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Why Is My Workers’ Compensation Claim Being Denied?

  • Jon Koutcher
  • 08/10/2021

Workers’ compensation cases are denied for many reasons. However, the hardest answer to explain to a client who was involved in a work accident is why their claim is being denied. Often the facts of the case warrant the acceptance of the claim by the employer or its workers’ compensation carrier. Too often, however, this is not the case. Here are some typical reasons for a claim being denied: if the accident was not witnessed by another coworker; if the accident happened off the employer’s premises; if the accident occurred after work hours; if the injury sustained by the injured worker is not consistent with the mechanism of injury; if notice was not provided to a supervisor for the employer timely; if the injured worker has a prior history of traumatic events; or if the injured worker previously injured the same body part. And, sometimes, there is just no rationale for why the claim is being denied.

Why Did The Insurance Company Deny My Workers’ Compensation Claim?

Sometimes the insurance company denies the claim just to deny the claim. An insurance company may try to strong arm the injured worker by denying the claim to force the injured worker back to work. In essence, the insurance company will try to “starve out” the injured worker. Insurance companies have physicians that can evaluate the injured worker during the claim process and without fail the injured worker receives an opinion of full recovery from these physicians. Whether this serves as a justifiable defense to the claim of the injured worker is questionable at best.
It is important to remember that insurance companies will deny a claim whenever there is a basis to do so. The Courts are full of claims that have been denied. You are not alone. The workers’ compensation lawyers at Pearson Koutcher Law litigate workers’ compensation claims that have been denied. It’s what we do! It’s one of the reasons we started our Firm. We aggressively and without delay litigate the claims of our clients. We understand far too well that your financial and emotional well being depends upon a successfully litigated claim. We understand the stress and impact the denied claim places on your family and overall well being.

How Do I Survive When My Workers’ Comp Claim Has Been Denied?

First, and without delay, call the Philadelphia Workers’ Compensation lawyers at Pearson Koutcher Law. Waiting does not help you whatsoever. There are strict time deadlines for providing notice of the accident and your injury to your employer, and there are strict time deadlines for the filing of your claim. The Philadelphia work injury attorneys at Pearson Koutcher Law will listen to you, give you advice that applies to your case and will be with you every step of the way. If a claim needs to be filed so you can begin to receive wage loss benefits, the Philadelphia workers’ compensation attorneys will institute litigation and walk you through the claim process without delay.

Secondly, an injured worker should see if the employer has light duty available. Some larger employers have the ability to create a position for an injured worker to perform, such as greeting customers, shredding paper or monitoring security cameras. Smaller employers typically do not have this flexibility. If the employer does not have a job within your physical limitations, perhaps there is a different employer who has available employment. This option is often not realistic. The economy is not over flowing with jobs, particularly when you are hurt and may only have training and experience in limited occupations.

Third, apply for other benefits at the same time your claim for workers’ compensation benefits is pending. Such benefits include unemployment compensation, short or long term disability, public assistance or social security disability. The Philadelphia workers’ compensation attorneys at Pearson Koutcher Law will explain to you the impact receiving these other types of benefits may have on your pending workers’ compensation claim.

Lastly, apply for a loan through a funding company. These are companies who will loan, or front you money, while your case is pending and being litigated. Often these loans are “nonrecourse” meaning you do not have personal liability to repay the loan if you do not win your case or obtain a successful result. However, interest on the amount of the loan will accrue, and there may be other fees associated with the loan.

Call The Pearson Koutcher Law to Discuss Your Workers’ Compensation Claim

The work injury attorneys at Pearson Koutcher Law will be with you every step of the way to ensure your claim is handled expeditiously and properly. Pearson Koutcher Law has over three decades of combined experience fighting for the rights of injured workers. Let our decades of experience handling claims for injured workers whose claims have been denied work for you.