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    Archive for January, 2021

    Avoiding Workers’ Comp Claim Denials

    Under the Pennsylvania Workers’ Compensation Act (the “ACT”), most workers are eligible for workers’ comp benefits to help pay for their work-related injury or illness, including compensation for medical expenses and lost wages. However, employers may deny workers’ comp claims for many reasons. The trick is to avoid giving your employer any reason to deny your claim. Let a Lancaster workers comp lawyer at Vanasse Law LLC help.

    The Most Common Reasons for Denial

    To avoid the pitfalls of fighting through a denied claim, you should be aware of the most common reasons for denials. Such reasons include:

    • The Injury is Not Compensable. To be considered “compensable” under the Act, an injury must have been sustained while the employee was within the course and scope of their employment. If the injury occurred outside of work, an employer may deny the worker benefits. 
    • Worker Behavior. While the workers’ comp system is “no-fault” (which means you have no obligation to show the employer was negligent), there are some types of employee behavior that may cause a claim denial, such as horseplay, ignored safety procedures, or being under the influence of drugs or alcohol at the time of the accident.
    • Insufficient Information. Your claims paperwork should include all relevant details, such as when and where the accident occurred, whether there were any witnesses, and what injuries were sustained. It is better to be over-thorough rather than merely supplying the bare minimum.
    • Not an Eligible Employee. Some employees are not eligible for state workers’ compensation benefits, including federal workers, railroad workers, longshoremen, independent contractors, and sole proprietors. However, they may be able to receive alternative forms of benefits.
    • Outside the Reporting Deadline. Injured workers should report their injuries to their employers as soon as possible. The Act states that injuries must be reported within 120 days of the incident, but you should file well before that limit — preferably immediately. Those who fail to report their injuries within the 120-day limit may be denied.
    • Pre-existing Condition. Employers have been known to deny claims involving pre-existing conditions, but this is not a valid cause for denial. Pre-existing conditions are covered under the Act if the condition was worsened by the employee’s work activities or environment. Common pre-existing injuries include back injuries, knee injuries, arthritis, broken bones, asthma, and even chronic anxiety.
    • Suspected Fraud. If the employer’s investigation reveals information that contradicts the employee’s information, the claim may be denied. Employers may even seek to back up their information with video surveillance, written statements from co-workers, or witness accounts.

    If Your Claim is Denied, Call a Lancaster Workers Comp Lawyer for Assistance

    In Pennsylvania, employees have several rights to appeal a denied workers’ compensation claim. Employees may also have alternative options, such as a personal injury lawsuit or a third-party claim. Still, the appeals process is complicated, and personal injury lawsuits can be quite tricky. That said, we encourage you to speak with our Lancaster workers comp lawyer as soon as possible to learn more about your rights and options under the law.

    Contact a Lancaster Workers Comp Lawyer at Vanasse Law LLC for Help With Your Claim

    If you are dealing with a claim denial, you do not need to handle it on your own. Contact a Lancaster workers comp lawyer at Vanasse Law LLC. Workers’ comp is what we do. Our experienced workers’ comp attorneys will help you examine your options and file any claims that are required.

    If you have suffered a work-related injury or illness, contact us online for a same-day response.

    Tags: Workers' Compensation

    Are Your Injuries Covered By Workers’ Compensation?

    In most cases, when an employee is injured on the job or develops an occupational illness, it is considered a workers’ comp injury that is eligible for a workers’ comp claim. For help regarding work-related injuries and illnesses, contact a Lancaster job accident lawyer at Vanasse Law LLC.

    If the claim is approved, the employee can receive medical coverage, wage replacement, and other benefits as compensation for the injury. However, to access these benefits, both the employee and employer must follow certain steps to ensure the benefits are distributed.

    Workers’ comp protects employees in that they do not have to establish fault by the employer. If you are hurt at work, benefits are likely available to you even if your employer did nothing wrong. Workers’ compensation also protects employers in that the benefits are generally the employee’s sole remedy — meaning you typically can’t sue the employer even if they were at fault. This is why workers’ comp is sometimes referred to as “workers’ comp insurance.”

    Of course, our Lancaster job accident lawyer knows there are various exceptions to these rules. The process of filing a workers’ comp claim for a workplace injury or illness can be quite complicated because of the multiple parties involved. These parties may include the employee, the employer, the insurance company, the healthcare provider, and the state’s workers’ compensation board.

    Common Injuries Covered by Workers’ Comp Insurance

    Workers’ comp covers injuries and illnesses that are within the “course and scope of your employment.” Most courts have interpreted this phrase broadly, in favor of the employee, and have been lenient regarding covered injuries. In general, if you were engaged in an activity that benefits your employer, your injury will be covered.

    Some of the most common workplace injuries/illnesses include:

    • Slips, Trips, and Falls. Slip, trip, and fall injuries are quite common, as nearly every surface in the typical workplace will become slippery or cluttered at some point. Another major risk in many work environments is falling while working at heights, such as from a ladder, scaffolding, and other high platforms.
    • Falling Objects. Being struck by falling objects is also quite common. This isn’t just a problem in warehouse-type environments. Objects may fall from shelves or out of cupboards and can cause serious injuries, particularly if the individual doesn’t see it coming.
    • Repetitive Strain Injuries (RSI). RSIs are another problem that’s become increasingly common in workplaces. It’s not just about developing carpal tunnel from computer keyboard use, but RSI can result from any joints’ repetitive motion. The long-term, cumulative impact of RSIs can be severe in some cases. Taking regular breaks and using ergonomic equipment can help prevent these types of injuries.
    • Crashes and Collisions. Crashes and collisions can result in serious injuries, often involve company cars/vans or forklifts, and are also quite frequent at work. Employers need to enforce seat belt laws and take other safety precautions, such as adequate training, especially for forklifts.
    • Cuts and Lacerations. All sorts of office apparatus can cause painful cuts. From paper cutters to scissors, it’s easy to cut yourself at work. Employers need to stress safety and encourage employees to take their time when using sharp instruments. 
    • Strained Muscles. Strained muscles are more common than you might think, especially for those who regularly lift heavy items at work. Neck and back strains, in particular, frequently occur in the workplace. These injuries can be avoided with some basic training on proper lifting techniques.
    • Occupational Illnesses. Workers’ comp typically covers illnesses or diseases that employees develop due to on-the-job exposure. Work-related illnesses can range from traditional occupational illnesses like black lung disease, exposure to coal dust, and asbestosis caused by asbestos exposure.
    • Stress-Related Injuries. The medical profession has increasingly recognized the link between long-term stress exposure and a wide range of physical and psychological illnesses. Still, it may be challenging to get workers’ comp benefits for illnesses caused by on-the-job stress, as it may depend on where you live, the nature of your illness, and the reason for the stress.

    Contact a Lancaster Job Accident Lawyer at Vanasse Law LLC for More Information

    It can be difficult to determine if workers’ comp covers some types of work-related injuries or illnesses. If you have suffered what you suspect is a compensable injury, contact a Lancaster job accident lawyer at Vanasse Law LLC. Workers’ comp is what we do. Our experienced workers’ comp attorneys will help you explore your legal options, which may include third-party claims, and help you with your claims.

    Let us help. Contact us online for a same-day response.

    Tags: Workers' Compensation, Workplace Accidents