Workers Compensation Claims
Reasons Why a Workers’ Compensation Claim May Be Turned Down
Black and Davison
In the aftermath of a work-related injury, one of your first courses of action will typically be to notify your employer and initiate the necessary steps to obtain workers’ compensation benefits. Though your claim may often seem pretty straightforward, it’s not at all uncommon for your application for benefits to be denied. Here are some of the more typical reasons why so many workers’ compensation claims are initially rejected.
You Waited Too Long to Notify Your Employer
Under the Pennsylvania workers’ compensation laws, you must provide notice to your employer within a specific time period. Accordingly, you’ll want to let your employer know about an injury or illness as soon as you know about it. Not only will you risk having your claim rejected outright for failure to timely file, but you also give opposing attorneys grounds for arguing that your injury wasn’t that serious or that it was caused by another event.
Your Claim Is Challenged
There are a number of reasons your employer or the workers’ compensation insurance company may contest your claim. Your employer may argue that the injury was not work-related, that you suffered the trauma while away from the job. Your employer may allege that your injuries are not as serious as you say they are, and may introduce evidence from a company doctor to support that claim (you will be required to submit to an “independent” examination from a company-selected doctor once you’ve notified your employer of the injury or illness).
Your employer may also claim that your injury was pre-existing. Under Pennsylvania law, a pre-existing injury will not bar you from eligibility for workers’ compensation benefits, provided you sought treatment for and fully recovered from the prior injury.
You Engaged in Wrongful Conduct
As a general rule, workers’ compensation benefits are available irrespective of fault. However, if you intentionally violate safe work practices, or if you intentionally self-inflict injuries, you will likely be disqualified for workers’ compensation benefits.