Denied Work Injury Claim

What to Do If You’re Denied Workers’ Compensation

Have you filed a claim for workers’ compensation (WC) benefits after being injured on the job and received the dreaded denial letter in your mailbox in response? There are various reasons why your workers’ compensation claim may have been denied, but you do have options for pursuing your claim and possibly having the denial reversed. Today we’re looking at some of the best subsequent actions you can take after a denied worker’s comp claim in Pennsylvania.

Hire A Workers’ Compensation Lawyer

Once your claim is denied, you are faced with a critical decision: whether to engage an experienced workers’ compensation lawyer to help you pursue the benefits you may rightfully deserve. Without an approved claim, neither your employer nor their insurance company is required to pay any of your medical bills, pay your wage loss. Most importantly, they may not be required to accommodate any physical limitations you may have when you return to work. You could lose your job due to your injuries and be faced with the nightmare scenario of having no income. There is even the possibility that you would be ineligible for unemployment if you are not “able and available” for work.

Many people are concerned that hiring a lawyer will jeopardize their job, or they are simply unsure whether their injuries even qualify for workers’ compensation, especially after receiving that denial from their employer or their employer’s WC insurance carrier. Here at Westmoreland Injury Lawyers, we’ve found that fear of hiring a lawyer to be unfounded over the course of the 30 years we have been handling workers’ comp cases. When you pursue a claim for workers’ compensation through your lawyer, most employers are less likely to lay you off or fire you over concerns that it would look bad in court. With solid legal support behind you, your employer is more likely to take your claim seriously.

But is hiring a lawyer to assist you with your denied claim expensive? It’s not. Many clients are pleased to know that many lawyers handle all WC cases on a contingency fee basis, which means we are only paid if we win your case. There is never a fee or cost to the client unless we successfully get you the benefits you deserve or a settlement.

Resolve The Dispute with Your Employer

Before hiring a lawyer, you are certainly encouraged to meet with your employer and/or their WC insurance company representatives to see if your denial was the result of a simple clerical error or misunderstanding. This process is sometimes helpful if your employer is disputing your claim for some more subjective reason, such as reporting that your injury was caused by “horseplay” or that you were not actually hurt during the course of your workday. It’s always a good idea to keep your relationship with your employer amicable even if you believe they are unfair in denying your claim. Keep the lines of communication open, and you may be able to resolve the issue informally.

Suppose you do not feel that you can meet with your employer without assistance from an impartial third party. In that case, you may undergo a more formal process called alternative dispute resolution, which involves a workers’ compensation judge to help settle differences between parties through mediation, settlement conference, or another informal conference. You or your employer may petition the Pennsylvania WC Office of Adjudication to begin the process. You may hire a lawyer to represent you in this process, but it is not required. It is crucial to note that if you do not hire an attorney for alternative dispute resolution, your employer is not entitled to involve one.

Claims denied because your injury was not reported on time or your claim was not filed on time are more challenging to solve without legal help. Under the workers’ compensation laws in PA, you only have three years to file a claim petition for a new injury and even less time if this is a reoccurrence of an old injury. Failure to take action could result in losing the right to be compensated for your injuries. If you are denied due with time limits, you should contact an experienced WC attorney like us here at Westmoreland Injury Lawyers immediately.

Appeal The Denial To The Pennsylvania Bureau Of Workers’ Compensation

More formal and complex than the alternative dispute resolution process we already discussed, you are entitled to file a claim petition with the PA Bureau of Workers’ Compensation to appeal your employer’s denial. This process also involves a WC judge but is much more difficult for individuals than dispute resolution.

The PA Department of Labor & Industry strongly suggests considering hiring an attorney for workers’ compensation proceedings due to the fact that your employer and/or their insurance company will definitely have experienced representation. If a WC judge decides in favor of your employer, you can further appeal to the Workers’ Compensation Appeal Board and then to Commonwealth Court, and you will likely want an experienced attorney by your side through those advanced steps.

Have you recently been denied workers’ compensation benefits and need help working through dispute resolution or appeals in the Greensburg, PA, area? Westmoreland Injury Lawyers will consult with you for free to determine whether you have a case and work through your potential next steps. Contact us today to get started, and don’t lose right your benefits without a fight.

Understanding the Terminology of Filing a Claim: A Guide for Anyone Filing a Claim

Filing a claim can be challenging even in the best, most straightforward circumstances. Here are some standard terms you might encounter to help you better understand the process. 

Experienced Workers’ Compensation Attorney

If you have suffered an unjust injury in the office, seeking a seasoned worker’s compensation attorney is crucial. Unlike general lawyers who may not be familiar with this section of the law, a dedicated lawyer can help you acquire the rightful funds and justice owed to you.

Workers Comp Claim

Filing a workers comp claim is the appropriate legal channel for compensation if you sustain any harm while performing your job. This unique workplace litigation pertains to those who suffer injuries exclusively during their shift, setting it apart from other claims.

Injured Workers

Employees who have been hurt on the job have an absolute right to receive financial compensation for their injuries, known as filing a workers comp claim. Taking advantage of one’s legal rights can provide immense relief and aid during trying moments.

Workers Compensation Denial

Do not lose hope if you were wrongfully denied worker’s compensation benefits! Working with a professional workers’ compensation attorney will help you gain what’s due to you. Additionally, having a lawyer experienced in these matters can be immensely advantageous; they possess the knowledge and experience to work toward your case’s success. Do not let those responsible for giving restitution deny justice any longer—take action!

Employer’s Insurance Company

Unraveling the intricate insurance policies of employers and understanding your rights for workers’ comp claims can be a challenging task. Employers must protect employees by purchasing dependable Workers’ Compensation Insurance from an insurer should any injury or illness be connected to their job role.

Companies must consider their lawful obligations when addressing employee injuries or illnesses. The insurance company will oversee the claim and ensure it is discussed, following legal guidelines and defending employers from potential lawsuits. Depending on the scenario, employees may be entitled to medical expenses, lost wages, and rehabilitation costs through workers’ compensation benefits.

Workers Comp Benefits

Employers are legally required to provide Worker’s Compensation Benefits (or Work Comp) for any work-related injury or illness. This benefit includes covering medical bills, rehabilitation costs, and wages lost during time away from work due to recovery. Not only that, but it also covers other associated expenses connected with the injury sustained.

For everyone’s benefit, it is essential that employers and employees alike have a thorough understanding of their respective state-specific laws concerning worker’s compensation benefits. Employees who have been injured or become ill from work must be aware of their rights. Both parties need to stay up-to-date with the regulations for everybody involved to achieve justice.

Appeals Process

Do you feel a ruling in your case was unjust? You can submit an appeal for another chance to show that justice has not been served. With the appeals process, you can present new evidence or argue why the decision should be reversed. Don’t let a poor verdict stand; fight for what is right!

Medical Records

A worker’s compensation claim necessitates having medical records. These documents demonstrate the injury sustained at work and how it happened. They also serve to help those who will determine whether or not you should receive your requested benefits. In other words, supporting documentation is crucial to ensuring your application is successful!

Job Injury Claim

If you have experienced a workplace injury, your initial step should be to file for workers comp. But don’t get discouraged if that route is unsuccessful – there’s always the option of acquiring legal assistance where an expert can help you get what is due to you. Don’t let someone else dictate how much compensation will suffice; take control and receive all the compensation entitled by your work-related accident!

© 2024 , Westmoreland Injury Lawyers LLC. All Rights Reserved. Website, Hosting & SEO services provided by EZMarketing