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When is a workers’ compensation claim denied?

The aftermath of a work-related injury can be painful, stressful and confusing as you figure out where to start or who to talk to about your situation. In order to protect your rights as an employee, you should be aware of the many potential reasons your claim could be denied.

Some of the most common reasons for claim denial include:

  • Not reporting an injury right away.If you don’t notify your employer of an injury within the specified time limit in your state, you can lose to compensation. According to the Pennsylvania Department of Labor & Industry, “[Unless] an employee gives notice to the employer within 21 days of the injury, no compensation is due…”
  • Not filing the claim on time. In Pennsylvania, you should file your workers’ compensation claim no later than 120 days after the date of your injury to accepted by the Bureau of Workers' Compensation.
  • Your injury claim is not covered.While many work injuries are covered, there are certain situations in which compensation may not be available. You might have trouble with your claim if you were intoxicated or engaging in reckless behavior at the time of the injury, or if your claim involves an injury that’s difficult to prove, such as a pre-existing condition or psychological issue.
  • Your employer disputes your injury claim.Employers want to reduce the amount of money spent on insurance and their liability for claims whenever possible.If your injury occurred outside of the workplace, after you were laid off or fired or if your injury did not require medical treatment or time off, your employer may dispute your claim.
  • Lacking evidence that your injury is work-related. If no one witnessed your accident or if there are discrepancies between the injury you reported and subsequent medical records, you may have a tough time proving your case. Make sure that your claim is a strong one by providing thorough and consistent testimony and evidence.

Was your workers’ compensation claim denied? If you’ve received a denial of benefits letter, don’t worry. You may have options available for filing an appeal. Work with a skilled employment law attorney who can protect your rights.

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