Workers' comp claim denied in Illinois: what to do next

Contact your employer or its insurer to find out why benefits are not being paid. If they still do not pay, file an Application for Adjustment of Claim with the Commission in CompFile.

Your employer's insurer, not the state, usually decides first. If they deny or delay, the free help listed here can explain your options.

Checked against official sources: October 31, 2026.

Deadlines are strict. If you are near one, call the state agency or free help today.

If your claim is denied or delayed in Illinois

Who decides: Illinois Workers' Compensation Commission: an arbitrator decides first; a panel of three commissioners reviews on appeal
First step: Contact your employer or its insurer to find out why benefits are not being paid. If they still do not pay, file an Application for Adjustment of Claim with the Commission in CompFile. The Commission assigns a case number and an arbitrator. Commission staff explain procedures but cannot give legal advice.
Form: Application for Adjustment of Claim (IC01), filed in CompFile
Deadline: There is no separate deadline to contest a denial: the Application for Adjustment of Claim must be filed within 3 years after the accident, or 2 years after the last payment of compensation, whichever is later. To appeal an arbitrator's decision, file a Petition for Review within 30 days after you receive the decision.
Medical disagreements: The employer may have you examined by a doctor of its choice and may use utilization review of your treatment; the arbitrator weighs this with all other evidence in deciding whether treatment was reasonably necessary. A denial after utilization review can be appealed, and the appeal must be reviewed by a physician when a physician recommended the care. If the employer uses its own doctor's exam instead of utilization review to question proposed treatment, that report must go to you and your treating provider within 90 days. You can refuse or limit involvement by employer-hired nurse case managers. If you believe your doctor's care is improper or inadequate, you can petition the Commission.
: Petition for an Immediate Hearing under Sec. 19(b) (IC07)
Petition for Immediate Hearing under Sec. 19(b-1) (IC14a)
Appealing the decision: Petition for Review (IC11) to the Commission within 30 days after receiving the arbitrator's decision; the Commission's decision can be reviewed by the circuit court, then the Appellate Court and in some cases the Illinois Supreme Court. Decisions in cases of State of Illinois employees are final at the Commission.

File an Application for Adjustment of Claim (IC01) in CompFile. A case number and arbitrator are assigned.
The case is set on the arbitrator's status call every three months. Either side can ask for a trial at the status call; it is up to the parties to move the case forward.
If you are off work and not receiving TTD or medical benefits, you can ask for a faster emergency hearing by petition under Section 19(b) or 19(b-1).
The arbitrator holds a trial and issues a written decision within 60 days.
Either side can appeal to the Commission (a panel of three commissioners) with a Petition for Review, then to the circuit court.

Law: 820 ILCS 305/8.7, 305/12, 305/19(a)-(f)

Source: iwcc.illinois.gov

Sources

The official sources for Illinois are listed on the Illinois page.

National rules that may also matter

Not covered by state workers' comp?

These federal programs and laws cover some groups of workers instead of, or in addition to, state workers' compensation. If one of them may apply to you, check its rules and deadlines too. They are different from your state's.

Federal Employees' Compensation Act (FECA): Civilian employees of the federal government, including Postal Service employees. Official page

Longshore and Harbor Workers' Compensation Act (Longshore Act): Maritime workers such as longshore workers, harbor workers, ship repairers, shipbuilders and ship-breakers, hurt on navigable waters of the United States or on an adjoining pier, wharf, dry dock, terminal or other area used to load, unload, repair or build ships. Some groups are excluded. Official page
Longshore maximum and minimum for October 1, 2026 to September 30, 2027 (fiscal year 2027): maximum $2,163.92 a week, minimum $540.98 a week.

Law: 33 U.S.C. 906(b); DOL Longshore NAWW table

Defense Base Act: Civilian employees working outside the United States on U.S. military bases or under a contract with the U.S. government for public works or national defense. Claims are handled by the Longshore program. Official page

Federal Black Lung Program: Coal miners who are totally disabled by black lung disease (pneumoconiosis) from coal mine work, and survivors of miners whose deaths were caused by it. Official page

Energy Employees Occupational Illness Compensation Program: Current or former employees of the U.S. Department of Energy and its contractors and subcontractors, and certain uranium miners, millers and ore transporters, who became ill from toxic exposures such as radiation, beryllium or silica at covered work sites, and their survivors. The program is set up by the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). Official page

Railroad workers (Federal Employers' Liability Act): Employees of railroads in interstate commerce. Instead of a workers' compensation claim, a federal law lets an injured railroad worker sue the railroad for damages caused by its negligence.

Seamen (Jones Act): A seaman injured in the course of employment may bring a lawsuit against the employer, with the right to a jury trial, under the same federal rules that apply to railroad workers.

National help

Your state workers' compensation agency answers questions about claims. Many have a free help line, an ombudsman or information officers for injured workers.

The Legal Services Corporation funds 129 nonprofit legal aid organizations in every state, D.C. and the territories. Enter your address on its website to find one near you. You can also look up legal information and free forms at LawHelp.org. Whether a local program handles workers' compensation cases varies.

LawHelp.org