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What to Do if Your Workers’ Comp Was Denied in Pennsylvania

Workers’ Comp is there to cover your injuries, but when your employer or the insurance company they work with denies your claim, it can feel like no one is there for you.  Our attorneys work to help injured workers get denials overturned – or avoid denials in the first place.  As such, you should take the following steps when your Workers’ Comp is denied.

First, do not panic.  There are many legal routes to getting denials overturned, but it can take some work.  Collect all of the records and evidence that you have and call a lawyer.  Our attorneys can file your case before an administrative law judge to have the insurance carrier’s petitions reversed or overturned.  We can also reach out to the insurance company directly to try to negotiate a settlement that gets you your benefits.

For a free review of your claim, call (267) 651-7945 to speak with Cardamone Law’s Certified Pennsylvania Workers’ Compensation Specialists about your case.

Steps to Take After a Workers’ Compensation Denial in Pennsylvania

It’s simple enough for us to say that there is only one step to take after your Workers’ Comp claim is denied: call a Pennsylvania Workers’ Compensation lawyer.  While you should definitely do that, there are some steps you can take immediately that will help us help you, and even without our help, will put you in a better position to win your claim.

Do Not Panic

Medical bills can be incredibly high, and if you cannot work right now, you may be looking at your expenses and beginning to lose your cool.  A denial is not the end of your case, and it does not mean that everything is over or lost.  There are plenty of chances left to get the denial overturned, and you could end up getting all the coverage you need.  So, for now, do not trust that the denial is the end of the story.

Do Not Pay

You may have already gotten medical bills for the care you received, but this care is supposed to be covered under your employer’s Workers’ Comp coverage.  Do not start paying everything out of pocket or using your own health insurance to cover these bills.  Simply save all of the bills you get and bring them to us.

Collect All Records

If you have any bills or mail that was sent to you from the hospital, your employer, or their insurance company, keep it all together.  Our lawyers can help you collect additional records like your medical records, but try to hold on to anything else you might already have.

Call Our Lawyers

Once you have all of your ducks in a row, call our attorneys.  We can help you collect missing information, but more importantly, we have the training and experience to help get denials overturned.  Let our attorneys handle this case for you while you focus on getting better.

Understanding Reasons for Workers’ Comp Denials in Pennsylvania

Workers’ Comp claims are denied for various reasons, and it is important to understand the reasons given in your case.  Not only will the excuses and processes behind the denial help us understand what needs to be done to overcome the denial legally, but it will also help us understand the thought process behind the insurance carrier’s denial and ways we might be able to simply get them to change their minds.

Injury Not “Work-Related”

If the insurance carrier says that the injury was not work-related, then the way to get them to change their mind is usually by providing more evidence.  In many cases, insurance carriers say an injury is not work-related because they simply do not have enough proof to believe it was related to your job.  If we can get accident reports from your manager, get statements from coworkers, or just send the insurance carrier more details about how the accident happened and what your job tasks are, they may reconsider their ruling or propose a negotiated settlement.

If the case goes to court, we will need this additional evidence to overcome the carrier’s case.

Injury Not “Disabling”

Sometimes, the insurance carrier accepts that they have to pay your medical bills, but they do not think that you are “disabled enough” going forward that they should pay you ongoing wage-loss benefits.  In these cases, it is often harder to supply evidence of your disability without medical examinations.  This new evidence might be enough to overcome the denial and get the insurance company to change its mind.  Otherwise, we can file in court to have a judge make this decision.

Disability Deemed “Partial”

Insurance carriers might not want to cover you for the full value of your lost work.  This could lead to them saying that your disability is only partial and that you should be able to return to work.  That would lower the overall value of your wage-loss benefits.

If this is incorrect and you and your doctor believe you are not able to work at all, then you should be entitled to higher benefits than you would get if you were working part time.  Classifications of “total” versus “partial” disability can also come up down the road after you have already received 104 weeks’ worth of benefits, at which point an impairment rating exam (IRE) is likely.

Filing in Court and Negotiating Settlements for Denied Workers’ Comp Claims in Pennsylvania

When the insurance company denies your case, we can often take it to them first to try to get the denial overturned.  If they are willing to reconsider new evidence, they might simply accept the claim, and you can start drawing benefits.  Otherwise, we can seek to negotiate with them to get a settlement that covers your needs.

If the insurance carrier is unwilling to work with us or negotiate, then we can leave the decision to administrative law judges and file any responses to the insurance company’s filing or make filings of our own to get the case accepted.

Call Our Workers’ Comp Lawyers in Pennsylvania Today

Call (267) 651-7945 for a free case evaluation with our Pennsylvania Workers’ Compensation lawyers at Cardamone Law.

Awards & Recognitions

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Cardamone Law Has Negotiated Some of the Largest Workers’ Comp Settlements in Pennsylvania

$6 Million
We Assisted Another Firm in Reaching Settlement
$2.2 Million
Spinal Injury
$897,000
Lower Back Injury
$650,000
Lower Back Injury
$550,000
Neck Injury
$425,000
Leg Injury
$375,000
Knee Injury
$325,000
Ankle Injury
$6 Million
We Assisted Another Firm in Reaching Settlement
$2.2 Million
Spinal Injury
$897,000
Lower Back Injury
$650,000
Lower Back Injury
$550,000
Neck Injury
$425,000
Leg Injury
$375,000
Knee Injury
$325,000
Ankle Injury

Client Testimonials

"Thank you from the bottom of my heart Mike and Shirley!!"

I called Shirley when I was scared and didn’t know what where my next dime was coming from after I was out with my work injury. Shirley was very kind and helpful guiding me every single step of the way. Mike was not your typical lawyer was not pushy but very responsive to all my gazillion questions. He helped me get my settlement quickly and settlement check in a very timely manner. Would recommend them to anyone! Mike helped calm all my fears and anxieties as I was trying to navigate one of the hardest and most stressful times in my life. Thank you from the bottom of my heart Mike and Shirley!!

- Jen Thompson
Google Reviews
"Tienes un equipo impresionante a pesar de ser una compañía pequeña, los resultados fueron excelentes!"

Yo le daría 10 estrellas en vez de 5 , Michael Cardamone es una persona genuina y un gran abogado, al principio de mi caso, yo estaba en la oscuridad y no sabia que pasos tendría que seguir porque Workers comp ,solo me cubría en esos momentos los beneficios medicos .Después, me eliminaron el puesto , no sabia como manejar mi situación (estaba con una cirugía y también sin trabajo,) grasias a Mike, el me dirigió por el camino correcto, me dieron una muy buena cantidad por mi caso. El fue muy comprensivo porque le hice muchas preguntas por email y siempre me las contesto a tiempo, brindando seguridad ,sabia que estaba en las manos correctas! Shirley y Francisco también fueron de gran ayuda con los recordatorios y servicios de traducción en Español. tienes un equipo impresionante a pesar de ser una compañía pequeña, los resultados fueron excelentes! se los recomiendo a todos. Muchas grasias Cardamone law!

- Marisol Rodriguez
Google Reviews
"Best Law Firm around!"

"Cardomone law is absolutely fantastic! They are very responsive and helpful and they will fight to get you what you deserve. Shirley is also very helpful whenever you have any questions! Best Law Firm around!"

- C. Edwards
Google Reviews
"Michael and Shirley are very dedicated...and getting the maximum amount favorable to my case"

"Cardamone Law Firm were very helpful to me since day one. Michael and Shirley are very dedicated to my case giving me updates, answering my questions, being honest with my case, and getting the maximum amount favorable to my case. Thank you so much for your service and dedication and helping me to achieve not only your case but to guide and refer me in other needs too! You guys are the best law firm friendly and dedicated. I will recommend to anyone."

- A. Ortiz
Google Reviews
"Michael won my workers comp case after my employer insurance denied my claim."

"Exceptional firm. Highly recommend this law firm. Michael won my Workers Comp case after my employer insurance denied my claim. Him and his staff were always at my reach for legal and emotional support. Am so happy I hire them. Thanks Michael and Ms. Shirley."

- Carlos P.
Google Reviews
"[They] did an excellent job in getting me financially compensated in a fairly short amount of time."

"I recently had a work related injury and was receiving Workers' Compensation (medical benefits only). Soon after I was fired, so I contacted Paul Silver at Cardamone Law Firm who did an excellent job in getting me financially compensated in a fairly short amount of time. Paul and his assistant Shirley always responded to any questions I had about the case in a very short amount of time. Thank you for helping me with this difficult case."

- Robin C.
Google Reviews
"Highly recommend."

"Cardamone Law was great with helping my husband with his Workers Comp issues. Mike and Shirley were the best with letting us know what was going on every step of the way. Highly recommend."

- Danielle P.
Google Reviews
"Mike Cardamone is amazing"

"Mike Cardamone is amazing. He is "hands down" one of the best lawyers I've ever had the privilege of knowing. He is very kind, understanding, knowledgeable in his field, always very thorough and helpful. He was extremely professional and someone who truly cares about his clients. I felt completely at ease with him. He was a pleasure to work with, explained everything in detail, as well as answered all my questions with knowledge and care. If you want someone you can trust, who communicates every step of the way, will fight for you and make sure you win your case, he is it! I will refer all my family and friends to him. Thank you so much Mike, for everything. I appreciate all your hard work and dedication in helping me."

- Allie M.
Google Reviews
Without a doubt YOU are the best!!!

"Without a doubt YOU are the best!!! Every person who is in the horrible position of being injured at work should have someone as kind, compassionate and knowledgeable as you on their side. You never once made me feel like I was one of a hundred other clients. I always knew you had my back! You answered calls and emails at all hours. You fought every fight for me so I only had to worry about getting well. Behind your nice, calm face there’s a pit bull ready to take on any employer or judge. I can never thank you enough."

- L. Edall
Google Reviews
"Best Workers' Comp Lawyer!"

"Michael is simply the best! He was there for me from day 1 till the end, and we won the case!! He is always available to help. I had a gazillion questions and he would answer them one by one. He's a great lawyer and I feel lucky to have found him online from reading other outstanding reviews about him. Believe me, they're true!"

- Faith B.
Google Reviews
"Great Attorney"

"Great attorney, handled case quickly and efficiently. I would recommend him and would use him again. He was always available to answer any questions we had. Thank you, Mr. Cardamone."

- H. Anderson
Google Reviews