Denied Workers’ Compensation Claims
Our Bucks County Workers’ Compensation lawyers fight for injured workers facing denied claims. Workers’ Compensation is an insurance program that all employers are required to carry. This is a no-fault protection plan created to provide injured workers necessary compensation for the treatment and recovery of their injuries. Sometimes, employers or the employer’s insurance company denies work injury claims. As an employee, it is important to know your rights.
You Must Report Your Injury
You must report your injury as soon as possible. The most common concern among workers is that they will be fired for reporting an injury. It is illegal for your employer to fire you for reporting a workplace injury. If you believe you were wrongfully terminated, contact our office right away. However, most people can report a workplace injury without being terminated. Even if you are not fired, you may experience retaliation in the workplace that makes your job uncomfortable to perform. You must report any latent or subtle retaliation that you experience when you get back to work after reporting an injury.
What are My Eligibility Requirements?
Workers’ Compensation is no-fault insurance that should pay you regardless of how you were injured. However, certain conditions must exist for a claim to be processed successfully:
- The employer carried Workers’ Compensation insurance. If your employer did not carry insurance on the date of your injury, they are in violation of existing federal and state law.
- An employee-employer relationship existed at the time of the injury. Some employers claim that they have not established an employer-employee relationship because you were an independent contractor. You can prove that you were engaged to work with that company, and we will use all the communications you provide to show you are due coverage.
- The employee’s injury occurred while performing the duties of their employment. Your employer might claim that you were not performing your duties when you were injured. We will show that you were working when you were hurt. We also work with clients who were traveling on behalf of their employer when they were injured.
- The employer received notice of the injury within the required time period per the state Workers’ Compensation law. Problems often arise when employees fail to notify their employer of the injury or the employer contests the nature of the injury. If you did not report your injury within the allotted time, you cannot be compensated properly. However, you should note the date, time, and the supervisor you spoke with. If you do not have this information, your supervisor can claim you never reported the injury.
You must use these tips to report your accident properly, note your employer’s response and file a claim for damages, if necessary.
What is the Time Limit for Reporting My Injury?
In the Commonwealth of Pennsylvania, you must report a workplace injury within 21 days of the injury. You cannot receive wage loss benefits under your employer’s Workers’ Compensation insurance if you miss the 21-day window. If you surpass the 21-day limit for reporting your injury, you are eligible for wage loss benefits on the date you report the injury. If you wait over 120 days to report your injury, you are barred from receiving Workers’ Compensation benefits. Some workers feel uncomfortable reporting their injury, and you can ask us how to report the injury properly.
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. You may be surprised by this denial, but you must provide us with the denial letter. A common claim is that employees were not performing their job duties when they were injured. For example, you may have been driving from one location to another when you were injured in a car accident. If you were on the clock and performing your job duties, even if you were not physically in an office or facility, you should be able to receive Workers’ Compensation benefits.
Your insurance company may also claim that your injury was pre-existing, but you can show that you were not injured before the date that you reported the injury. We will work with your doctor to obtain the documentation you need showing that your injury was not pre-existing. You may also have re-aggravated an old injury; your doctor can speak on this matter.
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 or asbestos, for at least two years during the 10 years prior to diagnosis of the disease. We will use your timecards and paychecks to prove that you were exposed for the required amount of time. We will investigate the claim thoroughly, and we will use your personal accounts to show that your employer was negligent with your health.
Our Workers’ Compensation lawyers will work diligently to obtain the benefits you deserve for your injuries. We have an understanding of what employers and insurance companies will do to save money, and we understand how to counter those claims during a settlement or in open court.
My Employer Did Not Have Insurance on the Date of My Injury
Employers must carry Workers’ Compensation insurance. 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 mandatory 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.
Do Not Speak to the Insurance Company
Complaining to the insurance company is easy. You may accidentally make statements that will allow them to dent your coverage. You should let us do the talking for you. We will investigate the claim and create a statement that accurately reflects what happened when you were hurt. Providing contradictory statements to the insurance company allows them to deny you for several reasons.
How Will a Workers’ Compensation Lawyer Help?
Employees whose Workers’ Compensation claims were initially denied should not give up. With the help of a skilled lawyer, denied applicants can appeal. Our attorneys can gather the necessary evidence to prove a claim is valid, including:
- Witness statements: Relay everyone who was present for the injury. If you have the wherewithal at the time of the accident, you should take pictures and ask for witness statements from your co-workers.
- Medical records: Provide all medical records pertaining to your injury. Ask your doctor to create a treatment plan that shows how much your care will cost in the future, and we will use that information when calculating damages.
- Physician reports: We will request your doctor to send a letter stating what happened, how you were injured, and how this has personally affected you. We may also use this letter to show that you have been disabled or your earning potential has been limited.
- Expert medical testimony: We will call in medical experts when needed to explain how and why your injuries occurred. We will also show that your injuries have been far more debilitating than your employer wants to admit.
Bucks County 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 Bucks County Workers’ Compensation lawyer at Freedman & Lorry, P.C. Our attorneys have experience and can help you through the process of filing or disputing a denied claim. For a free consultation, call us at 888-999-1962 or contact us online today. From our offices in Philadelphia, Cherry Hill, New Jersey, and Pinehurst, North Carolina, we serve injured workers throughout Pennsylvania.