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Workers' Compensation Questions Answered: What Should I Do If My Claim Is Denied?

August 12, 2011

What should I do if my claim is denied?
 
The Pennsylvania Workers’ Compensation Act requires an employer to either accept or deny a claim within twenty-one (21) days of the date that notice of the work injury is provided by the injured employee to the employer. Insurance companies routinely deny claims by issuing a Notice of Workers’ Compensation Denial. Often a denial will be issued because the insurance adjuster has not had sufficient time to investigate the claim. If you receive a Notice of Workers’ Compensation Denial, you should check to make sure that the insurance company has received written confirmation from your treating physician that your condition is work related and that you are, at a minimum, partially disabled as a result of your work injury or are incurring medical bills in connection with the injury. If the adjuster has all necessary information but persists in the denial, you should contact Willig, Williams & Davidson immediately. You should do so even if the adjuster says that this is only a “conditional denial” and the company will re-evaluate its position once you have undergone an “independent” medical evaluation.
 
How long do I have to file a claim petition?
 
If your claim is denied, you are entitled to file a Claim Petition for Compensation. A claim petition must be filed within three (3) years of the date of injury. In the case of an occupational disease, three (3) years from the date of wage loss or from the date when the worker knew that the injury was work related, whichever is later, provided it is within 300 weeks.
 
Should I hire an attorney?
 
Under most circumstances, you should hire an attorney to handle petitions before a workers’ compensation judge. The insurance company will always utilize an experienced attorney who will do a professional job of protecting the insurance company’s rights. While most judges will grant considerable leeway to you if you are not represented by an attorney, you must be familiar with workers’ compensation law and procedure and must be prepared to present all evidence necessary to meet your burden of proof.
 
Forms for filing a claim petition for compensation may be obtained by calling Willig, Williams & Davidson at 1-866-413COMP (2667) or 1-215-656-3600. Regardless of the length of your claim, you may obtain a free consultation by calling this number and asking to speak with a workers’ compensation attorney.
 
How can I pay for an attorney?
 
Most attorneys, including Willig, Williams & Davidson, will charge you a fee only if they are successful in obtaining or protecting your benefits. The Act limits attorney’s fees to no more than 20% of your compensation except under special circumstances.
 
Willig, Williams & Davidson Workers' Compensation Lawyers

The workers’ compensation attorneys at Willig, Williams & Davidson have a deep knowledge of workers’ comp law. Our lawyers use our workers’ compensation expertise and a broad client base to leverage the best possible results for our clients in Philadelphia, Pennsylvania and beyond. Our Workers’ Compensation Department provides advice, counseling and legal representation to sick and injured workers, to make sure that they receive 100 percent of the benefits required by law.
   
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