Work Injury Claim Denied

How to Take the Next Steps if Your Workers Compensation was Denied

Appealing a Workers’ Compensation Denial

claim for workers’ compensation benefits under the Pennsylvania Workers’ Compensation Act must be filed within three years of the injury. You must note this is not the same as notifying of your injury, and unlike with filing a claim you only have 120 days to give notice. Although the claim process can be very lengthy, it can be done. In certain circumstances, the statute of limitations can be extended; however, special requirements must be met. Therefore, if you benefits were denied, it is important to make sure you file a claim in a timely manner to ensure time to appeal.

After denial of a worker’s compensation claim, the employer’s insurance carrier will send you a Notice of Compensation Denial. It is important to read the Notice of Compensation Denial immediately upon receiving it, as there is a time limit for appealing. It is recommended to contact an experienced workers’ compensation attorney to assist you through the appeals process. The process can get very overwhelming!

Why Was I Denied?

There can be several reasons as to why a workers’ compensation claim has been denied, including:

  • Not filing in time
  • Not reporting the injury to the employer in a timely manner
  • The injury itself is not compensable
  • The employer is disputing the injury
  • Failing to seek medical treatment
  • Insufficient evidence that the injury is work-related

The appeals process can be a very complicated process, and it would be best handled by with an experienced work injury lawyer. Although the process can be daunting, an experienced Workers Compensation Attorney will be able to successfully guide you.

The Process of Filing an Appeal After a Denial

After receiving a Notice of Compensation Denial the first step is to file an appeal with the Pennsylvania Workers’ Compensation Appeal Board (WCAB), within 20 days. The WCAB, made up of 12 commissioners, will review the case and issue a written decision as to whether or not they agree with the initial determination.

In Pennsylvania, if the appealing worker disagrees with WCAB’s decision, they have an additional 30 days to appeal to the Pennsylvania Commonwealth Court. The Commonwealth Court will also review the case in its entirety in order to determine whether there was substantial evidence to deny the claim. While most decisions could end there, the appellate court could come up with an outcome, and they can appeal once more (within 30 days from the decision of the Commonwealth Court), to the Pennsylvania Supreme Court. At this level, an attorney must be present and may even be required to argue on their client’s behalf in front of the Supreme Court. Once the case hits the Supreme Court, the decision is final.

The appeals process is complicated and can be very time-consuming. With a good workers’ compensation attorney by your side, they will explain the appeals process in simple terms, file all of the requisite paperwork, and argue on your behalf to increase the likelihood of a favorable outcome.

 

Contact Brett Tessler Forthwith

 

Contact Us Today

Here at Tessler Law, we have the experience necessary to help you to get the benefits you deserve. Please do not hesitate to contact us or call 215-569-9005, and schedule a free consultation with one of our experienced attorneys.