Why Is My Employer Denying My Workers’ Compensation Claim?

In many cases of workplace injuries, the injured worker receives compensation without issue and then returns to work once they are healed. However, there are also plenty of cases in which this does not happen. If your claim for workers’ compensation is initially denied, you may be left wondering why your employer would do that. After all, you have worked for them for years and have not had any issues previously.

Well, the odds are that your employer was not the one who denied your claim for compensation. This article will explain who is actually behind most claim denials and why many of these seemingly bad faith denials of workers’ compensation happen.

Who Is Really Denying Your Claim?

workers' compensation fault

The decision of whether to accept or deny a claim ultimately comes from whoever is going to have to pay out the compensation related to that claim. If your employer is self-insured, then they are going to be the one who decides whether to accept or deny your claim. However, many employers are not self-insured. If your employer has purchased a workers’ compensation plan from an insurance company, the insurance company makes the decision. Insurance companies are the ones who are responsible for denying the majority of workers’ compensation claims.

There are some situations in which both the employer and insurance company have a say. These insurance plans are relatively uncommon, though.

Why Is Your Claim Being Denied?

Claim denial

Now that you know that your claim was most likely denied by your employer’s insurance company and not your employer themself, your next question is probably, “why was a denial issued in the first place?” In many cases of denied claims, it is the insurance company attempting to reduce its own expenses. They know that many people will simply abandon their claim if it is denied rather than hiring a workers’ compensation lawyer. And every time an injured worker abandons a claim, the insurance company saves money.

Conclusion

If your workers’ compensation claim is denied, it is easy to think that your employer has it out for you for some reason. But this is usually not the case. Your employer’s insurance company is the one that makes the decision. And a big difference between dealing with your employer and their insurance company is that the insurance company does not know you. They view you as a potential expense, not as an injured person. So, rather than giving up on your claim if it is initially denied, you should contact a workers’ compensation lawyer.

Hillsberg Law

My name is Geoffrey Hillsberg, and I have been solely practicing workers’ compensation law in the State of Pennsylvania since 1995. If you have been injured on the job in Delaware County, please contact my law office today. I will fight for your right to compensation after a workplace injury.


The advice offered above is general in nature and may not be applicable to every case. Consultation with an attorney is highly recommended. Reliance on this advice does not represent the formation of an attorney-client relationship in the absence of a fee agreement with Mr. Hillsberg.