As an employee, you’re given rights under the Pennsylvania Workers’ Compensation Act to collect benefits if you suffer a job-related injury or illness. However, even if you take the time to submit a claim, there’s a chance you could be denied compensation. Employers and insurance companies frequently refuse to pay out workers’ compensation benefits for a variety of reasons. Understanding some of the grounds for refusing claims can help you avoid receiving a denial letter. Here are three of the most common reasons claims don’t get approved.
Common Reasons Workers’ Compensation Benefits Are Denied
1. Employer Questions the Claim
If your employer has any doubts about the validity of your injury or disputes that it’s work-related, you may be denied benefits. They might say you weren’t performing your job duties at the time of the incident or that your injury is fabricated or exaggerated, therefore making you ineligible to receive compensation. Remember that it’s your responsibility to prove that your injury is severe enough to require workers’ compensation coverage.
2. The Injury Wasn’t Properly Reported
Most states require employees to notify their employer of a workplace injury within a certain time frame. In Pennsylvania, you have 120 days from the date of your injury or the date you became aware of your illness to provide notice. Failing to meet this deadline can disqualify you from collecting workers’ compensation. Additionally, it’s crucial to make sure your claim is properly filed and there aren’t any discrepancies in the paperwork when describing the nature of your injuries.
3. Insufficient Medical Evidence
After getting hurt at work, your top priority should be seeking medical treatment. Not only is this important for your recovery, but it will also provide vital documentation to help prove your claim. Benefits are often denied because an employee fails to include sufficient medical evidence of their injury or illness. It’s essential to have record of all diagnoses, prescribed medications, doctor-recommended procedures, and medical appointments to demonstrate that your injuries are serious and affect your ability to work.
If you’ve been denied workers’ compensation benefits or are considering applying, don’t hesitate to contact Stine & Associates, P.C. in Greensburg, PA. They’ll assist you in gathering as much evidence as possible to support your claim and aggressively fight for your right to receive full compensation. With more than 20 years of legal expertise, they know how to appropriately represent your interests in court. Call (724) 837-0160 to schedule a consultation, or visit them online to learn more about their proven track record of success.