Receiving a workers’ compensation denial notice can be confusing and even alarming. However, this does not always mean that it cannot be appealed.
Most Pennsylvania employers must carry worker’s compensation insurance, but there are exceptions, like when employees are independent contractors and certain agricultural workers. It is a no-fault system, so negligence does not need to be shown to be compensated if you qualify for coverage.
Specific guidelines must also be followed. The injury must be work-related. Once an accident occurs, it must be reported, and medical care sought. The employer files the forms, and the insurer has 21 days to decide.
If your workers’ compensation claim was denied, you may contact the Pennsylvania Bureau of Workers’ Compensation to file a claim petition. After submitting that, the Bureau will assign a judge to your case. Evidence will be required to support your case, which can be challenging for an injured employee. Below are examples of proof that can strengthen a claim:
- Eyewitness statements
- Photos and videos of the accident
- Photos and videos of the injuries
- Physician statements
- Your medical records
The employer or the company’s insurance provider will likely have an experienced lawyer representing them, so be aware that they may challenge your evidence. It is critical to have a lawyer; sometimes, it may be required.
Why Are Workers’ Compensation Claims Denied?
These claims are often rejected because the forms were not filled out correctly. There might be missing information or a missing document needed for processing. In other instances, there might be inaccurate details. Although the forms must be completed promptly, they should be filled out carefully without rushing.
Another reason for denial would be the worker’s inability to show that the injury or illness was valid or that it happened in the course or scope of their employment. If the worker acted recklessly or committed an illegal act that led to the injury, that would also be red-flagged.
Contact a West Chester Workers’ Compensation Lawyer at Wusinich, Sweeney & Ryan, LLC if Your Claim Was Denied
If an unexpected obstacle has gotten in the way of your workers’ compensation claim, you can fight to protect your rights by contacting a skilled West Chester workers’ compensation lawyer at Wusinich, Sweeney & Ryan, LLC. To schedule a free consultation, call us at 610-594-1600 or complete our online form. Located in Exton, Pennsylvania, we serve clients in Downingtown, West Chester, Exton, Coatesville, Phoenixville, Malvern, Lyndell, Wagontown, Uwchlan Township, Parkesburg, Chester Springs, Lancaster County, Reading, and Morgantown.