When one of our client’s workers compensation claims are denied, they come to us first. They demand to know why their claim was denied. They are understandably upset with their employer. After all you’ve done for a company, it seems surreal that they would deny your claim. Are they really willing to lose a good employee because they don’t feel like paying out a few thousand dollars out on worker comp. Our Philadelphia workers comp lawyers represents dozens of clients who want nothing more than compensation for their injuries. They don’t want to stay out of work for very long. They want to get healed so they can go back to work as soon as possible. However, things can change. You may get the impression that your employer has secretly been waiting for you to mess up. The problem is that, if you suffer a legitimate workplace accident injury, you should be taken care.
There Are Certain Categories of Workers Who Are Not Eligible for Workers Compensation
While it may not seem fair, there are categories of workers who are simply not entitled to workers compensation. These groups are the same whether you live in Philadelphia or Los Angeles. For some of these groups, it comes down to there being a heavy union influence in that industry. For example, railroad workers cannot apply for workers compensation. Nor can federal employees. That’s because there is a separate federal version of workers compensation that these employees can take advantage of.
Some of the other categories of workers who are not eligible for workers compensation in Pennsylvania include the following:
- Domestic servants
- Seasonal workers
- Temporary employees
- railroad workers
- federal employees
- agricultural workers
- independent contractors
Of course, this list isn’t exhaustive. However, if you find yourself on this list, you need to call a workers compensation attorney in Philadelphia as soon as possible. They can help you find another way to pursue benefits. For example, if they feel your case has merit, they may suggest that you hire a Philadelphia workers comp lawyer to file suit on your behalf. It all depends on the facts surrounding your case and the seriousness of your injuries.
Your Philadelphia Workers Comp Lawyer Must Also Prove You Meet the Requirements for Workers Compensation
Even if you are in a qualifying group of employees for workers comp purposes, that doesn’t mean you’re automatically entitled to workers compensation benefits. Your Philadelphia workers comp lawyer must also prove that you meet the basic criteria for workers compensation. These include (but are not limited to) the following:
- your injures must take on company property
- you must get hurt on company time
- if you work remotely or are a salaried employee, your accident must take place within your normal scope of employment
- You cannot be under the influence of drugs or alcohol at the time of your workplace accident
- You are not allowed to work a second job while collecting benefits
- You must agree to take a drug test prior to treatment
- You must be willing to be treated by a state-approved doctor
- You must participate in your treatment plan
Once you have met these criteria, there’s no reason why you shouldn’t be allowed to receive workers compensation benefits.
Why Would Your Employer Deny Your Claim?
You may be wondering why your workers comp claim was denied. The best thing to do is take the list outlined above and go through each one separately. Ultimately, you should find one of these criteria that you don’t meet. Your Philadelphia workers comp lawyer can also review your paperwork, including the letter of denial, to see what happened. If they don’t think your claim was fairly denied, they may file an appeal on your behalf. If this doesn’t work, then you still have the option of filing suit against your employer and their insurance company.
Let Your Philadelphia Workers Comp Lawyer Focus on the Legal Side of Things for You
One of the nice things about hiring a Philadelphia workers comp lawyer is that they can handle the legal side of things for you. This gives you a chance to fully recover from your injuries. It also lets you focus on taking care of your family while your attorney negotiates payment of your claim with the insurance company. The last thing you want to do is handle something like this one your own. That is what the big insurance companies are counting on. They want to intimidate you so that, when they deny your claim, you just walk away without putting up a fight.
When the insurance adjuster sees that you’ve retained a workers compensation lawyer in Philadelphia, they may change their tune. They may be willing to review your claim for a second time. Or they may simply agree to pay your claim knowing that they won’t be able to take advantage of you. Either way, as long as it gets you the benefits you deserve, who cares. Our goal is to get you workers comp benefits. As long as your injuries were the result of a workplace accident, there’s no reason why you should suffer.
Now, keep in mind, there are certain groups of workers who will never be allowed to collect workers compensation. If you fall into one of these groups, it’s nothing personal. It just means your Philadelphia workers comp lawyer has to find another way to pursue compensation. One obvious way to do that is to file suit. While this is a last resort, it’s something worth considering.
This is just one of the things you can discuss with your workers compensation lawyer in Philadelphia. We offer all new clients a free, initial consultation so it won’t cost you anything to get the opinion of a successful, legal professional.
If you have questions about your case give us a call. Since the consultation is free, you have nothing to lose.