Navigating Workers’ Compensation claims is a complex process that, if not handled properly, can be unsuccessful for injured workers. In Lower Paxton Township, victims often face several hurdles to recovering compensation following workplace accidents.
Workers’ Compensation claims are denied for many reasons, including insufficient medical evidence, unclear details about an accident, and failure to submit a claim before the deadline. If your claim for benefits was denied, our attorneys can appeal the decision by submitting a claim petition in Lower Paxton Township. If denied again, your case can be appealed again. Many workers cannot afford claim denials, which is why improving your chances of initial success by reporting your injuries, getting medical attention, and being careful in conversations with insurance representatives is important.
Call (215) 355-6400 to reach Lerner, Steinberg & Associates and discuss your case with our Lower Paxton Township Workers’ Compensation lawyers today.
Reasons Why Workers’ Compensation Claims Might Be Denied in Lower Paxton Township
Insurance carriers typically look for any reason to deny Workers’ Compensation claims for benefits in Lower Paxton Township. Understanding some of the most common reasons for claim denials can help workers avoid such mistakes when seeking benefits.
Our Workers’ Compensation lawyers can help you submit your claim for benefits in Lower Paxton Township to lower the chances of your claim being denied. One of the main reasons why claims are denied is due to insufficient information. Workers might fail to provide suitable details about an accident that caused them injury, leaving their employer and a Workers’ Compensation insurance carrier to believe that their injuries are unrelated to a workplace accident.
When injured workers fail to submit a claim for benefits within 120 days of an accident, or an employer suspects that drug or alcohol use was involved in an accident, claims might be denied. If a claimant unintentionally accepts fault for their injuries or is misinterpreted by an insurance company as having intentionally caused their injuries, they can be denied benefits.
Claims are also often denied when employees do not seek medical care from approved doctors for the first 90 days of their treatment following a workplace accident. Similarly, Workers’ Compensation claims might be denied if injured workers fail to provide suitable information about their injuries or medical records in support of their claim.
Appealing a Workers’ Compensation Claim in Lower Paxton Township
There are ways to appeal a denied Workers’ Compensation claim in Lower Paxton Township. It begins with submitting a claim petition so that a Workers’ Compensation judge can review a carrier’s initial decision. If a denial of benefits is upheld, you can continue to appeal your case.
Claim Petition
If your employer’s Workers’ Compensation insurance carrier denied your application for benefits, you can request that its decision be reviewed. Initial appeals are made by submitting a claim petition to the Pennsylvania Department of Labor and Industry Workers’ Compensation Office of Adjudication. In this petition, you must provide detailed information about your injuries and the benefits you are seeking. You must also give the information of your employer and their insurance carrier. The Workers’ Compensation judge for your case may or may not request a hearing to review certain facts before making their decision regarding your eligibility for benefits. If your employer’s carrier denied your claim because of insufficient information about your injuries or their case, now is the time to present that information to the Workers’ Compensation judge overseeing your case.
Board of Appeals
If you are again denied compensation after you have filed a claim petition for benefits in Lower Paxton Township, you can appeal your case again. This time it will be to the Workers’ Compensation Appeal Board. Appeals can be filed online or by mail. Appeals must be filed within 20 days of the circulation date of a Workers’ Compensation judge’s decision. Attached to your appeal petition must be the Workers’ Compensation judge’s decision that led to your second appeal. Hearings are held according to a petitioner’s preference. If your appeal is again denied, you might be able to advance your case further or sue another party for negligence in Lower Paxton Township.
Improving Your Chances of Filing a Successful Workers’ Compensation Claim in Lower Paxton Township
For many injured workers in Lower Paxton Township, getting their Workers’ Compensation claims denied and having to file appeals is simply not an option. Victims typically require benefits right away, especially when they are likely to miss time from work. Fortunately, there are several things victims can do to improve their chances of success when first submitting a Workers’ Compensation claim.
Workers’ Compensation claims are often most successful when insurance companies are unable to poke holes in a victim’s story. To reinforce your claim, report your injuries to your employer immediately. Do not wait to tell your boss about a workplace accident or hospital visit. Companies typically have a reporting process for work-related incidents, which injured workers should take advantage of.
Although many workers know that they have to, at some point, visit a doctor that is approved by their employer’s Workers’ Compensation carrier, they may not be aware that that medical professional has to be the primary doctor treating their injuries for at least 90 days following an accident in Pennsylvania. Following this requirement makes it more challenging for insurance companies to contest the findings of medical professionals.
Injured employees should be careful when speaking to a representative of a Workers’ Compensation insurance company and send any questions to our lawyers. Often, insurance agents intentionally try to confuse or frustrate victims in the hope that they will misspeak and say something that disqualifies them from getting Workers’ Compensation benefits in Lower Paxton Township.
Get Workers’ Compensation Benefits in Lower Paxton Township
Contact Lerner, Steinberg & Associates by calling (267) 692-4609 and have our Workers’ Compensation lawyers analyze your case today.