While most employers treat workers fairly, many worker’s comp claims are denied for financial reasons. Like other kinds of insurance, employers pay a premium to offer benefits to workers, and premiums increase when workers file claims. If a worker feels as though their claim has been unjustly denied, they should get Personalized Legal Service in Wilkes-Barre PA.
The Cost of Premiums
As mentioned above, premiums rise as workers file claims. Workers’ comp premiums go up when claim numbers are higher than estimated, or when workers have an expensive claim. For this reason, employers and insurers often use private investigators to monitor workers’ daily activities after they file claims.
Employers Have Certain Biases
Many employers do not believe that some injuries, especially those due to cumulative trauma, are legitimate. These companies assume that workers filing claims for ailments such as carpal tunnel syndrome or lumbar injuries often exaggerate those injuries. Employers’ biases are especially strong against conditions involving pain that cannot be verified by imaging, x-rays, and other diagnostic tools. However, some medical conditions are hard to verify objectively.
Reasons for Claim Denial
If an employer or their insurance company denies a worker’s claim or a part of it, the worker should be notified in writing. Most claims are denied for the following reasons:
• The injuries aren’t as serious as claimed
• The injury did not take place in the course of work
• The worker did not need treatment
• The worker did not need time off
Fighting a Denied Claim
If a worker is notified of a claim denial, they should write or call the employer’s insurer. If this does not resolve the issue, they should hire a worker’s comp attorney for Personalized Legal Service in Wilkes-Barre PA and get a hearing with the appropriate state board. Employees who are hurt or become sick on the job should file a worker’s comp claim to protect themselves with the help of a lawyer from The Law Office of Robert D. Elias.
It is irrelevant whether the employer believes in the legitimacy of the worker’s injury, and workers shouldn’t worry about retaliation from the employer. It is a worker’s right to take time off for medical treatment, and they waive their right to sue in exchange for benefits.