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Denials for workers’ compensation claims in Pennsylvania

On Behalf of | Dec 30, 2022 | Workers' Compensation

Workers’ compensation can aid people who experience hazardous conditions and accidents in the workplace.

Pennsylvania law mandates that employers carry workers’ compensation insurance to help cover injured employees’ bills and lost earnings. However, there are multiple reasons why insurers and employers might deny a worker’s request for support.

Qualifying for benefits

To receive workers’ compensation, the claimant must be an employee who experienced a work-related injury that resulted in impairment. Independent contractors, including gig workers and freelancers, do not qualify for workers’ compensation. In addition, claimants must be able to prove their injuries occurred due to work. Employees should report workplace injuries as soon as possible and file claims with the state within three years of the occurrence.

Workers cannot receive benefits for injuries sustained under the influence of intoxicants, including alcohol and illicit drugs. In addition, a worker cannot intentionally cause harm in order to receive benefits. However, the state of Pennsylvania has a no-fault policy, and injured employees do not need to prove workplace negligence to request workers’ compensation.

Responding to denials

When employers or insurers try to deny workers’ compensation claims, employees can file petitions and appeal the decision. Workers should gather crucial information to contest the denial. Video or photo evidence of accidents, injuries and workplace conditions can help strengthen a worker’s case. Furthermore, workers should seek medical care to obtain crucial records and expert opinions regarding their injuries and health issues.

Employees who experience work-related medical problems have the right to file for compensation. Additionally, workers have legal options for petitioning denials of workers’ compensation claims.