If you are hurt on the job, Pennsylvania laws allow you to pursue financial restitution through employer-sponsored workers’ compensation cover. The primary goal of these benefits is to pay for the resulting medical bill, lost income and other damages.
Workers’ compensation can provide much-needed relief to a family that is dealing with the loss of income following the breadwinner’s injury or illness. Unfortunately, not every workers’ compensation claim ends in approval.
Here are some of the reasons why your workers’ compensation claim may be denied:
Your injuries were not work-related
To be eligible for workers’ compensation, your injuries must have happened while performing your employer-sanctioned duties. In other words, you must have been at work or running an errand that was approved of by your employer. If you were out on a personal break or doing something that was not related to your work, your claim may not be approved.
You had a preexisting condition
A preexisting condition that is closely related to the injury or illness for which you are seeking compensation can lead to an inconclusive investigation. Consequently, both your employer and the insurance company can dispute your claim. However, a preexisting condition may not automatically lead to your claim’s refusal. For instance, if your condition was worsened by your work, then you may be eligible for compensation.
You did not report or pursue your claim in time
If you are hurt at work, you need to inform your employer about the accident and have it captured in the accident report. In Pennsylvania, you have up to 120 days to report your injury to your employer. Still, you need to file your workers’ comp claim within the statute of limitations period.
And in Pennsylvania, the statute of limitations for workers’ comp claims is three years. Your claim will be time-barred if you miss either timeline.
A workplace injury can leave you devastated. To explore and exercise your legal rights following a workers’ comp claim refusal, it helps to understand why your claim was denied in the first place.