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Philadelphia + Delaware County Denial of Workers’ Compensation Benefits Attorney

If you were injured at your place of employment, learning that your workers’ compensation claim was denied can be devastating. Workers’ compensation is supposed to be a safety net for workers who suffered a serious injury that requires taking time away from work. Unfortunately, some employers may look for ways to avoid paying your workers’ comp benefits, which can leave you in a precarious position with your medical bills and other expenses. If you or a family member was denied workers’ comp after being injured, you should consult with an experienced Philadelphia workers’ compensation attorney today.

At Schmidt, Kirifides & Rassias, our worker’s comp attorneys possess over 60 years of combined legal experience that they will utilize to help you appeal your denial of benefits. Our legal team will learn the intricacies of your case and assist you in developing a legal strategy to help you pursue the benefits that you deserve. To schedule a free legal consultation to discuss your benefits denial, call Schmidt, Kirifides & Rassias, at (610) 892-9300, or contact us online.

4 Common Reasons for Workers’ Comp Denial

There are multiple reasons why an employer may deny a claim for workers’ compensation. It is important to take the application and appeal process for workers’ comp seriously, a simple error in your paperwork could mean that you do not have the money you need to treat your injury. If your claim for benefits was denied, it could be for one of the following reasons.

Your Injury Does Not Qualify

One of the most common reasons for a workers’ comp claim being denied is because the injury is non-compensable. A non-compensable injury can be interpreted in a few ways under Pennsylvania’s Workers’ Compensation Act. One way your injury could be classified as non-compensable is if an employer believes that your injury occurred outside the scope of your employment. For example, if the bus you were riding to work was involved in an accident and you were seriously injured, your claim for workers’ comp could be denied.

Additionally, if the employer alleges that you were intoxicated while working or that you failed to follow safety protocols, this can also be used as a basis to deny your claim.

Your Employer Was Not Informed of Your Injury

If you are injured on the job in Pennsylvania, you must notify your employer of the injury within 21 days of the injury. If you fail to document your claim with your employer within this timeframe, it will be more difficult to prove your claim. However, Pennsylvania does allow up to 120 days to report your injury under certain circumstances.

If you reported your injury to your employer, be sure to request documentation of the injury report. If a supervisor neglects to file your report with your company’s human resources department, this may complicate matters if you need to appeal your benefits claim later.

The Severity of Your Injuries

Having your injuries evaluated by a physician is necessary before you can claim workers’ compensation benefits. Your employer may refer you to a doctor for your injuries, or you may have to schedule an appointment with a doctor that is qualified to assess your injuries. To determine whether you qualify for workers’ comp, the doctor will issue one of the following diagnoses regarding your injury:

  • Your injury is temporary
  • You suffered an injury that will permanently disable you
  • Whether your injury was the result of a pre-existing condition and whether your job requirements aggravated it
  • Whether your injury is directly correlated to your work responsibilities

Your physician’s report will affect the type of benefits you receive or whether you qualify for benefits at all.

You Are Not Covered Under the Workers’ Compensation Policy

Under certain circumstances, your employer or your employer’s insurance carrier may attempt to deny your claim by alleging that you do not qualify for benefits under the workers’ compensation insurance plan. Independent contractors, part-time employees, and even illegal aliens (“undocumented workers”) have the right to file workers’ compensation claims, but they can face difficulty in proving their right to benefits. The following is a list of workers that may not be covered under Pennsylvania’s Workers’ Compensation Act or that may be covered under other laws:

  • Agricultural workers
  • Casual employees
  • Domestic employees
  • Federal civilian employees
  • Harbor employees and other related positions
  • Railroad workers

This is not an exhaustive list. There are other occupations that may encounter difficulties when making a workers’ comp claim.

Our Delaware County Workplace Injury Lawyers Can Help You File an Appeal for Your Benefits

If you or a family member was denied workman’s compensation benefits, you should contact an experienced Delaware County workplace injury lawyer. At Schmidt, Kirifides & Rassias, our workers’ comp appeal lawyers are committed to protecting your rights and pursuing the benefits you need to handle your injury. To schedule a free legal consultation, call us at (610) 892-9300, or contact us online.


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