Workers’ Compensation

Denied Claims

Having your workers’ compensation claim denied can be overwhelming, especially when you’re already dealing with the physical and emotional impact of a work injury. At Lerner Steinberg & Associates, we understand how frustrating and financially stressful this situation can be.

With over 34 years of experience representing injured workers throughout Pennsylvania, our dedicated attorneys have successfully overturned countless claim denials. We provide personalized attention to each client, explaining complex legal matters in straightforward terms so you understand your rights and options.

SCHEDULE A FREE CONSULTATION

Contact Lerner Steinberg & Associates today by filling out our free consultation form or calling 215-714-1500 to discuss your case and learn how we can help you secure the compensation you deserve.

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Common Reasons for Workers' Compensation Claim Denials

Insurance companies often look for reasons to deny legitimate claims. Some of the most common reasons for denial include:

Missed Deadlines: Failing to report your injury to your employer within 120 days or not filing your claim within the statutory period
Employer Disputes: Your employer may claim the injury didn’t occur at work or within the scope of employment
Medical Evidence Issues: Insufficient medical documentation linking your injury to your job duties
Pre-existing Conditions: The insurer claiming your condition existed before your work injury
Independent Medical Examination (IME) Results: Unfavorable findings from an insurance company doctor
Disputes About Disability Status: Disagreements about whether you can return to work
Intoxication or Drug Use: Allegations that you were under the influence when injured
Procedural Errors: Mistakes in filing paperwork or following proper procedures

Warning Signs Your Claim Might Be Denied

Watch for these red flags that could indicate your claim is heading for denial:

Your employer seems reluctant to report your injury
The insurance adjuster requests multiple recorded statements
You’re being pressured to return to work before you’re medically ready
The insurance company delays authorizing medical treatment
You receive requests for extensive medical records unrelated to your injury
The insurer schedules you for an Independent Medical Examination (IME)

If you notice any of these warning signs, consulting with an experienced workers’ compensation attorney can help protect your rights.

Steps to Take After a Claim Denial

If you’ve received a Notice of Compensation Denial, don’t give up. Here’s what you should do:

Review the Denial Notice Carefully: The notice will explain the reasons for the denial
Gather Supporting Evidence: Collect medical records, accident reports, witness statements, and other documentation
Continue Medical Treatment: Keep seeing your doctor and following treatment recommendations
Consult with an Experienced Attorney: Most importantly, contact a workers’ compensation lawyer who can evaluate your case
File an Appeal: Your attorney can help you file a claim petition with the Pennsylvania Bureau of Workers’ Compensation

The Appeals Process in Pennsylvania

After a claim denial, the appeals process typically follows these steps:

Filing a Claim Petition: This must be done within three years of your injury

Assignment to a Workers’ Compensation Judge: Your case will be assigned to a judge in your geographic area

Hearings: You’ll attend multiple hearings where evidence is presented and testimony is given

Medical Examinations: You may need to undergo additional medical evaluations

Judge’s Decision: After reviewing all evidence, the judge will issue a written decision

Further Appeals if Necessary: If the judge doesn’t rule in your favor, additional appeals to the Workers’ Compensation Appeal Board, Commonwealth Court, and even the Pennsylvania Supreme Court may be possible

This process can be complex and time-consuming, making experienced legal representation essential.

How Lerner Steinberg & Associates Can Help With Your Denied Claim

Our attorneys bring decades of experience to your case, with specific expertise in overturning denied claims. When you work with us, we will:

Analyze Your Denial: We’ll carefully review the denial notice to understand the specific reasons for the decision
Develop a Strategic Response: Based on our analysis, we’ll create a customized legal strategy
Gather Crucial Evidence: We know what evidence is needed to build a strong case
Obtain Expert Medical Opinions: We work with respected medical professionals who understand the Pennsylvania workers’ compensation system
Handle All Paperwork and Deadlines: We ensure all documents are properly filed within required timeframes
Represent You at All Hearings: We’ll advocate for you throughout the entire process
Negotiate Settlements When Appropriate: Sometimes, a settlement may be in your best interest, and we’ll skillfully negotiate on your behalf
Pursue All Levels of Appeal if Necessary: We’re prepared to take your case as far as needed to seek justice

You focus on recovery; we’ll handle the rest.

Don't Wait to Appeal Your Denial

Time is critical when dealing with a denied workers’ compensation claim. In Pennsylvania, you generally have three years from the date of injury to file a claim petition, but waiting can weaken your case and extend the time you go without benefits.

The sooner you contact us after receiving a denial, the better we can protect your rights and build a strong case for your appeal.

Success Stories: Overturned Denials

Throughout our decades of practice, we’ve successfully overturned numerous claim denials for our clients. While each case is unique, here are some examples of how we’ve helped workers receive the benefits they deserved:

Secured full benefits for a construction worker whose claim was initially denied because the employer claimed he was an independent contractor
Overturned a denial for a CNA who developed back injuries over time through patient lifting, despite the insurer claiming it was a pre-existing condition
Won benefits for a manufacturing worker after an insurer denied the claim based on alleged safety rule violations
Successfully appealed a denial for an office worker with carpal tunnel syndrome when the insurer claimed the condition wasn’t work-related

Contact Lerner Steinberg & Associates Today

If your workers’ compensation claim has been denied, don’t face the appeals process alone. Our experienced attorneys understand the Pennsylvania workers’ compensation system and know how to effectively fight for your rights.

Serving injured workers throughout Pennsylvania, including Philadelphia, Montgomery County, Bucks County, Chester County, and Delaware County.