Thorndale Workers’ Compensation Lawyers

What Is Workers’ Compensation Insurance?

Workers’ compensation insurance provides financial benefits to employees suffering work-related injuries or illnesses. In Pennsylvania, most employers must carry workers’ compensation insurance.

Pennsylvania companies not carrying workers’ compensation insurance violate state and federal laws, prevent injured employees from receiving compensation, and risk fines and criminal prosecution for failure to protect employees.

How Do I File a Workers’ Compensation Claim?

Report the accident and any injuries to your supervisor, employer, or HR department. To process the claim quickly so injured employees can receive treatment, employers must take and submit an accident report to the company’s insurance carrier as soon as possible. Without an employer’s official accident report, any future claim for benefits and compensation will likely be denied. Nor will you be able to file if you do not seek medical evaluation and treatment for your injuries.

What Do Workers’ Compensation Benefits Cover?

Workers’ compensation benefits provide financial assistance for work-related injuries or illnesses, including:

• Medical expenses: Medical expenses directly related to your injuries are covered, such as emergency room visits, hospital stays, surgeries, doctor’s appointments, physical and rehabilitative therapy, prescription medications, and prosthetic devices, among others.
• Disability: Employees with injuries resulting in partial or total disabling conditions limiting the ability to work, such as paralysis, may be eligible for additional benefits, including ongoing wages, depending on the length of employment.
• Rehabilitative services: Workers’ compensation benefits may cover injuries requiring physical, occupational, or vocational therapy.
• Disfigurement: Cases of visible disfigurement or scarring caused by workplace injury may be covered under certain workers’ compensation policies.
• Lost wages: Workers’ compensation insurance provides a percentage of wages to those unable to work during recovery based on the salary before the injury.
• Death benefits: In accidents resulting in death, the surviving family dependents may be eligible for benefits, including lost wages and funeral expenses.

The actual length of time and amount of received workers’ compensation benefits varies, depending on the circumstances of employment, the accident, and the severity of injuries.

Can My Workers’ Compensation Claims Be Denied?

Workers’ compensation insurance companies can deny claims for several reasons, including:

• Accidents and injuries were not reported to management.
• Discrepancies between the injuries and accident report.
• Employer disputes the claim.
• Incomplete or incorrect paperwork.
• Injuries did not occur at work or are not work-related.
• Injuries are not severe enough for coverage.
• Injuries were caused by illegal drug or alcohol consumption.
• Injuries are self-inflicted.
• Medical treatment was not sought.
• Medical providers were outside the certified network.
• Missed filing deadlines.

If the insurance company denies your claim, they will inform you in writing and the reasons for the denial.

Can Denied Workers’ Compensation Claims Be Appealed?

Employees whose workers’ compensation benefits claims are denied can appeal the decision by submitting a written request for reconsideration. Additional evidence or information supporting the accident and injury claim must be included for the insurance company to reconsider.

If your claim is denied, hiring an experienced workers’ compensation lawyer with extensive knowledge of how the system and insurance companies work is critical and may be required. Working with a lawyer will guarantee that the appeal paperwork is accurate and thorough.

How Can a Thorndale Workers’ Compensation Lawyer Help Me?

Pennsylvania does not require workers to hire a lawyer to file a workers’ compensation claim, though representing yourself negatively impacts the outcome. Workers’ compensation law is complex, and claims for full benefits are challenging. You need a skilled and experienced lawyer on your side for the best possible outcome. Our experienced Thorndale workers’ compensation lawyers can do the following:

• Appeal denials.
• Communicate and negotiate with insurance company lawyers.
• Determine eligibility and type of appropriate settlements.
• Determine the actual cause of your accident.
• Document your medical case and whether you can return to work.
• File the initial claim.
• Handle third-party claims.
• Help modify benefits, if applicable.

At Wusinich, Sweeney & Ryan, LLC, our experienced Thorndale workers’ compensation lawyers are highly-skilled negotiators and litigators with a successful track record of obtaining full benefits for our clients.