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What can I do if my workers’ compensation claim is denied?

| Dec 20, 2019 | Uncategorized

It may have come as a shock that your employer’s insurance carrier denied your worker’s compensation claim. Because you were injured while working, you expected to qualify for worker’s compensation benefits. Bills may have quickly piled up as you have been recovering from your injury at home, and you may worry that you may not be able to pay them on your own.

Your situation was probably stressful enough before, when you trusted that the workers’ compensation system would give you the benefits you deserve. Now, you may feel discouraged. However, there is still hope.

You may file a claim petition

If your claim was denied and you cannot resolve the issue with your employer or employer’s insurance carrier, it may be reasonable to file a claim petition. You have three years to do this, but it may be advantageous to file it sooner rather than later. If you wait too long to file your petition, you may be unable to continue pursuing those benefits.

If you file a claim petition, there will be a hearing where the judge will hear both sides. The judge may ask you and your employer’s insurance carrier to try to reach an agreement out of court, which could mean mediation, a settlement conference or an informal conference.

Usually, parties can reach an agreement in the alternative dispute resolution session, but the judge can decide in cases when parties cannot reach an agreement. If you do not feel that the judge’s decision is reasonable, you may file an appeal. You have 20 days from the date of the judge’s decision to do so.

Even then, you may have options

That appeal goes to the Workers’ Compensation Appeal Board. If it is necessary to challenge the decision made there, you could file an appeal with the Commonwealth Court. You could even challenge that decision, if it is appropriate to do so.

While it is rarely necessary to go to such lengths, this process does show that there are almost always options. It is possible to hold decision-makers accountable for making unfair decisions, and it is possible to fight for the workers’ compensation benefits that you are entitled to receive.

If you are filing a workers’ compensation claim or the claim you filed has been denied, you may find it helpful to brush up on your rights. The process for obtaining workers’ compensation benefits can be complicated and minor errors along the way can have a major effect on your outcomes.