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Denied Workers Comp in Wilkes-Barre? We Can Help.

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A job site injury can lead to expensive medical treatment, lengthy physical therapy, costly rehabilitation, and time away from work without pay. Workplace injuries can be serious and result in workers’ compensation benefits. Nearly 150,000 workers were injured on the job in Pennsylvania in 2020.  For those injuries, over $1 million was paid by the workers’ comp system. Unfortunately, sometimes a workers comp claim is wrongly denied each year by workers’ comp insurance companies.

When you suffer a work injury on the job, a Wilkes-Barre workers’ compensation attorney can help you receive money to pay for your denied medical bills. If you or a loved one need a work injury lawyer to help you get money to cover your denied work injury, call Munley LawWe will answer your questions and discuss your options.

Workers’ Comp Benefits Cover Work Injury Medical Bills

Under Pennsylvania’s workers’ compensation law, most employees are eligible to receive compensation to treat work-related injuries or illnesses that occur on the job. Medical costs for injuries and illnesses made worse by your job are also covered by workers’ comp. Throughout Luzerne County, medical costs are covered by Pennsylvania workers’ comp laws. The laws cover the following medical costs:

  • surgery
  • doctor visits
  • medicine
  • medical equipment
  • lab tests
  • physical therapy
  • rehab services

There is no cap on the dollar amount of money you can receive to cover workers’ compensation medical costs. You are entitled to receive money for your treatments until your doctor determines that you no longer require treatment because you are fully healed.

Many Kinds of Work Injury Are Covered by Workers’ Comp

Many different kinds of work injury treatments are covered by Pennsylvania workers’ compensation insurance. All the following should be paid for by workers’ comp:

  • Services by physicians and other health care providers, including chiropractors.
  • Reasonable surgical expenses.
  • Reasonable medical services.
  • Hospital treatment, services, and supplies.
  • Prescription medicines.
  • Prescription supplies.
  • Orthopedic appliances and supplies, such as braces and crutches.

Limitations on Work Injury Treatment Costs Covered by Workers’ Comp

When you suffer a workplace injury, you may need to stay in the hospital. If you stay in the hospital, workers’ compensation provides for a semi-private room. If no semi-private rooms are available, worker’s comp will pay for a private hospital room.

Workers’ comp will pay for hospital treatment, services, and supplies. But the costs cannot exceed the usual costs the hospital charges for similar treatment, services, and supplies to other patients. This means that the hospital cannot charge more to the workers’ comp insurance company than they normally charge.

What to Do After a Workplace Injury in Wilkes-Barre

After a work-related accident in Wilkes-Barre and throughout Luzerne County, a workers’ compensation claim must be filled out and submitted to the employer shortly afterward, within three days if possible. If the report is not filed within 120 days of the incident that caused the injury, then you will not be eligible to receive benefits for your loss. Once you’ve submitted the incident report, insurance adjusters are likely to contact you to find out more. It is important to speak with a skilled attorney, Wilkes-Barre serving Luzerne County before talking to the insurance company. A work injury lawyer will ensure you receive the workers’ compensation you deserve, including payment of work injury treatment costs. An experienced Wilkes-Barre workers’ comp attorney will negotiate with the insurance company to protect your interests.

If you need a denied medical bills lawyer in Luzerne County, contact the Wilkes-Barre comp attorneys at Munley Law Personal Injury Attorneys today.

What If Workers’ Comp Denied Your Medical Bills?

Pennsylvania’s Workers’ Compensation Act is designed to provide pay for employees’ medical expenses when they are hurt on the job. Regrettably, your employer or its workers’ compensation insurance company may wrongly offer a denial, stating that:

  • the injury isn’t covered by workers’ comp insurance,
  • the injury happened outside of work,
  • the medical charges are unusually high, or
  • the worker was using alcohol or drugs while at work.

In addition to these kinds of unfair reasons for denying your medical costs, your employer may have valid reasons for denying your workers compensation claim, such as:

  • the incident report contains inaccurate information, or
  • the report was filed more than 120 days after the accident.

If Your Medical Bills Were Wrongly Denied, You Can Appeal

If you believe your workers’ compensation claim was denied when it should not have been, you can appeal. A skilled Wilkes-Barre workers’ compensation lawyer can help. The appeals process is complicated and can be frustrating. When you are trying to get well and get back the work, the last thing you need to worry about is covering the cost of your necessary treatments. A Wilkes-Barre workers’ compensation attorney who knows Pennsylvania workers’ compensation law will handle the appeal process on your behalf so you can focus on feeling better.

Do you need to appeal a denied workers’ compensation claim in Luzerne County? Discuss your options with a qualified Munley Law Personal Injury Attorneys workers’ compensation lawyer Wilkes-Barre today. 

FAQs for Denied Workers’ Compensation Case

What is Pennsylvania’s Workers’ Compensation System?

The Pennsylvania workers’ compensation structure is designed to protect both employees and employers. Through the system, employees who are hurt on the job site or during work off-site receive compensation. Employers pay to cover their workers. In exchange, employers are protected from lawsuits by their employees. For most employers, workers’ compensation coverage is required. If employers do not cover their workers, they may be sued by their employees and could even be criminally prosecuted.

What Kinds of Injuries Are Suffered at Work Each Year in Pennsylvania?

According to the Bureau of Workers’ Compensation of the Pennsylvania Department of Labor & Industry, nearly 150,000 workers in Pennsylvania were injured at work in 2020. Most work injuries occurred in the construction industry. The second highest number of injuries was in the trade, transportation, and utilities industry. Workers in the education and health services industry suffered the third-highest number of workplace injuries.

How Do I Know If I Am Covered by Workers’ Comp?

The Pennsylvania Workers’ Compensation Act requires most – but not all – Pennsylvania employers to protect their employees with workers’ compensation insurance, no matter the size of their business. Some situations where a worker might not be covered by Pennsylvania’s workers’ comp laws include:

  • independent contractors who are not employees,
  • volunteer workers,
  • agricultural workers who work less than 30 days in a year for one employer,
  • farm workers who earn less than $1,200 annually from one job,
  • employees covered by other workers’ comp laws, such as railroad and federal workers’ comp laws,
  • workers who provide domestic services such as house cleaning and lawn care.

Eligible employees are covered by Pennsylvania’s workers’ comp system for the entire time they work, beginning on the first day of the job, and are covered whether they work full-time, part-time, or seasonally.

Because workers’ comp policies ensure employees receive money for injuries suffered on the job, all work injury claims go through the workers’ compensation system instead of going to court.

When must I report my injury and file a claim?

Under Pennsylvania law, a worker’s injury must be reported to the employer within 120 days of the injury. You must file your claim with the Workers’ Compensation Bureau within 3 years of the date of the injury. These time limits make it very important for you to speak with an experienced Wilkes-Barre worker’s compensation lawyer as soon as possible. If you do not report your injury or file your claim in time, you will not be able to receive compensation for your medical bills and your claim will be denied.

What needs to be proved in a workers’ comp and specific loss benefits claim?

You will need to prove that:

  • you are an eligible employee,
  • your injury occurred on the job site or off-site while working,
  • your medical bills are reasonable, and
  • your medical services were necessary.

You may also need to prove that you were not under the influence of drugs or alcohol at the time of the accident. Proving each of these can be challenging if your employer or their workers’ compensation insurance company tries to show that some of this is not true. It can be difficult to have your entire cost of treatment paid by workers’ compensation is the hospital or doctor argue that their bills are reasonable, but the workers’ compensation insurance company disagrees. An insurance expert and a medical expert may be necessary to prove your case. An experienced Wilkes-Barre workers compensation lawyer can help you prove your case so you can receive the compensation you deserve.

What can I expect after I hire an attorney?

Typically, your attorney will investigate the accident that caused your injury and gather as much information as possible. Your legal team will review workers compensation cases through accident reports and medical documents, and interview you and witnesses. Your Wilkes-Barre personal injury attorney will also conduct a financial analysis. Your attorney may contact the insurance company and your doctors to review your treatment costs, whether they are reasonable, and whether workers’ comp will pay medical bills. Your attorney may also negotiate a reduction in the cost. Your legal team may hire a medical expert to prove that your medical services were necessary and that the costs are reasonable.

Munley Law Personal Injury Attorneys Is Not Just One Lawyer. We Are a Team of Lawyers Fighting for You.

At Munley Law Personal Injury Attorneys, you get a team of lawyers, not just one lawyer. We are a law firm dedicated to helping you receive the compensation you deserve. Our attorneys work together as a team to give you the insight, experience, and combined efforts of our entire law firm. Our workers’ compensation attorneys are highly skilled in workers comp and denied medical bills claims and are known throughout Luzerne County as hard-working Wilkes-Barre attorneys. We work to protect your rights and get you the compensation you deserve. Our mission is to help employees who are hurt in workplace accidents. We don’t charge you a fee unless we recover money for you for your injury and loss. Contact us today for a FREE case evaluation.

In Luzerne County, the workers’ compensation and medical benefits claim process is complex. It is difficult and frustrating, especially when you really need to focus on getting well. A simple mistake could result in your entire work comp claim being denied. This could mean none of your treatment costs get paid by workers’ comp. Even if you are already receiving your benefits and medical costs are being paid, the insurance company may try to stop your payments earlier than they are allowed to stop. Or they may try to pay less than the full amount owed for your medical costs.

You need a highly qualified work injury lawyer to help you get and keep the compensation you deserve for as long as legally possible. An experienced workers’ compensation attorney from our law firm in Wilkes-Barre is dedicated and committed to obtaining a favorable outcome in our workers’ compensation claims. The skilled workers’ compensation attorneys of Munley Law Personal Injury Attorneys accept all kinds of worker’s compensation cases, large and small, and have obtained many top settlements and verdicts for workers.

Every workers’ compensation attorney in Wilkes-Barre in our firm is professional, aggressive, and experienced at helping workers get their due in workers’ compensation claims. We work hard to protect your interests and ensure you are satisfied with your case’s outcome.

Call Munley Law Personal Injury Attorneys toll-free today to speak to a qualified personal injury lawyer. Or contact our law firm using our online form. We work on a contingency fee basis, which means you only pay our law firm for our services if and when we obtain money for you.

Do I Have A Case?

If you think you may have a personal injury case, contact us now for a FREE consultation.

    Munley Law Personal Injury Attorneys

    1170 PA-315
    Wilkes-Barre, PA 18702
    (570) 399-0406

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