What if the Insurance Company Refuses To Cover All My Work-Related Injuries?
If the insurance company refuses to cover all of your work-related injuries, you may be able to file a Review Petition to expand the accepted description of injury. In Pennsylvania workers’ compensation cases, employers sometimes accept only part of a workplace injury while denying additional physical or psychological conditions that resulted from the same accident. Correcting the injury description can be essential to obtaining medical treatment, wage loss benefits, and coverage for the full extent of your work-related injuries.
Why the Accepted Injury Description Matters
When a workers’ compensation claim is accepted, the insurance company identifies the injuries it agrees were caused by the work accident.
This is often called the “accepted injury description.”
Unfortunately, insurance companies do not always accept the full extent of a worker’s injuries. In some cases, they may:
- Accept one injured body part but deny another
- Accept a strain but deny a herniated disc
- Accept a physical injury but deny related psychological conditions
- Refuse to pay for treatment related to unrecognized injuries
When this happens, injured workers may find themselves unable to obtain the medical care and benefits they need.
Common Examples of Incomplete Injury Descriptions
It is common for an injured worker’s condition to become more apparent over time.
For example:
- A worker falls and initially reports a knee injury but later develops significant back pain.
- A worker suffers a shoulder injury and later learns they also sustained neck injuries.
- A worker develops depression, anxiety, or PTSD following a serious workplace accident.
- Diagnostic testing reveals injuries that were not identified immediately after the accident.
Even though these conditions may be related to the same work injury, the insurance company may refuse to recognize them unless action is taken.
Can I Add Additional Injuries to My Workers’ Compensation Claim?
Yes.
Pennsylvania workers’ compensation law allows injured workers to seek expansion of the accepted injury description when additional work-related conditions exist.
This is typically accomplished through a Review Petition.
A Review Petition asks a workers’ compensation judge to modify the accepted description of injury to reflect the full extent of the work-related injuries.
What Is a Review Petition?
A Review Petition is a legal filing used to correct or amend an existing workers’ compensation claim.
Workers often file Review Petitions when:
- The accepted injury description is incomplete
- Additional body parts were injured
- A more serious diagnosis is discovered
- Psychological injuries develop after a work injury
- The insurance company refuses to authorize treatment for a related condition
The goal is to ensure that all work-related injuries are formally recognized under the claim.
Can Psychological Injuries Be Added to a Workers’ Compensation Claim?
In some cases, yes.
Serious workplace injuries can affect both physical and mental health.
Workers may experience:
- Depression
- Anxiety
- Post-traumatic stress disorder (PTSD)
- Chronic pain-related psychological conditions
When a psychological condition develops as a result of a work-related physical injury, it may be possible to seek recognition of that condition through a Review Petition.
Adding psychological injuries may help injured workers obtain necessary mental health treatment and ensure the full impact of the injury is recognized.
Why Address an Incorrect Injury Description Quickly?
Waiting too long can create problems.
If the insurance company only accepts one injury, it may:
- Refuse treatment for other conditions
- Deny payment for medical bills
- Challenge your inability to work
- Attempt to suspend or modify your benefits
Addressing the issue early may help protect both your medical coverage and your wage-loss benefits while the dispute is being resolved.
How Can a Workers’ Compensation Lawyer Help?
A workers’ compensation attorney can help:
- Review your accepted injury description
- Gather supporting medical evidence
- Obtain expert medical opinions
- File a Review Petition
- Represent you before a workers’ compensation judge
- Pursue coverage for all work-related injuries
Because these cases often involve medical disputes, experienced legal representation can be critical.
Talk to a Pennsylvania Workers’ Compensation Lawyer
If the insurance company refuses to cover all of your work-related injuries, you may have options. Whether your accepted injury description is incomplete, additional injuries have been discovered, or you need treatment for a psychological condition related to your work injury, a Review Petition may help protect your rights.
The Pennsylvania workers’ compensation attorneys at Stern & Cohen have extensive experience helping injured workers expand accepted injury descriptions and obtain benefits for the full extent of their injuries. Contact us today for a free consultation.
FAQs
What is a Review Petition in Pennsylvania workers' compensation?
A Review Petition is a legal filing used to correct or expand the accepted description of injury in an existing workers’ compensation claim.
Can I add injuries to an accepted workers' compensation claim?
Yes. If additional injuries were caused by the same work accident, you may be able to seek recognition of those injuries through a Review Petition.
What if the insurance company only accepted part of my injury?
You may have the right to challenge the accepted injury description and seek coverage for additional work-related conditions.
Why won't workers' compensation pay for treatment to another body part?
The insurance company may be denying treatment because that body part is not included in the accepted injury description. A Review Petition may be necessary to establish the connection to the work injury.