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What are possible reasons to deny a workers’ comp claim?

On Behalf of | Apr 3, 2023 | Workers' Compensation |

Making sure you receive workers’ compensation to cover your medical bills after a work accident is an important priority. Unfortunately, insurers for a workplace do not always approve a claim.

If you wonder why an insurance company would deny you coverage, the Pennsylvania Department of Labor and Industry lists some possible reasons on a Notice of Workers’ Compensation Denial form.

Disputes over the injury

Insurance companies want to know that you had sustained an actual workplace injury. This means you got hurt because of your work activities and that the injury happened in the range of your employment.

Alternatively, your work activities could have aggravated an existing injury or condition you have to the point where it makes it difficult or impossible to work. A failure to meet any of these thresholds could result in a denial of your claim.

Denial due to non-employment

Your employment status could come into question as you pursue your workers’ comp claim. In some cases, insurance companies turn down a claim on the grounds that the worker actually did not work for the business covered by the insurer.

Not meeting timelines

State workers’ comp law establishes timelines you must meet if you are to process your claim. For example, you have 21 days from the time of your injury to notify your employer. Failing to meet these timelines could result in a denial.

If your workers’ compensation claim seems to be in trouble, do not feel you must go it alone. You have the right to appeal a denial. Contact a workers’ compensation attorney to get a free, no-obligation consultation on your case. Reach us online or call 610-892-9300.