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We Answer Questions About Denied Workers’ Comp Claims

Dennis-Plank-AttorneyBy Dennis L. Plank, Attorney

Denied workers’ compensation claims are common in Pennsylvania. Despite the commonwealth’s laws and regulations to protect workers’ rights, many employees face challenges when attempting to file claims for their entitled benefits, such as workers’ compensation or unemployment insurance.

These challenges can be frustrating and overwhelming, leaving workers with many questions about their options and rights. Fortunately, in many cases, workers are entitled to compensation for their injuries under the Pennsylvania Workers’ Compensation Act.

The definition of a work injury in Pennsylvania is broad and encompasses any injury, illness, or medical condition resulting from employment. These injuries and illnesses directly related to a worker’s employment qualify an employee for workers’ compensation.

Below, we’ve provided some common questions we receive from our clients to help you better understand the workers’ compensation process:

Is It Necessary to Visit a Doctor for Every Workplace Injury?

While not every injury may require a doctor’s visit, it is highly recommended that you seek medical attention for any injury that occurs in the workplace. A doctor will be able to properly evaluate the extent of the injury and identify any potential complications.

Visiting a doctor also creates a record of the injury that can be used to support your claim for workers’ compensation benefits.

If your employer has an approved list of doctors or medical facilities, you should seek treatment from one of these providers. Inform the healthcare provider that your injury occurred on the job, as this will ensure that your medical records reflect the cause of the injury.

How Should I Inform My Employer About My Work Injury?

It is crucial to report any work-related injury to your supervisor in writing immediately after the incident occurs. This will help ensure that your employer knows the situation and can take necessary steps to ensure your safety and well-being.

Reporting the injury in writing, such as through an email, text, or HR form, creates a better record of the incident. You can rely on this as evidence if you need to seek workers’ compensation later.

Also, you should report all injuries, no matter how minor they may seem. The symptoms could worsen over time, leading to more serious complications. Remember that failing to report an injury promptly can cause issues with your employer’s workers’ compensation insurance and make it more difficult to receive the benefits you are entitled to.


What Are My Rights When It Comes to Workers’ Compensation Benefits?

According to the law in PA, your employer must provide compensation for the duration of your injury or until you can return to work. However, employers may limit payouts in different ways. If you feel you are being mistreated, seek the help of an experienced workers’ compensation attorney who can guide you and protect your rights.

How Soon Can I Start Receiving Workers’ Compensation Benefits?

Your employer has twenty-one days to respond after reporting your work-related injury and filing a workers’ compensation claim. During this time, they will investigate the claim and determine whether it meets Pennsylvania’s workers’ compensation benefits criteria.

If your claim is approved, you will receive a Notice of Compensation Payable or a Notice of Temporary Compensation Payable. The amount and duration of benefits will depend on the severity of your injury and how long it takes to recover.

However, if your employer denies your claim, they will issue a Notice of Compensation Denial, which means you will not receive any benefits. In this case, seek legal advice from a workers’ compensation lawyer to appeal the decision and fight for the benefits you deserve.

What Is a Utilization Review (UR), and What Should I Do If I Receive One?

Employers in Pennsylvania must file a Utilization Review (UR) if they want to challenge the payment of workers’ medical expense compensation benefits. If you receive a UR, your employer has attempted to curtail or avoid paying these benefits.

Always share a copy of your UR with a workers’ compensation lawyer immediately to ensure your rights are protected and to receive guidance on how to proceed.


What Is an Independent Medical Examination (IME), and Do I Need to Attend One?

If you have filed a workers’ compensation claim in Pennsylvania, your employer may require you to undergo an Independent Medical Examination (IME) by a doctor of their choosing. The purpose of an IME is to evaluate the extent of your work-related injury and determine if it still exists or has decreased in severity.

IMEs are typically requested up to twice a year, and your employer may use the results to challenge your claim or adjust your benefits. As an injured employee, you’re mandated to attend an IME. However, you first need to understand your rights and seek the guidance of a workers’ compensation attorney beforehand.

How Can I Afford a Workers’ Comp Attorney If My Claim Is Denied?

Many employees seeking denied comp benefits have concerns about the cost of hiring a workers’ compensation attorney. In PA, most lawyers charge contingency fees. This means that the attorney only gets paid if you win your case.

We follow the contingency model at Going and Plank. If we win your case, the attorney handling your case receives a percentage of your workers’ comp benefits or settlement. If we lose, there is no fee.

What Do Petitions to Terminate, Modify, or Suspend My Benefits Mean?

An employer or its insurance company that wants to deny or change your workers’ compensation claim may file a petition to terminate, modify, or suspend your benefits. These petitions indicate that you could lose your benefits or see them reduced. If you receive such a petition, seeking legal assistance from a workers’ comp attorney is crucial.

Is It Possible for My Employee to Fire Me If I Make A Workers’ Compensation Claim?

When filing a workers’ compensation claim, one of the most significant concerns is whether your employer can fire you. While there’s no legal obligation for an employer to keep your job open until you’re fully recovered, they cannot fire you solely for filing a workers’ comp claim.

Retaliation for filing a claim is illegal. If you feel your employer is hitting back against you, you should speak with an employee rights attorney to help protect your rights.

What Can I do If an Employer Denies My Workers’ Compensation Claims

Getting injured on the job can be a challenging experience, but it becomes even more complicated if your employer denies your workers’ compensation claim. Pennsylvania’s workers’ compensation insurance firms have lawyers who aim to minimize payouts.

This means that injured employees are at a disadvantage if they don’t hire a lawyer. Hiring an experienced workers’ compensation attorney can make all the difference in effectively defending your rights and getting the compensation you deserve.

Schedule a Free Consultation

If you’ve been denied workers’ compensation benefits, don’t hesitate to contact the experienced attorneys at Going and Plank. Contact us to schedule a free consultation to review your case, and get guidance on how to proceed, so you can get the compensation you deserve.

Want to learn more about denied workers’ comp claims in Lancaster County, Pennsylvania? Check out these articles.

Why Lancaster County Employers Deny Workers’ Comp Claims

Why Insurance Companies Deny Workers’ Comp Claims

Five Ways to Ensure a Workers’ Compensation Claim is Approved

We Answer Questions About Denied Workers’ Comp Claims in Pennsylvania


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