call 215-512-1500
Habla Espanol

Scranton Workers’ Compensation Denial Lawyer

Every employer in the state must offer workers’ compensation that covers medical treatment for work-related injuries and conditions. This program helps employees manage the consequences of workplace injuries and protects employers from potential lawsuits.

Unfortunately, employers and their insurance companies do not always handle claims fairly. They might try to save money by denying a legitimate workers’ compensation claim. If your employer is not honoring its obligation to you, contact a Scranton workers’ compensation denial lawyer for help. The legal team at Gross & Kenny, LLP is dedicated to help injured employees get the workers’ compensation benefits they need.

Requirements for Filing a Workers’ Compensation Claim

The workers’ compensation program offers valuable benefits, but employees must follow strict rules to access them. Insurers will deny claims if an injured employee does not follow the correct procedures.

Reporting the Injury

You should report a work-related injury to your supervisor as soon as possible. While workers’ compensation may partially cover claims that are reported within 120 days of an injury, an employee is only eligible for full benefits if they report their injury within 21 days. 

Getting Medical Care

Anyone suffering a work-related injury must see an employer-approved medical professional within 90 days. A medical professional will create a formal report that serves as crucial evidence of the connection between the person’s job duties and their injuries. 

An employee may not immediately realize that a condition, such as bursitis or hearing loss, is related to their work. In such cases, a worker should notify their employer as soon as they have a diagnosis of the injury or condition. The employer will likely require the worker to see an approved workers’ compensation physician to confirm the diagnosis and its relationship to the employee’s work. Work with a Scranton attorney when filing your workers’ compensation claim to meet these procedural requirements and minimize the chances of receiving a denial. 

Reasons for Denial of Workers’ Compensation Claims

After filing a workers’ compensation claim, three things could happen: the employer’s insurer could accept the claim, deny it, or accept it temporarily. If the employer or their insurer denies the claim, they must state the reason for denial. If the insurer offers a temporary approval, they will have to make a final decision whether to accept or deny the claim within 90 days. 

Some reasons an employer or insurer might cite for denying a Workers’ Compensation claim include:

  • More than 120 days have passed since the injury
  • There is insufficient proof the injury or condition is work-related
  • The physician’s examination does not indicate the injury requires time off 
  • The information provided is not adequate to make a final determination
  • The worker’s complaint is the result of a pre-existing condition
  • The injury resulted from the employee’s intentional act or intoxication

In addition, if the employer has classified the worker as an independent contractor and not an employee, the insurer might assert the worker is not entitled to workers’ comp benefits. Many workers’ compensation claims are erroneously denied, and a determined Scranton attorney could challenge an insurer’s decision.

Responding to a Denial

Anyone who believes the outcome of a workers’ compensation case is unreasonable has 20 days from the judge’s decision to file an appeal. Our attorneys could present injury reports, medical records, worker testimonies, and any relevant evidence to support a worker’s claim for benefits. After considering both sides’ evidence, the judge decides whether workers’ compensation should pay the claim.

If the judge continues to deny benefits, you could file an appeal to the Workers’ Compensation Appeals Board. Further appeals could be available through the state and federal court system. Our legal team could exhaust all options to try and get the benefits you need and deserve. 

Consult a Scranton Attorney About a Workers’ Compensation Claim Denial

If you work in Pennsylvania, you are entitled to workers’ compensation benefits if you experience a work-related injury or condition. Do not allow your employer’s insurer to intimidate you out of benefits you are entitled to.

A Scranton workers’ compensation denial lawyer could assess your case to determine whether there is cause for an appeal and take the lead throughout this process. Call today to speak with a member of our knowledgeable legal team.

Personal Injury Attorney Philadelphia | Gross & Kenny, LLP

Personal Injury Attorney Philadelphia | Gross & Kenny, LLP
Social Media Auto Publish Powered By :


Get Help Now!

    All Fields Are Required

    By clicking submit you are agreeing to the Terms and Conditions.