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Q: What are my options to get my case reconsidered—and can I get help—if my boss has rejected my workers’ compensation claim?

A:

It’s fairly common for workers’ compensation claims to be denied by either the employer, or by the insurance company that has been hired to administer benefits to workers hurt on the job. Sometimes, these people legitimately think that employees do not qualify for comp benefits. Much of the time, though, claims are denied purely as a cost-savings measure; the company blocks the claim and hopes the employee will give up pursuing his benefits.

You’d be surprised at how often that sort of intimidation tactic works. Some people are so timid about dealing with bureaucracy that they surrender their legal rights, even though thousands of dollars may be at stake.

If you sincerely believe that you have a legitimate workers’ compensation claim in Pennsylvania, we encourage you not to give up so easily. When your boss denies your claim, that’s not the end of the road. Let’s map out the next two stations along the way:

  1. Demand a hearing. You can respond to a claim denial by contacting the Pennsylvania Bureau of Workers’ Compensation to request a hearing before a judge who specializes in workers’ compensation cases. As a matter of fact, either side—you or your employer—can demand this sort of hearing. In practice, this is usually a series of hearings conducted a little less formally than a regular trial. Both sides can call witnesses (or submit depositions of witnesses’ testimony), submit medical records, and provide other forms of evidence to document or rebut your workers’ compensation claim. After the last hearing, the judge will provide a written decision, outlining how he came to affirm or deny your benefits.
  2. File an appeal. If you don’t like the decision from the workers’ compensation judge, you can appeal this decision to the Pennsylvania Workers’ Compensation Appeal Board. However, you can only appeal if you believe you can prove the Bureau of Workers’ Compensation judge made an error in applying the law in your case; you can’t appeal without a good reason. Similarly, your employer (or his insurance company) can also appeal a decision granting you workers’ compensation benefits if he can show the judge’s decision to be contrary to legal precedent.

Yes, You Can Get Help

An administrative law hearing to claim your workers’ compensation benefits is very complex. An appeal is even more complicated and demands a detailed familiarity with Pennsylvania workers’ compensation law. Let’s be honest: you probably do not have the skills or specialized training to go ahead with these procedures on your own.

The workers’ compensation lawyers of Schmidt Kramer have precisely those skills and the depth of experience, and that’s why we have been able to help hundreds of our fellow Pennsylvanians get the workers’ comp settlements they deserve. We want to share that experience with you, and we’ll even do it at our own expense. Contact us today and request a copy of our client book, Who Pays The Bills When You Are Injured At Work?, and we will send it to you FREE.

Read the book. Once you’re convinced that we know what we’re doing and that we’re the legal team you want for your work injury case, call us at 717-888-8888 or 888-476-0807 toll-free to schedule a free, confidential case review. We’d be honored to work hard to get you the best available outcome for your case.