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How an appeal of a workers' compensation claim works

Previous post have discussed how the idea behind Illinois' workers' compensation system is to make sure Illinois workers get the financial help they need after an injury and do so quickly.

Unfortunately, though, there are many situations in which a claim for benefits may be denied outright or, as is more common, may be in dispute because the worker feels he or she is entitled to more than what the employer or the employer's insurance company is willing to pay.

When this happens, a worker has the right to appeal directly to the Illinois Workers' Compensation Commission by submitting a claim. The Commission will assign the case to a hearing officer called an arbitrator who, if unable to facilitate an agreement, will make a decision on the matter.

The worker can then appeal that decision, within a certain timeframe, to the Commission for a further hearing by three Commissioners. If he or she is not an employee of the state and still does not like the decision, then he or she can file a request for further review in a local court and continue to appeal, even all the way up to the Illinois Supreme Court.

It is important to remember, however, that very few disputed cases actually get in to the court system at all, and all the fewer actually get reviewed by the Illinois Supreme Court. By the time a case does make it in to the courts, the courts are going to be likely to assume, at least to a certain extent, that the decisions reached by the arbitrator and Commission are correct.

Although workers have an ample opportunity to appeal an unfavorable workers' compensation decision, doing so can be tricky on a practical level, especially since there a lot of deadlines and other special rules one is expected to know and follow when appealing a case. This is why it is usually a good idea to have the help of an experienced workers' compensation attorney when pursuing an appeal.

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