Denial of Workers’ Compensation Benefits
When you are injured on the job, you need compensation as quickly as possible to cover the cost of medical bills, lost wages, and other expenses associated with your injury. However, for a variety of reasons, your employer may initially deny your workers’ compensation claim, making an inconvenient situation even worse. The Philadelphia work injury lawyers at Larry Pitt & Associates, P.C. are here to help you obtain the workers’ compensation benefits you deserve, even if you were initially denied. Common reasons for denial include:
- Improper Reporting: In Pennsylvania, injured workers should report their injuries to their employer immediately but are required to do so within 120 days of the incident. During the first 21 days, workers may be eligible to receive temporary benefits while their claim is being investigated or their employer may decide to approve or deny their claim. Workers who fail to report their injury to their employer within the 120-day deadline may be ineligible to receive workers’ compensation benefits regardless of the merit of their underlying claim.
- Missing or Inaccurate Information: When reporting injuries to your employer, you should include details such as the date of the accident, where the accident occurred, how the accident happened, whether there were any witnesses, what type of injuries you sustained, and what medical diagnoses or opinions you received. If all required forms are not filled out completely and accurately by either you or your employer, your claim may be denied. Missing or inaccurate information is a common reason for denial. It is imperative to strictly follow all requirements when submitting a claim.
- Employer Disputes Claim: Workers are only entitled to workers’ compensation benefits for injuries that happen on the job. Your employer may question whether your injury occurred on the job or outside of work. They may also question the severity of the injury based on your doctor’s diagnosis. It is important to have a qualified doctor confirm that your injury is related to your job, that it is either temporarily or permanently disabling, and that it was not a preexisting condition aggravated by something other than your job duties. Workers who sustained injuries while engaged in illegal activity, such as using drugs, may also be denied benefits.
Appealing a Denial
Fortunately, you have the option to appeal if your claim is initially denied by your employer. You must file a Claim Petition with the Pennsylvania Workers’ Compensation Bureau within three years from the date of your injury. Your appeal will be decided by a workers’ compensation judge.
If that appeal is denied, you may then appeal to the Pennsylvania Workers’ Compensation Appeal Board within 20 calendar days from the date of the judge’s decision. This process can be complex, and it is imperative to follow all instructions. This includes attaching a copy of the workers’ compensation judge’s decision to the appeal, completing a proof of service page, and mailing the original along with two copies.
A knowledgeable workers’ compensation lawyer can help ensure that all your paperwork is properly completed and submitted on time, so you have the best chances of obtaining a reversal of your denial. We can also help you with further appeals if your first two are denied. If your claim is denied by both the workers’ compensation judge and the appeal board, you may then appeal to the Pennsylvania Commonwealth Court within 30 days of the appeal board’s decision. Most claims end there, but in rare situations, you may finally appeal to the Pennsylvania Supreme Court.
Philadelphia, PA Workers’ Compensation Lawyers at Larry Pitt & Associates, P.C. Assist Injured Workers in Appealing Denied Claims
If your claim for workers’ compensation benefits was denied, contact the Philadelphia workers’ compensation lawyers at Larry Pitt & Associates, P.C. We can help you compile the necessary medical paperwork and ensure that you are following filing deadlines and other requirements. For a free consultation, call us at 888-PITT-LAW or complete our online contact form.
We serve clients in Berks County, Bucks County, Chester County, Delaware County, Montgomery County, and Philadelphia County. Our team also provides skilled representation to those residing in and around Abington, Ambler, Ardmore, Bala Cynwyd, Bensalem, Clifton Heights, Crum Lynne, Darby, Downingtown, Doylestown, Drexel Hill, Essington, Folcroft, Glenolden, Haverford, Havertown, Holmes, Kutztown, Lansdowne, Media, Merion Station, Morton, Narberth, Norristown, Norwood, Philadelphia, Prospect Park, Quakertown, Reading, Roxborough, Sharon Hill, Upper Darby, West Chester, and Wynnewood.