In an ideal world, your employer or their insurance company would provide you with all of the financial support and benefits you need to recover from a workplace injury.
Unfortunately, workers’ compensation claims are often messy. From claims being denied to retaliation from your employer, navigating workers’ compensation alone can be complicated and leave you with less money than your claim is worth.
There are dozens of reasons to call a Philadelphia workers compensation attorney, and this article explains the top 6.
1. Your Workers’ Compensation Claim is Denied
Workers’ compensation is a benefit designed to help employees who sustained a work-related injury get back on their feet and return to work. Benefits include lost wages, medical bills, and other supplemental benefits.
Because insurance companies (who usually foot the bill for a workers’ comp claim) are profit-driven enterprises, they will look for any reason to deny a claim or delay your benefits. Further, claim denials have risen by 20% in the past several years.
Even if your claim is denied, you still have recourse. According to Risk & Insurance Magazine, 67% of denied claims are paid within a year, and the increase in payment after converting a denied claim is substantial.
There are several reasons a workers’ compensation claim can get rejected, and not all of them are legitimate. Having experienced legal representation on your side can help ensure your rights (and finances) are protected.
2. You Have a Pre-Existing Condition
Insurance companies love pre-existing conditions because it often provides grounds for denying a claim. The insurance company will argue that it was the pre-existing condition, not a workplace injury, that led to your symptoms.
If you do have a pre-existing condition that is related to your injury, it makes a workers’ compensation claim and the associated legal issues more complex, but not impossible to win. For example, if you have a pre-existing condition that was made worse by the injury, you should still be entitled to benefits.
3. You Are Facing an Accusation of Fraud
If you’ve been accused of faking or exaggerating an injury to get benefits, it’s an uphill battle to get paid. Other fraud accusations include making false statements or claiming that an injury happened at work when it actually happened outside of work.
Proving that your claim is legitimate requires gathering evidence to bolster your case and get the benefits needed to recover from your injuries. An experienced workers’ compensation attorney will typically have a systematic process for fighting fraud allegations.
4. The Insurance Company or Employer Requests that You Undergo an Independent Medical Exam
A request for an independent medical exam usually occurs after you’ve been receiving benefits for a while and your employer or insurance company wants to find out to what extent you’ve recovered from your injury. Their goal is to reduce or terminate benefits and get you back at work.
When this happens, we recommend consulting an attorney to mitigate the risk of having your benefits lessened or ended unjustly.
5. Your Symptoms Develop Over Time
It’s not unusual to be injured and not have symptoms until much later – sometimes weeks or months. This is especially true for soft tissue injuries, repetitive stress injuries, and environmental illnesses.
To make compensation matters more complicated, your initial injury may seem minimal, while more severe symptoms are lurking underneath. A workers’ compensation attorney can help establish timelines for your injuries to prove their severity and ensure fair compensation.
6. Your Employer Has Retaliated Against You
Retaliating against an employee after they file a workers’ comp claim is illegal, but it does happen. Retaliation can come in several forms, including:
- Reducing your hours
- Reducing wages or salary
- Creating a hostile work environment
- Giving an unjustified poor performance review
- Rejecting a promotion
- Failing to pay earned bonuses or commissions
- Denying reasonable requests for accommodation
Philadelphia workers may be entitled to additional compensation if they have faced retaliation from an employer, including wrongful termination. If you are facing retaliation in response to filing a workers’ compensation claim, contact an attorney to begin building your case
Contact an Experienced Philadelphia Workers Compensation Attorney
At the Law Offices of Eric A. Shore, we will review your workers’ compensation case at no charge, and we never charge a fee upfront. If you have a case and we win, our payment comes from your settlement or judgment. To find out how to receive maximum compensation for your workers’ compensation claim, call our law firm at 1-800-CANT-WORK.