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Certified Workers’ Compensation Specialist*
AS AUTHORIZED BY THE PA SUPREME COURT

Certified Workers’ Compensation Specialist*
AS AUTHORIZED BY THE PA SUPREME COURT

Reasons for the denial of workers’ compensation claims

Why did your employer’s insurance company deny your claim for workers’ compensation benefits? The news stuns you because you had a work-related injury that has temporarily prevented you from doing your job.

You are counting on those benefits to help provide for your family and pay for the medical expenses. Despite the denial, you have options, and the main one is to file an appeal. Still, the insurance company’s decision eats at you.

Missing deadlines, employer disputes claim

Sometimes, employers and insurance companies may conspire to deny your claim. However, here are some of the more common reasons for the denial of workers’ compensation benefits:

  • You failed to report the injury in a timely manner: You must report the injury to your employer within 21 days in Pennsylvania.
  • The claim for benefits was not filed in time: If the injury is not reported within 120 days of its occurrence, you will not receive any compensation.
  • Your employer disputes the claim: The employer may contend the injury was not work-related or was the result of horseplay on the job.
  • Your injury does not qualify you: This may happen if your injury occurred because of horseplay or while impaired due to alcohol or drugs.
  • Failure to seek medical treatment: You must seek medical attention to obtain the benefits. It is crucial to provide records for all your visits.

When seeking benefits, it is important to understand what you must do to secure them and the possibility that the insurance company may deny your claim.

File A Claim Petition

With the denial of a workers’ compensation claim, do not panic. Many reasons exist. However, you may overcome this challenge by filing a Claim Petition.