The Sad Truth About Many Employers

Why Some Workers’ Compensation Claims Get Denied

By nature, I am not a cynical guy. I really am a “glass half-full” type of person and I think my optimism makes me a good advocate and my clients savor my approach. When I tell them that despite how bleak things may feel now, in my hands, all will work out, I think most trust in me (even though they perhaps cannot envision the pathway to success like I can).

However, despite my positive nature, I cannot help but realize that employers and their insurance companies often make terrible decisions when their employee gets hurt at work.

Will Your Employer Do the Right Thing After a Workplace Injury?

Within the last week, I spoke to a new client. Let’s call him John Doe.

John works for a Fortune 500 company. We are all familiar with them and all of us use their products regularly. Warren Buffett is a big fan.

John has worked for this company for over 22 years. Over two decades. He is 55 years old, so most of his working career has been with this company. He really likes working there.

In all his time there, he has never sustained an injury. In fact, he has never had a physical injury outside of work either. No meaningful trips to the doctor for John Doe ever.

Unfortunately, in September of 2022, he came down off a piece of equipment and the way he landed on the hard flooring, he had an electric pain in his lower back that shot into his buttocks.

He followed all the proper protocol. He told a supervisor and went to the medical clinic on-site. It was immediately clear that he should cease doing his regular job that is quite strenuous in nature.

First sign of disrespect: instead of letting John recuperate, they stuck him in the lunchroom for an eight-hour shift with nothing to do.

He literally was forced to stare at four walls.

Why treat a human being like this?

You are going to make a point of not paying him any workers’ compensation payments by forcing him to show up to work and bring no value to your company?

Sounds like detention for suffering a work injury while engaged in production for your company.

Such a bad look.

You have a 22-year employee sitting there with his thoughts and wondering what he did to deserve this.

Corporate Greed and Denied Workers’ Compensation Claims

Then John goes to a very reputable orthopedic institute in the region and starts getting appropriate medical attention for his condition, including an epidural steroid injection to the spine.

The medical specialist diagnoses a condition and unquestionably draws the connection between the injury and the event at work.

No hesitation.

What happens next?

The second sign of complete disrespect.

Two days after the injection, John gets a call from his employer of two decades that his workers’ compensation claim is being denied and he cannot come into work.

Why is it being denied?

“Your injury is a pre-existing condition.”

Let’s review:

• John worked for the company for 22 years.
• He never had a work injury before.
• He never had a lower back injury before.
• He never sought treatment for back pain.
• A highly qualified doctor connected the condition to the workplace accident.

Yet his claim was denied.

How does this happen?

The sad reality is that it is often corporate greed.

Someone in management or someone focused solely on costs decided the most cost-effective approach was to deny a loyal employee’s workers’ compensation claim.

It would be one thing if John had a lengthy history of back problems or multiple prior injuries. Even then, it may not justify a denial.

But that is not what happened here.

What Should You Do If Your Workers’ Compensation Claim Is Denied?

I could hear the disappointment in John’s voice when we spoke.

I explained the next steps.

I arranged for him to see a new doctor because the previous practice would likely stop treatment after the workers’ compensation denial.

Fortunately, I know physicians who are willing to help injured workers even when payment is not guaranteed.

I prepared a Claim Petition to pursue his lost wages and medical benefits.

This is what Stern & Cohen does.

And I assured him that we would move quickly.

The lesson here is one I see regularly:

Loyalty is rarely a two-way street.

John gave more than two decades of service to his employer.

When he needed help, they questioned his credibility and denied his claim.

Now the relationship has been permanently damaged.

John no longer trusts them and is understandably hesitant to return.

Meanwhile, I get to present an exceptionally strong case to a Workers’ Compensation Judge.

The facts are compelling.

The witness is credible.

And when the evidence is presented, the tables often turn.

In situations like this, denying a legitimate claim frequently ends up costing far more than simply doing the right thing from the beginning.

Talk to a Pennsylvania Workers’ Compensation Lawyer

When you get injured on the job, do not assume your employer or the insurance company will do the right thing.

Sometimes they will.

Sometimes they won’t.

If your workers’ compensation claim has been denied, delayed, or disputed, it is important to understand your rights as soon as possible.

At Stern & Cohen, we help injured workers pursue medical benefits, wage-loss benefits, and denied workers’ compensation claims throughout Pennsylvania.

Contact us today!

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