Workers’ compensation is an insurance program that almost all employers are required to have. This is a no-fault protection plan to provide workers who are injured on the job necessary compensation for the treatment and recovery of their injuries. However, sometimes employers or the employer’s insurance company denies work injury claims. As an employee in or around the Philadelphia area, it is important to know your rights.
Although injured workers do not need to prove who was responsible for their injuries, certain conditions must exist for a claim to be processed successfully:
- On the date of the accident, the employer carried workers’ compensation insurance
- An employee-employer relationship existed at the time of injury
- The employee’s injury arose out of the course of employment
- The employer received notice of the injury within the required time period per state workers’ compensation law
The above requirements may appear simplistic; however, problems often arise when employees fail to notify their employer of the injury on time, or the employer contests the nature of the injury.
My Employer Claims My Injury is Not Work-Related
An employer or insurance company may claim that an employee’s injury did not occur during the course of employment.
- The employee was not working when they were injured
- The injury occurred during the commute to or from work
- The injury was preexisting
My Claim Was Denied Due to the Type of Injury I Sustained
Although most states have similar rules when it comes to types of injuries covered, the Pennsylvania Workers’ Compensation Act specifically states that injuries that occurred due to illegal activity will not be covered. This includes injuries caused by intoxication or illegal drug use.
Workers’ compensation insurance also covers diseases and illnesses caused by exposure to toxic substances in the workplace. However, certain occupational illness must fall within strict guidelines for a claim to be valid.
For example, lung disease claims will not be valid unless the claimant suffered occupational exposure to a known toxin, such as silica, coal or asbestos for at least two years during the ten years prior to diagnosis of the disease.
My Employer Did Not Have Workers Comp Insurance on the Date of my Injury
Employers must carry workers’ compensation insurance for all employees regardless of their employment status. Therefore, nearly all workers are covered. Exceptions include those who are self-employed and those classified as independent contractors. Maritime workers and federal employees are covered for work injuries under separate laws.
In rare instances, an employer may fail to acquire the mandatory workers’ compensation coverage. This is illegal, but it does happen. Employees injured at work have guaranteed rights to collect compensation for their injuries and should speak to an attorney regarding their options.
How a Workers’ Compensation Lawyer Can Help
Employees whose workers’ compensation claim was initially denied should not give up. With the help of a skilled workers’ comp lawyer, denied applicants can appeal a denied claim. An attorney can help to gather the necessary evidence to prove a claim is valid, including:
- Witness statements
- Medical records
- Physician reports
- Expert medical testimony
Philadelphia Workers’ Compensation Lawyers at Freedman & Lorry, P.C. Protect the Rights of Injured Workers
If your workers’ compensation claim was denied or your payments have suddenly stopped, contact a Philadelphia workers’ compensation lawyer at Freedman & Lorry, P.C. Our attorneys have experience with workers’ compensation laws and procedure and can help you through the process of filing a claim or disputing a denied claim. For a free consultation, call 888-999-1962 or contact us online today. From our offices in Philadelphia, Cherry Hill, New Jersey, and Pinehurst, North Carolina, we provide experienced legal counsel to workers throughout the surrounding areas as well as in South Jersey and Pennsylvania.