Common Causes for Workers’ Compensation Denials

Philadelphia workers’ compensation lawyers weigh in on common causes for workers’ compensation denialWhen you get hurt on the job, you may be concerned whether your injury is covered by workers’ compensation. Workers’ compensation insurance does cover workplace injuries regardless of who is at fault for the injury. However, there are some circumstances where a work injury claim may be denied. Hiring an experienced workers’ compensation lawyer can help ensure you receive the benefits to which you are entitled.

Workers’ Compensation Process

After sustaining an injury on the job, it is important that you report the injury to your employer as soon as possible. After reporting the injury, your employer will provide you with the necessary paperwork. Your employer will then submit the paperwork to their workers’ compensation insurance carrier. The injured employees’ doctor will also need to submit medical documents. After the insurance provider receives all the documents, they will either approve your claim or deny it.

Why Would my Workers’ Compensation Claim be Denied?

If you receive a letter informing you that your workers’ compensation claim was denied, it may be for a few different reasons including:

  • Your injury was not reported on time. The deadline for reporting your injury to your employer differs from state to state. Generally, it is best to report your injury as soon as possible.
  • Your claim was not filed on time. Filing guidelines vary by state.
  • Your employer disputes the seriousness of your injuries.
  • You do not have enough evidence to prove that your injury happened at work.
  • You failed to receive medical treatment.
  • You were under the influence of illegal drugs or alcohol at the time of your accident.

What Workers’ Compensation Will Not Cover

Workers’ compensation insurance typically will not cover:

  • Self-inflicted injuries
  • Injuries sustained outside of work
  • Injuries that resulted from horseplay or fighting
  • Injuries that resulted while violating company policies or while committing a crime

What Can I Do if my Claim was Denied?

If your claim was denied, you have a right to appeal it. Information for filing an appeal should be contained on your letter of denial. Before filing an appeal, you will want to consult an experienced workers’ compensation lawyer.

The process of filing an appeal can be long and complex. It may also differ from state to state. You should expect to have a hearing before an administrative law judge. This hearing may be held either through the labor department or states’ workers’ compensation board. Be sure to bring important documents that pertain to your injury.

What if my Employer Does Not Follow the Workers’ Compensation Process?

Your employer may receive a fine for not supplying the injured employee the proper paperwork; failing to file the claim on time; appealing a claim without probable cause; and for not carrying workers’ compensation insurance at all.

Bucks County Workers’ Compensation Lawyers at Freedman & Lorry, P.C. Successfully Handle Workers’ Compensation Appeals

If you were injured on the job and are planning to file a workers’ compensation claim, you need a lawyer who can get you the compensation you deserve for your injuries. Contact a Bucks County workers’ compensation lawyer at Freedman & Lorry, P.C. Our experienced lawyers will fight hard for your rights. For a free consultation, contact us online or call us at 888-999-1962. With offices in Philadelphia, Cherry Hill, New Jersey, and Pinehurst, North Carolina, we represent clients throughout Pennsylvania and South Jersey.