If your workers’ compensation claim has been denied or your insurer refuses to pay for necessary medical treatment, a Wilkes-Barre workers’ compensation lawyer can help you understand your options. Munley Law has nearly 70 years of experience helping injured Pennsylvania workers challenge denied medical bills and pursue the benefits available under the law.
Our workers’ comp lawyers have won millions of dollars’ worth of settlements for clients to date, including a $12 million verdict for a forklift accident victim, a $4 million settlement against a trucking broker shipper, and $1 million for a work-related crush injury.
Our attorneys also hold some of the legal industry’s top certifications and awards, including AV Preeminent Ratings from Martindale-Hubbell. J. Christopher Munley has been named Best Lawyers’ Lawyer of the Year for Workers’ Compensation, and Caroline Munley is also named a certified workers’ compensation specialist by the Pennsylvania Bar Association’s Section on Workers’ Compensation Law.
If you or a loved one needs a personal injury lawyer to help you pursue payment for denied work-related medical expenses and other available workers’ compensation benefits, call Munley Law. We will answer your questions and discuss your legal options for pursuing workers’ compensation benefits.
Contact a Workers’ Compensation Attorney at Munley Law
Call Us At 844-686-5397 Do 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, illnesses, or complex situations involving third-party claims 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. Workers’ compensation generally covers reasonable and necessary medical treatment related to your work injury for as long as that treatment remains medically necessary under Pennsylvania law.
How Many Kinds of Work Injuries 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.
Are There 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, workers’ 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 the hospital cannot charge the workers’ comp insurance company more than it normally charges.
What to Do After a Workplace Injury in Wilkes-Barre
After a work-related accident in Wilkes-Barre or throughout Luzerne County, a workers’ compensation claim must be filed with the employer shortly afterward, within 3 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 serving Wilkes-Barre, Luzerne County, before talking to the insurance company.
A work injury lawyer can help you pursue the workers’ compensation benefits available under Pennsylvania law, including payment for covered medical treatment. An experienced Wilkes-Barre workers’ compensation attorney can also communicate with the insurance company, address disputes over medical bills, and protect your rights throughout the claims process.
What If Workers’ Comp Denied Your Medical Bills?
Although Pennsylvania’s Workers’ Compensation Act provides medical benefits for many work-related injuries and illnesses, insurers sometimes deny payment for medical bills or severe cases that may potentially qualify for workers’ compensation death benefits. A denial does not necessarily mean your treatment isn’t covered. In some cases, the insurance company disputes whether the injury is work-related, whether the treatment was necessary, or whether proper procedures were followed.
- 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 to work, the last thing you need to worry about is covering the cost of your necessary treatments.
An experienced workers’ compensation attorney can guide you through the appeals process while you focus on your recovery.
Latest Statistics on Workplace Injuries in Pennsylvania
The 2024 Pennsylvania Workers’ Compensation report states that in 2024, there were 165,985 work-related injuries and illnesses referred to the Bureau of Workers’ Compensation, constituting an injury rate of 27.0 per 1,000 workers. There were 4,560 more injuries reported in 2024 than there were in 2023, but fatalities decreased from 84 deaths in 2023 to 75 in 2024.
A total of 89,796 workplace injuries – more than half of those reported in 2024 – took place in the Trade and Transportation and Education and Health Services sectors. Overall, strain and sprain injuries were the most common that year, accounting for 35.1% of all reported injuries, and contusions, crushing, and bruising accounted for 22.1% of cases. Overexertion and struck-by incidents were the most common causes of these injuries, 1,960 of which took place in Luzerne County in 2024 alone.
FAQs for Denied Workers’ Compensation Cases
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 Pennsylvania Bureau of Workers’ Compensation, 165,985 work-related injuries and illnesses were reported in 2024, resulting in an injury rate of 27.0 per 1,000 workers. Most work injuries occurred in the construction industry. The second-highest number of injuries occurred 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.
Workers’ compensation is intended to provide eligible employees with medical and wage-loss benefits after a work-related injury or illness, subject to Pennsylvania law.
When Must I Report My Injury and File a Claim?
Under Pennsylvania law and the statute of limitations for personal injury claims, 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 workers’ 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.
Disputes sometimes arise over whether medical treatment was necessary or whether the charges were reasonable. In those situations, medical testimony or other evidence may be needed to support your claim.
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.
Why Choose Munley Law for Workers’ Comp Claims?
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.
Having an experienced workers’ compensation lawyer on your side can make it easier to respond to disputes over medical treatment, deadlines, and benefit eligibility. An experienced workers’ compensation attorney from our law firm in Wilkes-Barre is dedicated to advocating for injured workers throughout the claims and appeals process. The skilled workers’ compensation attorneys at Munley Law Personal Injury Attorneys accept all kinds of workers’ compensation cases, large and small, and have secured numerous top settlements and verdicts for workers.
Our Achievements and Awards
Every workers’ compensation attorney in our firm has experience handling Pennsylvania workers’ compensation claims and is committed to providing responsive, client-focused representation throughout the legal process.
Our firm and attorneys also hold some of the legal industry’s most respected awards and certifications. Marion Munley and Caroline Munley are members of the International Society of Barristers and the Litigation Counsel of America, and all of our attorneys belong to the American Association of Justice, where Marion Munley is currently serving as the Vice President of the AAJ, and the Pennsylvania Bar Association, through which Caroline Munley is named a certified workers’ compensation specialist by the Section on Workers’ Compensation Law.
All of our attorneys have been honored by Best Lawyers, with Marion Munley named Lawyer of the Year for Product Liability Litigation, Medical Malpractice Law, and Personal Injury Litigation, Daniel Munley named Lawyer of the Year for Product Liability Litigation, J. Christopher Munley named Lawyer of the Year for Workers’ Compensation, and our firm consecutively named to Best Law Firms. Eight of our lawyers hold Super Lawyers status, including Marion Munley, who features in the Top 10 Super Lawyers in Pennsylvania, Top 100 Super Lawyers in Pennsylvania, and Top 50 Women Pennsylvania Super Lawyers lists, and all five partners are listed in the Lawdragon 500 Leading Plaintiff Consumer Lawyers list, with Marion Munley named to the Lawdragon 500 Leading Lawyers in America list.
Call Munley Law toll-free today or contact our law firm using our online form to speak to a qualified personal injury lawyer. 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.
Robert W. Munley, III
Robert W. Munley, III is a highly regarded and respected workers’ compensation lawyer. Bob has earned numerous accolades during his career fighting for injured workers, including being named to Best Lawyers in America in 2013 and appointed to the 2026 Lawdragon 500 Leading Lawyers in America guide. Bob is also known for being outspoken in helping attorneys fight for workers rights nationwide, taking part in speaking arrangements such as the Pennsylvania Workers Compensation Symposium and the Pennsylvania Workers Compensation Information Distribution Seminar.
Reviewed by Bernadine Munley, Esq., Personal Injury Attorney at Munley Law, on August 6, 2026.
