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What happens after a workers’ compensation claim denial?

On Behalf of | Mar 29, 2018 | Firm News |

No one plans to get hurt at work. After all, the injury you suffer can often result in an inability to work and lost wages as you recover. Sadly, hundreds of people get hurt at work in Pennsylvania every day. Thankfully, in most cases, these workers also have the protection of workers’ compensation, which ensures that those who get hurt while working for a living won’t end up impoverished as a result.

Workers’ compensation can cover medical expenses, a portion of your lost wages and even scarring and disfigurement in some cases. These benefits can help you pay the bills and can ensure that you receive adequate medical care, regardless of whether you have regular health insurance with a high deductible or a high co-pay. Unfortunately, some people who apply for workers’ compensation coverage end up denied. These people do have the right to appeal that decision, and we can help.

Act in a timely manner to file an appeal

If your initial claim for benefits ended up denied, you should take a moment to determine why. Don’t let the Notice of Compensation Denial dissuade you from pursuing the benefits you need. Instead, allow it to help you address the issues that led to the denial of benefits. Knowing what caused the denial can make the process of pursuing the claim easier.

Many people find that they simply made mistakes in their paperwork. Correcting those, collecting medical documentation and filing an appeal can help these people obtain their benefits. For others, there might be deeper issues, such as poor word choice by the doctor who wrote about your condition. Sometimes, your employer could try to contest or deny your claim for coverage for no apparent reason.

Why would an employer want to deny your claim?

Employers have to pay premiums to carry workers’ compensation insurance for the protection of their staff. Their premium costs depend on a number of factors, including their industry, their safety history and the size of the staff. A major accident and claim could end up costing the company more money in the future.

Other times, however, an employer may not have all the information. In the chaos after an accident, it is possible for someone to misplace an incident report or other critical paperwork. Sometimes, a manager may think the accident resulted from horseplay at work or was intentional to cover up an injury from outside of work. If there were witnesses to the incident, they can provide documentation for your version of events and verify when you sustained your injury.  That is why it is important to report any injury right away, no matter how small or insignificant you think it is.

You have a right to pursue your benefits

Denials for coverage can leave people feeling disheartened and depressed. Don’t let those negative emotions keep you from seeking the coverage and benefits you need for recovery.

Filing a workers’ compensation claim appeal in Pennsylvania can be stressful, but doing so is the right choice if you face an inappropriate denial for workers’ compensation benefits.