who deliver that pizza or our packages encounter some of the worst weather conditions, not only while driving, but also when bringing that package to the front door of homes or offices. Whether driving or walking, if you are injured when making a delivery, you could have a case for workers' compensation or personal injury.

Assuming your accident arose out of and in the course of your employment, you likely have a claim against your employer who is legally obligated to have workers' compensation insurance for that purpose. One of the many benefits of a workers' compensation claim is that you don't even need to show that your employer was negligent in causing your injury. If you were doing your job and the injury happened as a result thereof, you are likely covered. The easiest example in the context of the delivery business would be if you were injured in a car accident, regardless of who is at fault. Other examples would include injuries resulting from a slip and fall at a house or business.


What should you do if you have been injured on the job? You'll need to file a workers' compensation claim, and it's essential that you take the proper steps in order to be eligible. You should always discuss your case with an experienced Aurora workers' compensation attorney before making any decisions about your case. At Woodruff Johnson & Evans Law Offices, we have years of experience assisting injured employees with their Illinois workers' compensation claims and can speak with you about your options.

In the meantime, it's important to understand the requirements of a successful workers' compensation claim. We have some tips for you to consider closely.

Report Your Injury As Soon As Possible

Workers' compensation claims in Aurora are governed by the Illinois Workers' Compensation Act (820 ILCS 305/). Under Illinois law, employees who suffer injuries at work are required to notify their employers as soon as possible. The requirements for providing notice of the injury include:


Serious injuries can lead to permanent limitations that might not allow you to return to your former job. This is particularly true if you do heavy, strenuous work.

What happens if your injury prevents you from returning to the same kind of work? An employer has two choices. The first option is to provide you with a job that fits your restrictions. The second choice is created under Section 8(a) of the Illinois Workers' Compensation Act, which requires an employer to provide "treatment, instruction, and training necessary for [your] physical, mental, and vocational rehabilitation". Thus, if you have been in a work accident and now have permanent restrictions that your employer cannot accommodate, your employer is obligated to assist you while seeking work or provide job retraining.

Your weekly benefits will continue to be paid as long as you participate in the vocational rehabilitation process. The workers' compensationbenefits are called "maintenancebenefits" rather than "TTD" or "temporary total disability", but they are paid at the same rate as your TTD benefits. In addition to the assistance, instruction, and training you receive while engaged in vocational rehabilitation, you are also entitled to reimbursement for any incidental costs you incur. Such costs include printing and mailing resumes, faxing resumes, placing telephone calls to potential employers, and travel expenses for interviews. These costs can add up over time, so it is important to document and keep track of these expenses so that you do not miss out on any compensation to which you are entitled.

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