Why Are Some Philadelphia Workers’ Compensation Claims Denied?

June 13, 2017

A workplace injury can add undue stress to your already hectic life. Workers’ compensation is a no-fault program that is overseen by the state of Pennsylvania. Workers’ compensation provides coverage for medical expenses related to the job-related injury and a partial wage-replacement disability benefit payment and other programs such as job training for those workers’ whose injuries prevent them from returning to the job they held when they were injured. It also provides a death benefit to the families of those workers who lost their lives in a workplace accident.

While workers’ compensation is a no-fault program, it does not mean that everyone who applies for benefits automatically gets approved. There are a few criteria, which if you do not follow them, your worker’s compensation claim will likely be denied:

  1. You failed to report your injury to your employer. Failure to report your injury within 120 days will make you ineligible to apply for workers’ compensation benefits.
  2. You did not seek medical care immediately/ or you failed to visit an approved medical provider. A workers’ compensation claimant must visit an approved medical provider for the first 90 days after the first medical treatment for the injury.
  3. Your injury did not occur on the job. Workers’ compensation applies only to injuries that a worker sustains while doing their work.
  4. You were intoxicated or under the influence of drugs when the accident occurred. Workers’ compensation does not cover accidents that are the result of impairment by alcohol or drugs. The presence of drugs or alcohol in a post-injury blood test will disqualify you from receiving benefits.
  5. There are inconsistencies between the accident report and your medical records. If your story about what happened to cause your injury, and what the medical records show, it will throw suspicion on your claim and your employer’s insurer might use that as an excuse to deny your claim.

If your claim has been denied, our experienced Philadelphia workers’ compensation attorneys are here to help protect your rights. You can schedule a free consultation where you can explain you case to a knowledgeable lawyer on our team. We will advise you about the merits of your case and recommend next steps.

If you have suffered a workplace injury and your application for workers’ compensation benefits was wrongly denied, you are welcome to complete our contact form or call 888.PITT.LAW to schedule a consultation with a Philadelphia workers’ compensation lawyer at Larry Pitt & Associates. Our attorneys have experience helping injured workers obtain the benefits they deserve. We are proud to serve clients throughout Berks, Bucks, Chester, Delaware, Montgomery, and Philadelphia Counties.