• Home
  • Tag: Employee Rights

Why are Workers’ Compensation Claims Denied in Pennsylvania?

What is Workers’ Compensation?

Workers’ compensation is actually a type of insurance. Employers are required by Pennsylvania law to carry workers’ compensation insurance, often called workers’ comp. When employees are hurt on the job, they may incur medical expenses, miss work, or suffer long-term consequences. Employees who are injured or disabled in connection with their job are usually eligible to receive workers’ compensation benefits which may include recovering lost income, payment of medical bills and, in some cases, a lump sum settlement.

Workers’ Compensation in Pennsylvania

Each state has a slightly different plan. In our state, The Pennsylvania Workers’ Compensation Act requires most employers to compensate employees for lost income and medical expenses. If you’ve been hurt on the job, you may also qualify for potential lump sum settlements. Until 2011, small businesses were exempt from carrying workers’ compensation insurance. In 2011, a measure was signed that expanded the availability of workers’ compensation coverage to all types of small businesses, including sole proprietors, partners in partnerships, and members of limited liability corporations.

However, many workers’ compensation claims in Pennsylvania are denied. While not all denials can be successfully overturned, scheduling a free consultation with an attorney from Going and Plank may be your first step towards getting the compensation you deserve.

Why are Workers’ Compensation Claims Denied?

There are many reasons workers’ compensation claims are denied in Pennsylvania. Each case is different, and no one policy covers all situations. However, there are some circumstances that are especially problematic for employees and insurance companies. In these cases, insurance companies are more likely to deny your claim. An experienced workers’ compensation attorney can help you navigate complicated situations. Here’s a list of some of the common reasons workers’ comp claims are denied.

Denied Because of Lack of Witnesses

Without a witness, it’s easier for insurance companies to claim your accident never happened, or to claim it happened elsewhere. If you make a claim without the proof of an eyewitness, insurance companies will question your claim, and many such claims get denied. If you’ve been hurt at work, but no one saw your injury, Going and Plank may be able to build a case, especially if you told co-workers or supervisors about your injury when it happened, if there are witnesses who saw you before or after the accident, or if you left work that day to seek medical attention. Contact us for a free workers’ comp consultation.

Denied Because You Didn’t Report Your Injury Immediately

Sometimes employees get hurt at work and consider it a minor injury. You may put off reporting your injury until you realize it’s a larger issue. Whenever you experience any type of seemingly minor injury at work, such as a bumped head or a sore joint, report it immediately even if you feel it’s a minor mishap. Often small injuries develop into major medical issues, so cover your bases and report all incidents, big or small. Even if you waited to report your injury, you may still be entitled to workers’ comp. Contact us at Going and Plank for a free consultation.

Denied Because of Inconsistent Accounts

If your version of your injury if different from the accounts given by witnesses, co-workers, supervisors or medical professionals, your workers’ comp claim may be denied. If you feel others are deliberately misrepresenting your injury, or that you are being treated unfairly, contact us at Going and Plank to schedule a free consultation.

Workers-comp-compensation-File-claim-PA-Pennsylvania-Lawyer

Denied Because You Filed a Claim After You Were let go or Fired

Even small injuries at work can quickly escalate into bad situations. It’s important to report work injuries immediately. If you miss working for a few days after your injury to rest up, even if you take sick days, your employer may decide to fire you in the interim. In fact, some employers will fire you because you were hurt on the job, to avoid a claim. Insurance companies often think that if you waited to file a claim until after the termination, it’s an attempt at revenge. If this is your situation, contact us at Going and Plank to discuss your choices.

Denied Because a Medical Exam Detects Illegal Drug use in Your System

After a work-related accident, some employers require a test for illegal substances. Your workers’ comp claim can be denied if drug use led to an increased chance of an accident. However, certain exceptions may apply. Schedule a free consultation with a workers’ comp attorney to weigh your options.

Denied Because You Refuse to Issue a Recorded Statement

Employees may be asked to make a recorded statement for the insurance company, but you are not legally required to make this statement. Since recorded statements can be used against you, it’s smart to consult a workers’ comp lawyer at this point.

*****

When you retain Going and Plank to represent your interests, we will take the time to thoroughly analyze your claim in order to ensure that lost income is recovered, medical bills are paid, and a lump sum settlement is fully and expertly considered. Click here to schedule a free consultation. 

Click to Call