Workers often assume their claim for workers’ compensation benefits for a job injury or illness is a given. Unfortunately, that is not always the case. Your employer’s workers’ compensation insurance provider wants to pay as little as possible. Any error in your application or any reason to believe your accident did not happen as you describe is cause for a denial.
Why Workers’ Compensation Claims are Denied
Workers’ compensation claims are denied for a variety of reasons, including:
- The claim contained incorrect information
- Claim was filed after the deadline
- Questions concerning if the injury occurred at work
- The injury or illness is not covered under state workers’ compensation guidelines
- The employee filed their claim after termination or they quit
- The worker did not seek medical treatment for the work injury or illness
It is important to report your work accident and injuries to your employer as soon as possible, seek medical care for your condition, and file your claim in a timely manner.
What to Do After Receiving a Denied Claim
Injured workers depend on benefits to pay their medical bills and supplement their lost income when an injury keeps them from working. Therefore, it is understandably frustrating to file a claim only to receive a notice that it was denied. Yet, a denial letter is not a reason to give up on your claim since you can appeal the decision.
Before entering the appeals process, you should know it can take a great deal of time, multiple levels of appeals, and a hearing before an administrative law judge to receive a final decision on your claim. With the guidance of an experienced Downingtown workers’ compensation lawyer, there is a chance your appeal can be successful. With the assistance of your attorney, file your appeal with the deadline noted on your denial letter. Next, wait for a hearing date. To support your claim, bring your medical records, accident reports, and medical diagnoses to your hearing. Based on this hearing, you may have to continue with additional levels of appeals until you receive a final determination on your workers’ compensation claim.
Downingtown Workers’ Compensation Lawyers at Wusinich & Sweeney, LLC Help Clients Appeal Denied Claims
A denied claim is unfortunate, but not a reason to give up seeking the benefits you deserve under Pennsylvania’s workers’ compensation system. Because you may be going up against your employer’s insurance company and their lawyer, you need the skilled representation of an experienced Downingtown workers’ compensation lawyer at Wusinich & Sweeney, LLC. To get started, call us at 610-594-1600 or contact us online to schedule a free consultation. Located in Exton, Pennsylvania, we serve clients throughout Downingtown, West Chester, Exton, Coatesville, Phoenixville, Malvern, Lyndell, Wagontown, Uwchlan Township, Parkesburg, Chester Springs, Lancaster County, Reading and Morgantown.