There are a few different deadlines when it comes to getting compensation for a work injury. One is that you are supposed to notify your employer within 45 days. Another is that you are supposed to file a claim within two years of your injury (or two years after last payment of benefits if you had been receiving them). And as we’ve said before, getting medical treatment right away is important if you want medical coverage.
Insurance companies can use any type of delay or missed deadline to deny your claim. They won’t necessarily win, but they will certainly try. They’ll say that you waited too long and therefore they don’t have to pay you lost wages or cover your medical bills.
Waiting also can cause a problem when it comes to proving the cause of an injury. The longer you wait, the harder it is to connect it to your job and prove that the injury was, in fact, caused by your employment. It opens the door for the insurer to say that because you waited, something else in the meantime could have caused the injury. Sometimes, a claim is rightfully denied. Other times, if you fight back you can get benefits. It all depends on the type of injury, how long you waited, why you waited and in some cases what you did while you were waiting.
In a recent case in Illinois, a worker was denied benefits for a shoulder injury because he waited for eight months after the date of injury to seek medical treatment. His job required him to do a lot of reaching overhead and one day he felt a pulling sensation and pain in his shoulder. It continued to worsen over the eight months and he eventually decided to make an appointment with a doctor. After trying physical therapy for a while, his doctor recommended surgery. The insurance company tried to fight it.
In this case, the arbitrator determined that it was clear that work caused the man’s shoulder injury, despite the delay in seeking treatment, and that he should be covered. It also seemed important to the arbitrators that the worker had taken care of himself during those eight months. He testified that he self-medicated and rested his arm. He also testified that he wasn’t aware that he had the right to seek medical treatment. In other words, the reasons for his delay were reasonable. And most importantly, it was still clear that work had caused the injury.
The bottom line is that you should not delay medical treatment, but if you do, don’t let the insurance company tell you you’re out of luck. If you can still prove that work caused your injury, you should be entitled to benefits.
We are workers' compensation attorneys who help people with Illinois work injuries anywhere in IL via our statewide network of attorneys. Contact us and we will answer your questions or find the right lawyer for your situation.