There is no guarantee that your workers’ compensation claim will be approved. Sometimes perfectly legitimate claims that should be covered by the workers’ compensation system are denied.
You can file an appeal, but the process can be intimidating and confusing if you are not familiar with Pennsylvania’s workers’ compensation system.
That is why you should strongly consider working with an experienced Harrisburg workers’ compensation lawyer. The attorneys at Schmidt Kramer have extensive knowledge of the process and are prepared to fight for your best interests every step of the way.
Common Reasons Claims are Denied
There are a wide variety of reasons why workers’ compensation claims are denied, from small errors to disputes about the circumstances of the injury:
- The claim contained incorrect information about your injury
- The claim was submitted after the 120-day deadline
- Your employer questioned the severity of the injury
- Your employer claimed the injury did not occur at work
- Your employer claimed you were engaged in some type of illegal activity when the injury occurred
Appeals Process
Once you submit a workers’ compensation claim, your employer must either approve or deny it within 21 days of your injury.
If you receive a denial, you have three years from the date of your injury to begin the appeals process by filing a Claim Petition with Pennsylvania’s Bureau of Workers’ Compensation. Your claim petition will be assigned to a workers’ compensation judge in the county where you live.
Workers’ Compensation Hearing
You will receive a Notice of Assignment telling you the name of the judge who has been assigned to your case along with the date, time and location of your appeal hearing.
At the hearing, both sides can present evidence to the judge. If you require more time to obtain medical evidence or to call more witnesses, you can request that the hearing date be pushed back.
After the hearing, the judge may refer your case for mediation if he or she believes it might resolve the issue. Once the mediation session concludes, the judge will issue a written decision.
However, if the judge does not schedule your case for mediation, you can request an informal conference or settlement conference with the judge to resolve the issue.
Appealing the Judge’s Decision
If the judge does not overturn the denial, you have 20 days from the date you receive the written decision to file an appeal with the Workers’ Compensation Appeal Board.
The board will issue a decision and you have 30 days from the receipt of that decision to appeal to the Commonwealth Court if your claim is still denied. The Commonwealth Court will then issue a decision and you have 30 days from receiving that decision to file a Petition for Allowance of an Appeal with the Pennsylvania Supreme Court.
Contact Our Firm Right Away for a Free Consultation
The workers’ compensation system was designed to provide compensation to employees who were injured on the job. Compensation helps injured workers pay their bills during their recovery and may even help them learn new skills so they can reenter the workforce once they have fully recovered.
Unfortunately, even legitimate workers’ compensation claims are sometimes denied. When that happens, you should contact one of our attorneys for a free legal consultation to determine if you may be able to win an appeal. We are prepared to guide you through every step of the process.
We take cases on contingency, which means there is no upfront fee and you will not be charged for our services unless you receive the compensation you deserve.
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