Workers’ Compensation claims are typically processed within weeks or a few months, and that can seem like a long time when you have medical bills and cannot return to work. If the claim is denied or the benefits are insufficient, you may need to file an appeal, which could take even more time to settle. Some laws protect your rights in these situations, and working with an experienced lawyer can often speed up the appeal process.
How Are Workers’ Compensation Claims Processed?
Employees with a work-related injury or illness in Pennsylvania must report it to the employer within 21 days. Employers must immediately report the information to their insurers and file a First Report of Injury. If the worker does not inform the employer about the injury or illness within 120 days of its occurrence, the claim will be denied without a chance for compensation.
The employee should receive a Notice of Compensation Payable, a Notice of Temporary Compensation Payable, or a Notice of Workers’ Compensation Deniable within 21 days after they notify the employer. The employee might also get a Notice Stopping Temporary Compensation.
When benefits are approved, employees may receive medical, lost, and other compensation coverage. Claims are denied for different reasons, like improperly filled out paperwork or questions about the extent of the employee’s injury or illness.
My Workers’ Compensation Claim Was Denied. Now What?
A Workers’ Compensation claim denial can be quite upsetting, but you can appeal by sending a Claim Petition. This must be completed, filed within 20 days, and submitted to the judge. The Claim Petition must be sent within three years after the date of the injury, but waiting that long is not recommended.
The hearing takes place in your county, with a judge assigned to the case. Both sides will present their cases, and the judge may schedule the case for mediation – the decision is not made at the hearing. Mediation may or may not lead to an acceptable settlement.
What if I Disagree With the Workers’ Compensation Judge’s Decision?
If you are unsatisfied with the decision, the next step is to file a new appeal with Pennsylvania’s Workers’ Compensation Appeals Board. Expect it to take six to 12 months to tell you whether your claim was successful; sometimes, more than one hearing is necessary. After that, appeals can be made to the Commonwealth Court and the Pennsylvania Supreme Court in rare cases.
Keeping all this in mind, the time for a Workers’ Compensation claim to settle varies depending on the case’s complexity. Filling out the paperwork carefully and gathering as much evidence as possible can help with appeals, as will patience and understanding of how the process typically plays out.
Contact a Philadelphia Workers’ Compensation Lawyer at Freedman & Lorry, P.C. for Legal Guidance
Challenging a Workers’ Compensation denial can be complicated and time-consuming, but a skilled Philadelphia Workers’ Compensation lawyer at Freedman & Lorry, P.C. can fight to get you benefits. Call 888-999-1962 or complete our online form to schedule a free consultation. Located in Philadelphia and Cherry Hill, New Jersey, we serve clients in Pennsylvania, New Jersey, and North Carolina.