By Dennis L. Plank, Attorney.
Workplace injuries can significantly impact an individual’s physical and financial life. In addition to the pain and suffering, injured employees may also face lost wages and expensive medical bills.
In Lancaster County, workers hurt on the job are eligible for compensation under the Pennsylvania Workers’ Compensation Act. However, some employers may deny these benefits, intentionally or unintentionally.
Under PA law, employers are required to carry insurance that covers medical bills and lost wages. The law also stipulates that in certain situations, employers can legally deny claims.
However, many employees find filing a claim complex, intimidating, and tedious. To make matters worse, some employers take advantage of a few mistakes to deny valid claims.
If your claim is denied, it’s important to understand your rights under the Workers’ Compensation Act and to work with an experienced workers’ compensation attorney to recover your benefits.
In this article, we’ll delve into some common reasons workers’ compensation claims are denied in Lancaster County and how an experienced attorney for Going and Plank Law offices can help appeal denied claims.
Many employers deny comp claims because employees miss their filing deadline. Under Pennsylvania law, staff must report job-related injuries or illnesses to their place of work within 120 days to be eligible for maximum compensation for medical expenses and lost wages.
The employee must properly submit a claim, in the form of a written report, detailing the injury, when it occurred, where it happened, and why injuries prevent them from returning to work. One copy remains for the employee’s records, and one is for the employer.
Claims submitted outside the required deadline will not be considered for compensation by many employers. However, there are exceptions to this, even if a filer misses the deadline. For example, exceptions can be made if the employer knew about the injury. Other exceptions may exist if the employee could not notify the employer due to incapacity or if the employer did not clearly state the workers’ compensation rules.
Reporting the injury as early as possible offers the best chance for an approved claim. However, exceptions exist, and a workers’ compensation attorney can help assess the viability of contesting a claim.
Errors in Paperwork or the Filing Process
Workers’ compensation claims in Lancaster County require significant documentation. Unfortunately, it’s easy to make mistakes during the filing process, and that can lead to a claim being denied.
Employees must provide a long list of information and documentation when they file a workers’ compensation claim. However, the employer may deny the claim if there are errors in the paperwork. For example, if the employee doesn’t provide the correct date of injury, the employer may deny the claim.
Lack of Witnesses to the Injury
Most workers’ compensation insurance companies rely on eyewitness accounts to approve claims. For a claim to be approved, staff must be able to prove that the injury or illness is related to their job.
If there are no eyewitnesses to the incident, the company may deny the claim for workers’ compensation. However, an attorney may still be able to appeal the denial by presenting evidence, such as the injured person telling a colleague or supervisor about the incident or accident.
Claim Denied After an Employee Leaves the Company
An employee’s compensation claim may be denied if filed after leaving the company. Once the employee is away from the job, it’s easier for employers to argue that the filing is unfounded or was made as a retaliation.
However, employees who have had their claim denied after termination can still argue their case. They can seek the help of a workers’ compensation attorney to gather evidence and coworker accounts to support their claim. It’s worth noting that employees who quit may not be eligible for benefits covering lost wages since they voluntarily gave up their wages.
It is also illegal to terminate an employee for reporting a workplace injury. Employees who believe they were fired for reporting an injury should immediately contact a workers’ compensation lawyer.
Doctor Cannot Classify Injuries as Work Related
All workers in Pennsylvania are required under the workers’ compensation law to receive treatment for their work-related injuries within ninety days from physicians approved by their employer. This is to help the insurance providers know the exact cause of the injury and act accordingly.
The insurance provider may decline a claim if the doctor reports that the injury occurred outside of the workplace or was caused by a pre-existing condition. However, some injuries that occur outside of the work environment can still qualify for compensation benefits. For instance, if an employee sustains an injury while traveling to a remote job site, traveling for work-related purposes, or making deliveries for their company, they may qualify for workers’ comp.
Employees with pre-existing conditions are also eligible for compensation if their work-related activities result in a new injury. It is crucial to have a lawyer to guide employees through the complex laws of workers’ compensation in Lancaster County to ensure they receive the benefits to which they are entitled.
Hire an Attorney
Don’t let your workers’ comp claim be denied in Lancaster County. If you’re struggling to navigate the legal process and don’t know where to turn, The Law Offices of Going and Plank in downtown Lancaster can help.
Our experienced attorneys will guide you through every step of the process, from meeting deadlines to securing evidence and documenting testimonies. Trust us to fight for the maximum benefits you deserve. Contact us today to schedule a consultation.
Want to learn more about denied workers’ comp claims in Lancaster County, Pennsylvania? Check out these articles.
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
Can Lancaster County Employers Legally Deny Workers’ Comp Claims?