What to Do When Your Pennsylvania Workers’ Comp Claim is Denied

Your Options When Your Pennsylvania Workers’ Compensation Claim is Rejected

You’ve been hurt on the job and you’ve followed all the appropriate steps to secure benefits under Pennsylvania’s workers’ compensation laws. You’ve notified your employer in a timely manner. You’ve been examined by a company-approved doctor. You’ve provided medical documentation of your condition. But your employer’s workers’ compensation insurance carrier has denied your claim. Now what do you do?
Workers’ compensation benefits are far from automatic, even when your injury appears to be undeniably work-related. Employers and their insurers will deny legitimate claims for a variety of reasons:

• There may unintentionally be inaccurate information in the accident report
• Your employer may allege that the injury occurred outside of work
• Your employer may question the legitimacy or the severity of your injury
• Your application for benefits may have been filed after the deadline
• Your employer may accuse you of participating in illegal activity at work

Your Right to Appeal the Denial of a Workers’ Compensation Claim

Under Pennsylvania law, when your initial workers’ compensation claim is denied, you can submit a “Claim Petition” with the Pennsylvania Bureau of Workers’ Compensation. Your case will be heard by an administrative law judge at the Bureau, and the judge may grant or reject your appeal.

If the judge denies your appeal, you can file an appeal of that decision, but you must do so within 20 days of the date the opinion is issued. The Workers’ Compensation Appeals Board will then review your case and issue their own written opinion. If that decision is not in your favor, you can seek redress through the Pennsylvania Commonwealth Court, but must file your appeal within 30 days of the Appeals Board decision.

Contact Our Office

At Barnard, Mezzanotte, Pinnie & Seelaus, we have protected the rights of individuals throughout Delaware since 1980. We offer a free initial consultation. To schedule an appointment, call us at 610-565-4055 or contact us online.

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