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4 reasons a workers’ compensation could be denied

On Behalf of | Apr 10, 2024 | Workplace Accidents |

Injured employees may be able to apply for worker’s compensation benefits, such as medical coverage and lost wages. These benefits are meant to help employees recover from their injuries and maintain financial obligations.

A claim could be denied, which could greatly affect an employee’s life. Here is how that can happen:

The injured worker missed a deadline

It is often important to report a workplace injury as soon as it has occurred to receive worker’s comp benefits. In Pennsylvania, injured workers have 21 days to report their injury to their employer. An employer must then begin an investigation into a claim. If an injury goes unreported for more than 120 days, a claim could be denied. 

The injury did not happen at work

One important condition for an injured worker to receive benefits is that the injury must have happened while they were working. For example, if a worker fell on a slick surface and hurt their back while on the job, then they may receive benefits. A worker may be denied benefits if they were not working, for instance, while they were driving home after their shift was over.

The injury was self-inflicted

Workers’ comp is on no-fault basis, which means that an employee could receive benefits whether a co-worker, employer or their own actions led to an injury – on one condition. An employee can not cause their own injuries on purpose in the hopes that they would be eligible for comp benefits. If it is discovered that their injuries were self-inflicted, then a claim could be denied. 

There was not enough documentation of the injury

Workers often have to get a medical evaluation after sustaining their injuries. A medical evaluation can help identify and clarify how an injury impacts an employee’s ability to work. Without conclusive documentation, a claim may be denied. 

If your workers’ compensation claim was denied, it can help to seek legal help to learn about your options.