Can Lancaster County Employers Legally Deny Workers’ Comp Claims?

Can Lancaster County Employers Legally Deny Workers’ Comp Claims?

Dennis Plank Bankruptcy AttorneyBy Dennis L. Plank, Attorney

On-the-job injuries can cause more than just physical trauma. Depending on the severity of the injury, employees may also have the trauma of mounting medical bills and lost wages, especially if they are unable to return to work.

Lancaster County employees who sustain injuries at work have recourse thanks to the Pennsylvania Workers’ Compensation Act, established in 1915 to compensate workers injured on the job, regardless of fault. As part of the law, most employers in Pennsylvania must provide workers’ compensation insurance coverage for their employees. However, insurance companies want to protect an employer’s rights and their own financial interests.

Can Lancaster County employers legally deny workers’ compensation claims? In short, the answer is yes. The filing process is complicated, with many pitfalls that make it easy for insurance companies to deny a claim.

The good news? Even when insurers deny claims, employees can often appeal successfully with the help of an experienced workers’ compensation attorney. The best course of action is to avoid those pitfalls that can lead to a denied claim in the first place. When employees get injured on the job, they should take these important steps to improve their chances for a successful workers’ comp claim and receive the maximum benefits in Pennsylvania:

Report a Work-Related Injury Promptly

Pennsylvania law requires an employee to report a work-related injury within 120 days of the date of injury to receive workers’ compensation benefits. In the case of injuries that may occur over time, such as arthritis or lung disease, an employee must report the injury within 120 days of the date a doctor diagnoses the condition and connects it to the patient’s employment. Failure to meet the reporting deadline could result in a denied claim.

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For the best chance to receive the maximum compensation for medical bills and lost wages, report any work-related injury in writing to an employer as soon as possible. Include a description of the injury, along with details of when and where the incident that resulted in the injury occurred. Don’t forget to retain a personal copy of the report.

See a Doctor as Soon as Possible

Pennsylvania law requires workers to seek treatment from an employer-approved physician within 90 days of an injury. Getting an immediate medical evaluation is important for several reasons. First, receiving prompt and proper treatment improves the chances of a successful recovery. Second, it is crucial that a physician verifies and thoroughly documents any work-related injuries as soon as possible. They should also note any physical limitations and work restrictions the employee may have as a result of those injuries.

If the employee delays seeing a doctor, the insurance company may try to argue that the injury is not that serious, that it isn’t related to the job, or that it never even occurred. Filing a claim without a medical evaluation verifying the injury and its cause will likely result in denial.

Report any Injury, Even if it Seems Minor

It might be tempting to ignore a little bump on the head or a twinge in the back after a work-related incident, but seemingly minor injuries can develop into more serious problems. Failure to report those injuries up front could make it harder to claim them in the future. Be sure to have a doctor evaluate all potential injuries following a workplace incident, not just the obvious ones. Now is not the time to tough out the pain in silence. It could end up being a costly mistake, both physically and financially.

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Document any Witnesses to a Work-Related Injury

Insurance companies may deny a workers’ comp claim if there are no witnesses to the accident. In such cases, employees should also document any co-workers or supervisors they may have seen or spoken to before or after the injury, as well as whether they left work to receive medical attention.

Be Thorough When Filing Workers’ Compensation Paperwork

Correctly filing a workers’ comp claim requires significant paperwork and lots of detailed recordkeeping and documentation. It is easy to make mistakes or inadvertently fail to submit a piece of information. Insurance companies often find those reasons in simple paperwork errors.

Hire an Experienced Lancaster County Attorney

Insurance companies will find many reasons to deny a workers’ compensation claim. It could be something as simple as a missed deadline. Or they could claim the injury occurred outside work hours or that it was connected to a pre-existing condition. If a terminated employee files a workers’ comp claim after leaving the company, an insurance firm could issue a denial, claiming the filing is unfounded or based on revenge. In all of these cases, an experienced workers’ compensation attorney can help. They can navigate complicated paperwork and deadlines, secure evidence, and document testimony to file an initial claim or to appeal a denied claim.

The Law Offices of Going and Plank in downtown Lancaster can help Lancaster County employees navigate the complicated workers’ compensation process, appeal denied claims, and secure the maximum benefits they deserve. Contact us today for a free consultation to ensure fair and legal treatment, and to review options for the best possible settlement.



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