Questions About Denied Workers’ Compensation Claims I Going and Plank

By Dennis L. Plank, Attorney

When workers are hurt on the job, they are often entitled to Workers’ Compensation. The Pennsylvania Workers’ Compensation Act defines a work injury as any injury, medical condition, or disease that is caused by a person’s employment, but it doesn’t list specific types of injuries. If the injury or resulting illness is directly related to the worker’s employment, that employee may qualify for workers’ compensation.

However, some aspects of workers’ compensation can be confusing. And when someone is denied workers’ comp, it can be difficult to discern if the denial is justified.

At Going and Plank, we’re experts in helping clients fight denied claims. We even offer free consultations to discuss your case. We’ve listed some of the more common questions asked by our clients.

How do I tell my employer that I was hurt on the job?

First, report any work injury to your supervisor in writing, such as in an email, text, or form filed with HR. Report your injury even if it appears to be minor or if you think it won’t require medical care. Sometimes small injuries can lead to more significant issues or come back after they seem to be healed. If you have a record of your complaint, you are better equipped to seek workers’ compensation if it eventually becomes necessary.

Do I have to see a doctor for every injury?

It’s wise to see a doctor, even if the injury appears to be minor. A doctor will not only provide a record of your condition, but they will also be able to spot potential issues and help you proactively manage any complications.

How quickly can I start receiving workers’ comp benefits?

Your PA employer and their insurance company have twenty-one days to respond. After twenty-one days, they can approve the claim and issue a Notice of Compensation Payable or Notice of Temporary Compensation Payable.

Alternately, your employer may deny the claim and issue a Notice of Compensation Denial. If you feel that you were denied benefits unfairly, call a workers’ comp lawyer immediately.

How long do workers’ compensation benefits last?

Under the law, the employer must provide compensation for the duration of the injury or until the employee is ready to go back to work. However, many Pennsylvania employers will try to limit the payout in a variety of ways. If you feel you are being mistreated, consult an attorney.

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What is a Utilization Review (UR)?

PA employers must file a Utilization Review (UR) when they want to challenge the payment of workers’ medical expense compensation benefits. If you receive a UR, your employer is attempting to curtail or avoid paying these benefits. Share a copy of your UR with a worker’s comp lawyer immediately to protect your rights.

What if I can’t afford a workers’ comp attorney to fight a denied claim?

Many workers’ comp attorneys charge contingency fees. Going and Plank follows this model. If we win your case, your attorney receives a percentage of your workers’ comp benefits or settlement. If we lose, there’s no fee.

What is an IME?

The Pennsylvania Workers’ Compensation Act states that an employer may require an examination by a doctor of their choosing. This Independent Medical Examination, or IME, is usually performed to determine if a work-related injury continues to exist or if it has decreased in severity. IMEs are typically requested up to twice a year. While IMEs are often mandated, it’s wise to talk to an attorney before attending a mandated doctor’s appointment to ensure your rights are protected.

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What do I do if my employer denies my claim?

Workers’ compensation insurance firms have lawyers who are charged with minimizing the number of payouts. That means that an injured employee is at a true disadvantage if they do not retain a lawyer. Experienced workers’ comp attorneys know the law and can effectively defend employee rights.

What is a petition to terminate, modify, or suspend my benefits?

These petitions serve as notice that your employer or its insurance company is attempting to deny or change the status of your workers’ compensation claim. If you receive a petition to terminate, modify, or suspend benefits, contact a workers’ comp attorney immediately. Going and Plank offers free consultations for Pennsylvania workers who have received such petitions.

Can my employer fire me if I make a workers’ compensation claim?

Pennsylvania is an employment-at-will state, so most employers are not legally obligated to keep your job open until you are well enough to return to work. But a Lancaster County employer cannot legally fire you solely because you made a workers’ comp claim. Retaliation related to a workers’ compensation claim is illegal. An employee’s rights attorney may be able to help if you feel you are being fired in retaliation for filing a workers’ compensation claim.