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How are disputes regarding Workers’ Compensation benefits resolved?

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Many disputes arise between the employer and employee during the course of a workers' compensation claim. For example, there may be disagreements about whether the work related injury is compensable, the nature and extent of injury, whether the injury is causally related to the accident, the type of medical treatment required, or the amount of benefits due.

The first avenue in resolving disputes is negotiation. Skilled negotiators can often arrive at a resolution without the need for a hearing. If the dispute cannot be resolved through negotiation, however, an arbitrator at the Illinois Workers' Compensation Commission will conduct a trial - pursuant to Illinois law and procedural rules set forth by the Commission - and issue a ruling within 60 days. The law also provides for an appeal process, one that can take the case as high as the Illinois Supreme Court.

In a case headed for arbitration, it's certain that the employer will retain legal counsel, if it has not done so already. In preparation for trial, among other things, it is necessary to obtain and carefully analyze all medical records, to conduct doctors' depositions, and to prepare witnesses to testify at the hearing. If you don't have an experienced and capable workers' compensation attorney on your side, you don't stand much of a chance against the insurance company who does.

The appeals process for work comp cases is complex, so it is important you work with a lawyer who is experienced. There are strict deadlines for making the appeal and failure to abide by those deadlines could compromise the validity of your claim or cause your claim to be dismissed and forever bar your opportunity to recover compensation for your work related injury. The levels for appeal are as follows:

  • Arbitrator appeal: An appeal that is an administrative action filed with the Commission for a hearing before an Arbitrator to appeal an insurance carrier's wrongfully denial of benefits or access to care.
  • Commission appeal: Appeals before a panel of three commissioners on the Illinois workers' comp board to appeal a decision of an Arbitrator.
  • Circuit Court appeal: An appeal handled in the county where the injury/workplace accident took place from a Illinois Workers' Compensation decision. The service requirements are different and the standard of review is higher in that you must show that the decision of the Illinois Workers' Compensation is against the manifest weight of the evidence.
  • Appellate Court appeal: Both parties have the right to appeal to the Illinois Worker's Compensation Commission Division of the Illinois Appellate Court. This process requires extensive briefing.
  • Illinois Supreme Court appeal: This is granted only with leave of the Court.

Nessler & Associates has experience at all levels of appeal, including arguing a workers' compensation case in before the Illinois Supreme Court. Our workers comp lawyers will use this experience to aggressively pursue your claim, whether at the arbitration level, or a higher level of appeal.  

To ensure you are receiving all the benefits you're entitled to, speak to one of the experienced workers' comp attorneys at The Law Offices of Frederick W. Nessler & Associates, LTD. Contact us online by pressing the button below, or call us at 217-698-0202, or toll free at 800-727-8010, for more information or to schedule a free consultation.