The unthinkable has happened — you have been injured on the job. To make it worse, although you took the proper steps to report your injury, your claim was still denied. This can be a frustrating time but there are vital steps you need take to move forward with your claim.
Jennifer Kline, one of KBG’s certified workers’ compensation lawyers, talks about the steps that you should take if your workers’ compensation claim has been denied.
What do I do if my claim is denied?
If the insurance company denies your claim, you should receive a Notice of Workers’ Compensation Denial form. The carrier will check at least one of five boxes on the form indicating why they are denying your claim. Just because the insurance company has denied your claim doesn’t mean you are out of options. To the contrary, once you receive the denial, you are able to contest the denial and pursue a claim for your injury.
Should I speak with a lawyer before appealing?
Yes. The Notice of Workers’ Compensation Denial specifically indicates:
“You have the right to contest this denial of your claim for workers’ compensation benefits. Your petition will be heard by a workers’ compensation judge. You and your employer will have the opportunity to testify and provide medical evidence with respect to your claim. Both you and your employer will have the right to bring witnesses. You may retain an attorney to represent you in this proceeding although representation by an attorney is not required by law. Because of the legal complications that can arise in occupational disease and workers’ compensation cases, you may want to consider legal advice.”
The insurance company will have an attorney representing them in the proceedings. You will be at an extreme disadvantage if you are not represented. The proceedings are long – approximately nine months – and can be complicated due to evidentiary rules and deadlines and are difficult to pursue without an attorney advocating for you.
Is there a strict deadline for appealing my case?
Yes. Typically in Pennsylvania, you have three years from the date of injury to file your claim and appeal the denial.
Would it benefit my case to reach out to the insurer?
Probably not. Once the insurance company issues a denial, it is extremely unlikely it will voluntarily accept your claim.
At KBG, we know it is stressful when you are hurt on the job. Having the insurance company deny your claim only increases that stress. We offer free consultations and are happy to speak with you at any stage of your claim.
If you’ve been injured on the job, contact KBG Injury Law. We’ll fight to get you the Results You Deserve®.
The personal injury attorneys at KBG Injury Law are all experienced litigators. Almost all of them represented insurance companies prior to becoming advocates for injured people, which provides them with a unique perspective and insight into how these companies operate. They also offer extensive courtroom experience if going to trial is the best legal alternative for the client.