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How Long Could It Take to Resolve a Pennsylvania Workers’ Compensation Claim?

law books on shelfUnfortunately, there is no definitive answer to this question, as each claim is different. No two injuries are the same and people respond to treatment differently. It is also important to note employers have different insurance policies and employees can choose their own doctors so different doctors are involved.

These are just some of the many factors that may play into the duration of a workers’ compensation claim. An experienced attorney can help give you a better idea of how long your claim may take to resolve.

Below, learn more about how the issues mentioned above could impact the duration of a claim, one way or another.

Reaching a Decision on a Workers’ Comp Claim

Pennsylvania law requires injured workers to inform their employers within 120 days. If you do not report the injury in that time, it is unlikely you will be able to file a claim or recover benefits. There may be exceptions, but it is still important to tell your employer about the injury as soon as possible.

Waiting to report your injury delays your receipt of benefits. Waiting could also make your employer or its workers’ comp insurance suspicious about your claim. They may say you were injured outside of work or are lying about being injured to get money. This could also cause delays in the process.

You must file a workers’ comp claim within three years of the date of your injury. You may not need to go through the process of filing a claim, as your employer should move the process along once notified of your injury. However, sometimes employers refuse to accept responsibility for an injury. When that happens, it may be on the employee to file a claim.  

It is important to note the Bureau of Workers’ Compensation requires employers to report injuries that result in disability lasting longer than one day or shift within 48 hours.

Once a claim has been filed, the insurance company is required to decide on approval or denial within 21 days.

If your claim is approved, you should receive benefits shortly. If nothing goes wrong during this process, you could begin receiving benefits in a matter of weeks. While many claims are denied and contested, others are approved quickly.

It is important to note some claims require a longer investigation than others. Within 21 days of you notifying your employer of your injury, your employer may issue a Notice of Temporary Compensation Payable so it can have another 90 days to investigate. That means you would receive benefits while the investigation continues.

After those 90 days, your claim could be approved, which means it could take three months to resolve your claim, even though you would start receiving benefits before that time.

What if Your Claim Gets Denied?

It could take eight months or more to overturn a denied workers’ compensation claim. The first step is filing a claim petition. Once you do this, the case should be assigned to a workers’ compensation judge based on the county where you live. You will be notified of the date, time and place of the initial hearing.

It could take anywhere from 15 to 45 days for the initial hearing to be scheduled. After the hearing, you are given 90 days to provide medical evidence, which usually consists of a medical deposition of your treating doctor. After you submit medical evidence, your employer gets 90 days to depose a medical expert. During these six months, a status hearing and mediation may be scheduled.

If mediation does not result in a settlement, a final hearing will be scheduled. Tis allows both sides to update the judge on the medical evidence. At this point, the judge can issue a briefing schedule. Both sides will be required to submit briefs within 30 days. The procedure for submitting briefs often depends on the judge assigned to the case.

After briefs have been submitted, it may take another 30 to 60 days before a judge decides to overturn the denial of benefits or uphold the denial.

When you add up all these steps, it amounts to about eight to 13 months. It may be possible to reach a settlement at some point and then you will not need to go through any more steps.  

Need Help Securing Workers’ Comp Benefits? Call Schmidt Kramer

The Harrisburg workers’ compensation lawyers at our firm have helped many injured workers secure benefits. We have extensive knowledge of Pennsylvania workers’ compensation laws and how to appeal denied claims.

Give us a call today to learn more about the benefits of legal representation after a workplace injury. Insurance companies regularly deny or undervalue claims, even with claims where it seems like there should be no roadblocks.

An initial consultation is free and comes with no obligation to take legal action. Our attorneys are also not paid unless our clients get paid.

Schmidt Kramer. We are here to help. Call (717) 888-8888.