What Are the Top 3 Reasons Workers Comp Claims are Denied?

top three reasons workers comp claims are denied
Find a Lawyer Near You

It is a sad truth that frequently, a person who has been hurt on the job or while performing work for their employer in Williamsport, PA, is sometimes not allowed to receive Worker’s Compensation benefits. This can be either because of an intentional move by the employer to avoid paying out what they owe or simply because the injured worker was found to have contributed to their injury somehow. In any case, if you feel that your claim has been unjustly denied and you are ready to fight back, it is essential that you know more about what employers and insurance companies look for when declaring someone ineligible for Worker’s Compensation benefits.

Entitlement to Worker’s Comp Benefits

People who are capable of working may still make Worker’s Compensation claims if they are temporarily unable to perform every task associated with their position. If you fall into this category and want to make a claim, your doctor will need to provide an assessment describing the full extent of your injury. This should include information about what types of tasks you cannot perform and how long you might be unable to work.


PPC for Legal

To help ensure that all relevant details are included in this report, ask your doctor specifically what limitations you should expect after your appointment. You can then convey this information accurately when filling out the necessary paperwork. In addition, if there is any other information that can add to prove that you were indeed performing work-related activities at the time of your injury, it should be added as well.

Of course, even if you have documentation showing that work was involved, this does not mean that you will be approved. It is still possible for your claim to be denied if there is evidence that some action on your part caused or hastened your injury. For example, suppose someone who works as a construction worker falls from a ladder and breaks their leg. Because the ladder had been improperly erected, which could have been prevented with proper training and safety protocols, they would not be eligible for Worker’s Compensation benefits under Pennsylvania law.

One final consideration in these situations is whether or not the employer has a history of mishandling a similar situation or denying claims unfairly. Any pattern can raise red flags with insurance companies, especially regarding claims made by injured employees. If your case seems suspicious to an insurer, they might ask for more evidence to support your claim or attempt to implicate you in some way.


Injury RX

As this shows, there are several reasons why Worker’s Compensation claims get denied. However, by being familiar with the information above, you can prepare yourself for what could happen and increase your case’s chances of being resolved fairly. If you would like to learn more about how to receive the benefits that you deserve after an injury at work, speak with an attorney as soon as possible to get help with a denied Worker’s Comp claim.

How An Experienced Attorney Can Help with Denied Worker’s Comp Claims

If you are injured at work, you may be able to qualify for Worker’s Comp benefits. Even if you have a minor injury that seems to heal quickly, the insurance company covering your employer must approve your claim. The money they provide through Worker’s Compensation can help pay medical bills and other expenses while you are unable to work. If an insurer denies payment or offers an unreasonably low payment figure, filing a dispute claim with the Department of Labor could resolve the issue. However, this does not always fix problems with denied Worker’s Comp claims in Williamsport, PA. Having an experienced Workers’ Compensation attorney on your side often produces better results because handling these cases without one can be challenging.

An Example of A Denied Worker’s Comp Claim

A recent example of a denied Worker’s Comp claim concerns an employee who was dismissed after being injured on the job. The man fractured his shoulder at work, but his employer refused to pay for treatment or Worker’s Compensation benefits. He pursued a claim against the company, but they did not submit enough evidence to support their cause, and the Department of Labor threw it out. Unfortunately, he also lost his counterclaim against his former employer because he did not file it on time. It is easy to see how this situation could have been avoided if the man had hired an experienced Workers Compensation lawyer instead of filing alone.

There are legal reasons an employer may have for not wanting to provide benefits. For example, they may feel that it is a way to avoid paying employees fairly or covering necessary fees related to their business. In other cases, the company could be attempting to retaliate against you because you filed a claim when they felt you should have been fired instead. The attorney can help determine if the denial of your claim was justified and whether there were any illegal motives involved in the decision.


Computer Forensics

If your injury prevents you from working and the insurer denies Worker’s Comp benefits, don’t hesitate to get legal representation. You need someone on your side who knows the ins and outs of Pennsylvania Worker’s Comp laws. With their experience, they can help you understand your claim. Even though most cases do not end up going to court, hiring an attorney still helps increase the chances of receiving fair compensation for your injuries.

Learn More About Worker’s Comp Claims And Attorneys

To find out more about Workers Compensation claims in Williamsport, PA, be sure to do your research. Read articles that discuss how an attorney can help with denied claims, what types of injuries are covered by Worker’s Comp laws, and other information off of the trusted websites. If you have questions about filing for benefits or want to schedule a free consultation with someone experienced in the field, call the attorney you wish to speak with and get more information.

Clifford Rieders

Clifford A. Rieders is a partner at Rieders, Travis, Humphrey, Waters & Dohrmann, a Williamsport personal injury law firm.

Leave a Reply

Your email address will not be published. Required fields are marked *

Related Posts