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7 Claim Mistakes and the Impact on Your Workers’ Compensation

claim mistakes

Costly Workers’ Compensation Claim Mistakes

Claim mistakes hurt the thousands of workers who are injured on the job and apply for Pennsylvania workers’ compensation. The most recent report shows 9,375 workers filed workers’ compensation claims in 2016. Those claims, however, are increasingly being denied. In fact, over the last few years, denial rates have increased by 20 percent. Often times, it’s because of mistakes being made unknowingly by the injured worker.

Let’s take a look at some of the top workers’ compensation claim mistakes.

  • Failing to properly report your injury or accident
  • Telling your employer you’re not hurt
  • Not seeking medical treatment for your workplace injury
  • Ignoring your doctor’s advice
  • Submitting incorrect claim forms
  • Missing the deadline to apply for workers’ compensation
  • Missing the deadline to appeal a denied claim

Failing to Properly Report Your Injury

Workplace injuries should be brought to the attention of an employer or supervisor right away. The best thing to do is to notify your employer in writing of any accident, injury or medical diagnosis as soon as possible. It’s important to get something on the record as soon as possible, even if it is an incomplete explanation of your injury and condition. Having the date, the time of the accident and any other contributing factors—along with the fact you that intend to seek workers’ compensation benefits, are the most important items to note. If at all possible, obtain your workplace policy for reporting accidents and follow them as closely as possible.

Telling Your Employer You’re Not Hurt

Don’t let pride get in the way. Often times, when an injury happens, an employee brushes it off saying, “I’m fine.” Don’t understate your injury. Anything said directly following an accident at work can be used by the employer and the insurance company to deny a claim.

Not Seeking Medical Treatment for Your Workplace Injury

After a workplace accident, allow those around you to treat the injury. Many times, this prompts a formal workplace injury report to be filed. Without documentation of your injury, insurance companies may deny your claim. This is especially true if the injured worker never schedules a follow-up appointment with a doctor who can properly diagnose the injury. Documentation is absolutely essential in a workers’ compensation claim.

Ignoring Your Doctor’s Advice

Don’t be the tough guy! If a doctor has advised you to take some time off or to undergo physical therapy, do so. If you don’t follow your doctor’s advice, your workers’ compensation claim could be denied, or your benefits may be reduced. Your employer’s insurance company is looking out for itself, and any reason you can give them to question your injury, works against you. By not following a doctor’s order, an insurance company might try to claim you sustained your injury outside of work or that you aggravated it by not seeking medical care.

Submitting the Wrong Claim Form

Pennsylvania’s Workers’ Compensation office has hundreds of different claim forms. If you submit the wrong one, it could be a costly mistake. That’s why it is so important to have someone looking out for you through the process. Your employer and your insurance company may try to minimize their damage, and likely doesn’t have your best interest at heart. An experienced workers’ compensation attorney will make sure deadlines are hit; the correct forms are filed, and instruct you of what to do and not to do throughout the process.

Missing the Deadline to Apply for Workers’ Compensation

Pennsylvania has specific rules and regulations when it comes to applying for workers’ compensation benefits. Depending on the circumstances surrounding your injury, you could have 21 days to 120 days to apply for benefits.

Missing the Deadline to Appeal a Denied Claim

If your employer or its insurance company denies your initial application for workers’ compensation benefits, you’ll have several additional opportunities to get the benefits you deserve. Each case is different, but generally speaking you have 20 to 30 days to file your appeal.

Workers’ compensation insurers deny many legitimate claims. It happens all the time. As outlined above, there are many things that can happen that jeopardize an employee’s right to collect the compensation they deserve. Acceptance rates are historically low—so it is critical to hire an experienced attorney when filing for workers’ compensation to make sure you never miss a step.

Consulting with an attorney will ensure that your rights are protected and that you are maximizing the value of your claim. If you or someone you know was injured on the job, Call Georgelis First at 1-800-HURT-NOW. Give us a call today so we can help you through the process. The insurance company has countless employees working against you; you should have someone on your side making sure that you are protected.


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