Why Was My Workers’ Compensation Denied?

Work injuries can be common depending on which industry you work in. In the event you find yourself injured and unable to work and are expecting high medical bills or future discomfort, you should consider filing for workers’ compensation. Do not be discouraged if your claim is denied. Unfortunately, employers and insurance often fight against and deny workers’ compensation claims. Some reasons can include: 

The injury was not at work.

One of the most common reasons for denying a claim is that an injury did not occur at work. Do not be deterred. It is possible to appeal most these claims and obtain the benefits you deserve.

The injury was not work-related.

Claims may also be denied if an employer believes an employee was injured while they were not performing the duties of their job. If an employer believes an employee was engaging in roughhousing, horseplay or consuming alcohol or drugs, they may deny a claim.

There was no injury.

An employer and/or an insurance company may try to deter you by claiming you were not injured or your injury was not serious enough to prevent you from working. Rest assured, you can appeal this type of denial.

Failing to report the injury to your employer or file a claim before the deadline.

There is a strict timeline for telling your employer that you have been injured and filing a claim. In the state of Pennsylvania, you have 21 days from the injury or you may not be able to benefit from filing a claim. This deadline is strict. This is why it is critical that you report your claim as soon as possible after an injury.

Failing to seek medical treatment.

If you do not seek medical treatment for your injury, that may invalidate your claim and give your employer the impression that it is not serious or it will not keep you from being able to do your job. Seeking treatment will benefit you and give your situation more credibility.

You went to the wrong doctor for treatment.

You might be more comfortable going to your own doctor if you are injured. However, in Pennsylvania, a company can require you to see a list of panel medical providers, doctors of their choosing, to evaluate and treat you for the first 90 days following an injury. If your doctor is not approved, getting medical treatment from him or her might disqualify you. Make sure to check with your company’s requirements before seeking help to avoid going to the wrong doctor.

Work injuries can be serious and prohibit you from being able to work and support yourself or your family. You have the right to be compensated if you were injured. If your claim was unfairly denied, talk to a workers’ compensation attorney about your options.

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