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Why would an employer dispute a worker’s claim for benefits?

On Behalf of | Nov 13, 2023 | Workers' Compensation |

On paper, workers’ compensation will cover the costs of your work-related injuries or occupational diseases. However, your employer won’t necessarily grant your request for benefits automatically.

Your employer will have various reasons why it thinks you’re not eligible for benefits. Understanding these reasons will help resolve a claim dispute, especially when you file with the Illinois Workers’ Compensation Commission (IWCC).

Commonly disputed issues

If your employer disputes your claim for benefits, chances are that it has an issue with one of the following:

  • Jurisdiction: Were you subject to Illinois’ workers’ compensation or occupational diseases laws on the date of your accident?
  • Employment: Were you officially an employee during the accident?
  • Course of employment: Were the accidental injuries or occupational diseases the result of an incident during your employment with the employer?
  • A clear line of cause: Is your medical condition the result of the alleged accident or exposure, or did the accident/exposure aggravate pre-existing conditions?
  • Notice: Was your employer notified of the accident or exposure event within the time limit?

You’ll have to prove that you meet all these requirements before the IWCC.

The burden of proof

If you take your disputed claim to the IWCC for a hearing, it’s essential to remember that the burden of proof lies on you, the employee. Your employer doesn’t need to disprove your claim, so you’ll have to make a strong case as to why you meet the above criteria.

Remember that if an employer doesn’t pay any benefits even after you’ve filed a claim, the IWCC won’t step in automatically to help. You’ll have to file a claim to request an administrative hearing. Also, keep in mind that certain occupational diseases, particularly those with symptoms that don’t manifest until years later, have different time limits. Having legal support on your side might be a good idea to avoid any confusion when filing claims.