Of all the things true about Illinois work injury law, the truest is that no matter how nice the insurance company is acting or how obvious your case is, if the insurance company can come up with any reason to deny your benefits, they will.
And when I say any reason, it’s often a ridiculous reason that they know they will likely lose at trial, but they do so in order to frustrate you or hope you’ll drop the case.
In a recent claim, a UPS worker fractured her leg when while driving a work vehicle, the vehicle tipped over. This was a part of her job duties and her supervisor approved of her driving. She wasn’t driving in a reckless manner, the accident happened when the steering wheel locked up on her. She wasn’t driving with the proper certification to operate this vehicle, but had received training in how to operate it and had been previously certified. He license expired the year before the accident and she didn’t renew it.
So as you can guess, the insurance company denied the case because she violated a safety rule. Specifically she was driving with an expired certificate.
This is a nonsense denial and the Arbitrator of course found in her favor. Was she violating a safety rule? Technically yes, but her supervisor was aware of it and it was common practice at their facility. It’s not as if she was told not to drive or had been disciplined for operating the vehicle without a current certificate to do so.
It would be different if she was joy riding or purposely acting reckless. That clearly did not happen. What did happen is that this worker got a serious injury and it was made worse due to the stress of having her claim unreasonably denied.
If your case is denied for violating a safety rule, ask yourself the following:
1. Was the work you were doing when hurt for the benefit of your employer?
2. Were they aware of what you were doing?
If you answer yes to one of these and certainly to both then you likely have a good case. Don’t get frustrated by the form letter you get in the mail that says your case is denied.
Bonus tip, cases often get denied because the worker does something that isn’t what they normally do. In other words, if your job is to answer the phones, but you hop in a golf cart to deliver some mail because you are trying to help out, if you crash you should have a case. The Illinois Workers’ Compensation Commission typically doesn’t punish people who get hurt while trying to help out.