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February 1, 2016

Why was my worker’s compensation claim was denied?

Philly workers comp

 

Often, honest employees may have their worker’s compensation claims denied.  If this happens to you, contact an experienced worker’s compensation attorney at The Levin Firm to enforce your rights.  Below are a few reasons why your worker’s compensation claim may be denied.

1.No one witnessed your injury

Even if no one else saw your injury, you should still make sure to report the injury to your co-workers and to your supervisor immediately, and you should make sure that you tell everyone the exact same thing about how your injury occurred.

2.You Didn’t Report Your Injury Immediately

In most states, there is a small window of time where you can report work related injuries, so it is critical not to wait.  If you get hurt at work, report it to a supervisor immediately and fill out an accident report.

3.Discrepancy Between Your Accident Report and Medical Records

Be consistent when you describe your accident and how you sustained your injuries.  If you tell your supervisor that the accident happened one way, but tell your doctor that the accident happened in a different way, that will hurt your case.

4.Illegal Drugs in Your System

When you seek medical attention following your accident, the different types of tests performed on you could reveal the presence of illegal drugs in your system.  Clearly, this would lead the insurer to deny your worker’s compensation claim.  However, it is very important not to miss any medical appointments you may have. If you develop a pattern of missing medical appointments, the insurer will assume that your injury is not severe and will start looking for ways to terminate your benefits. If you are injured and unable to work, it is especially critical that you go to all of your medical appointments.

5.You Filed a Claim After You Were Fired

If you filed your worker’s compensation claim after you were laid off or fired from your job, the insurer will likely assume that the claim is nothing more than a frivolous revenge claim.

6.You Did not Give The Insurance Company a Recorded Statement or Refused to Sign Medical Authorizations

This is tricky, and is one of many reasons why you should consult with an experienced worker’s compensation attorney.  Workers’ compensation insurers will often ask injured employees to give a recorded statement describing the accident and the injuries. Unfortunately, that puts the employee in a really tough position.  For example, if the employee refuses to give the statement, then the insurance adjuster can tell the employee that their failure to give the statement prevented the insurer from starting their compensation benefits.

However, you can give the insurer a limited medical authorization.  In this case, the insurer would ask you to sign an authorization allowing it to obtain copies of your medical records. This request is reasonable as long as it is limited to the medical records and bills relating to your work injury. The insurer is allowed to see those records and bills. But you should not sign any authorizations allowing the insurer to get any other medical records or bills without discussing that authorization with a workers’ compensation lawyer.

The Philadelphia worker’s compensation lawyers at The Levin Firm understand these issues, and work together with a team of investigators and support staff to investigate every claim so that we may aggressively and zealously represent our clients and obtain the best possible results.

When you need a Philadelphia, Pennsylvania or New Jersey personal injury attorney to represent you, a family member or friend whose worker’s compensation claim has been denied, contact The Levin Firm at (215) 825-5183.  We represent every client zealously in order to obtain the best results possible in each case.

Sources

1.      http://www.alllaw.com/articles/nolo/workers-compensation/why-claim-denied.html

2.      http://www.alllaw.com/articles/employment

 

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