What to Do if Your Workers’ Compensation Claim is Denied

Experiencing a debilitating injury at the workplace can be cause enough for severe stress. But when your workers’ compensation claim is denied, it can feel completely overwhelming. There are several reasons as to why your claim for benefits may have been denied. Fortunately, there you do have some recourse.

Common Reasons for a Denial of Workers’ Compensation Benefits

Though there exist numerous reasons, some of the most common reasons Workers’ Compensation claims are denied include:

Injury was not reported in time: Individual state laws determine the requirement for how soon after the injury occurs that you must report it to your supervisor. In Pennsylvania, you generally have 120 days. Failure to report an injury in a timely manner can also make it difficult to prove the injury was work-related.

Claim was not filed in time: State laws have deadlines for filing an initial claim. If you fail to file a claim within the required time, you may be barred from receiving benefits. The statute of limitations in Pennsylvania is three years from the date of injury.

Employer disputes the claim: Your employer may oppose the claim, arguing that the accident occurred outside of work, occurred due to unprofessional horseplay, or for some other disqualifying reason.

Injury is not compensable: Injuries that may have been caused due to employee misconduct are generally not compensable. Additionally, some injuries can be extremely difficult to prove. Having a seasoned work injury lawyer on your side can help.

Obtained no medical treatment: In most cases, you are required to seek medical treatment to be eligible workers’ compensation benefits.

Insufficient evidence to prove that the injury is work-related: It is not always simple to determine whether an injury in fact occurred at work. Additional medical exams and evidence such as witness testimony may serve to help you.

What You Can Do: Appealing a Denial

If your claim has been denied, you may wish to appeal the decision. It is important that you file your appeal within the deadline listed on your denial letter. This is determined by the state in which your claim is filed.

Prior to initiating an appeal, it is in your best interest to consult an experienced workers’ compensation lawyer to review the facts of your case. It may be that your claim was denied due to something as simple as a clerical error.

Though the process varies in each state, the first level of appeal in Pennsylvania involves a hearing before a Workers’ Compensation judge. During this hearing you will have to present medical evidence, possibly photographs of the workspace where the injury occurred, and any other information you have to support your claim. It is important to bear in mind that there are further levels of appeal beyond this and utilizing a Philadelphia workers’ compensation lawyer may be your best course of action to gain the compensation you need.

Philadelphia Workers’ Compensation Lawyers at Freedman & Lorry, P.C. Help Employees with Denied Claims

If you have been injured on the job and have unsuccessfully filed a claim for workers’ compensation benefits, we can help. The Philadelphia workers’ compensation lawyers at Freedman & Lorry, P.C. represent clients suffering from work-related injuries in Pennsylvania and beyond. For a free consultation, call 888-999-1962 or contact us online today. We have offices in Philadelphia, Cherry Hill, New Jersey, and Pinehurst, North Carolina to serve clients throughout the surrounding areas.