You have rights. A workers' compensation lawyer can protect them.
In most cases, when workers are injured on the job, workers' compensation pays for injury-related expenses.
But what happens if your employer's workers' compensation insurance company refuses to pay your medical bills? What options are available to you? Can you appeal your denied workers' comp claim? And who approves or denies your appeal?
O'Malley & Langan has been helping injured workers for decades, and our experienced workers' compensation attorneys know exactly what to do.
"If you get hurt at work, we will fight for the money you deserve," says O'Malley & Langan Founder and Senior Partner Todd J. O'Malley.
Does workers' compensation cover medical expenses?
The short answer? Yes. In most cases, your medical bills should be paid for by your employer's workers' compensation insurance firm. That's why workers' compensation exists in Pennsylvania – to pay for work-related injuries or illnesses. The Pennsylvania Workers' Compensation Act is very clear about this. Injured workers should receive financial compensation for medical expenses related to work injuries.
Is there a limit on how many medical bills workers' compensation covers?
In general, no. If you have a medical bill for a legitimate medical procedure related to your work-related injury or illness, workers' compensation should pay it. There's also no time limit on medical expenses. For example, if you need follow-up surgery years after your work-related injury, workers' compensation should pay for your medical procedure and any other medical care related to your workplace injury.
Why do workers' comp insurance companies refuse to pay medical bills?
Workers' compensation insurance companies sometimes refuse to pay for medical bills associated with work-related injuries or illnesses. Some of the reasons why include:
- Your employer's workers' compensation insurance company says that you are not hurt, and your medical care was unnecessary.
- The insurance company claims your injury or illness is not work-related.
- You did not notify your employer about your workplace injury soon enough after it occurred. You have 120 days from the date of your injury to inform your employer. However, the longer you wait, the more likely your employer's workers' compensation insurance company might deny your injury claim.
- The company claims your injury or illness is a pre-existing medical condition you had before you got hurt at work.
- Your doctor or the medical professional who treated you is not on your insurance company's approved list of healthcare providers.
- The insurance company claims the healthcare provider who treated you did not correctly submit medical bills.
- There was a clerical error.
Can I appeal my denied workers' compensation claim?
Yes. You have the right to appeal your denied workers' compensation claim and demand the money you deserve for the cost of your medical care. However, be aware that such legal cases can be very complicated. That's why it's essential to have an experienced Pennsylvania workers' compensation lawyer handling your appeal.
"When you've been injured on the job, dealing with workers' comp issues can feel overwhelming," says attorney Mary Anne O. Lucas. "We can help you overcome obstacles on your path to recovery and aggressively advocate for your best interests throughout the entire legal process."
Who rules on my workers' compensation appeal?
A workers' compensation judge for the Pennsylvania Bureau of Workers' Compensation will decide whether to approve or deny your workers' compensation appeal. To file an appeal, you will need to submit a form known as a Claim Petition with the state Bureau of Workers' Compensation. If you have questions about how the appeal process works, call our office and ask to speak with attorney Joe Grady, a former Workers’ Compensation Judge. After 30 years of distinguished service on the bench, he joined O’Malley & Langan last year.
“Having seen so many lives affected by work injuries in different ways, I understand the importance of good representation with any work injury,” says Attorney Grady, reflecting on his decision to join O’Malley & Langan. “The attorneys at O’Malley & Langan appeared before me for many years representing clients with work injuries. I can say - without hesitation - they were always well prepared, understood the issues, and provided the best representation for their clients.”
How much time do I have to appeal a denied workers' comp claim?
You need to act fast if your worker's compensation claim has been denied, or if you believe you should receive more money for your medical expenses. Specifically, once a Workers' Compensation Judge in Pennsylvania makes a decision, you have 20 days to file an appeal. If you miss that deadline, you could miss your opportunity to receive the benefits you deserve.
Are there other financial sources for workplace injury medical bills?
Sometimes. Depending on the circumstances of your workplace injury, you may be able to obtain additional financial compensation for your expenses. This is especially true if your workplace injury was caused by someone working for another company, a common situation in many construction accidents. If this is the case, you may be able to file a third-party lawsuit against the other company, in addition to obtaining workers' compensation benefits.
Contact the Law Offices of O'Malley & Langan for help.
Workers' compensation cases in Pennsylvania involving serious workplace injuries often become complicated legal cases. This is why it's critical that you have an experienced workers' compensation lawyer on your side who understands how the system works.
"The last thing you should have to worry about after your workplace injury is how to pay for your medical expenses," says O'Malley & Langan Founder and Senior Partner Todd J. O'Malley. "That's our job, and we're prepared to fight for every dollar you rightfully deserve."
Put your trust in a law firm that puts the needs of injured workers first. Contact us and schedule a free, confidential consultation. We’d be glad to sit down with you in person at one of our offices in Scranton, Pittston, or Towanda, or schedule a phone call or virtual meeting. We’ll take the time to listen to your story and offer guidance on what to do next. There’s no obligation, so what do you have to lose? Call us today at 570-344-2667.
