Workers’ compensation benefits may be the only lifeline available to someone who gets hurt on the job or develops an occupational illness. As soon as an injury occurs or symptoms arise, an employee may no longer be able to do their job and earn a living. They may need an indefinite leave of absence while they recover.
Not only will they have to worry about medical costs, but there are also lost wages to consider. In theory, Pennsylvania’s workers’ compensation program protects those in need of disability benefits while they can’t work and medical care because of a job-related condition.
Sadly, some people who suffer an injury or illness on the job are denied when they apply for workers’ compensation benefits. These individuals may feel despair, but the truth is that a denied claim often is just the start of the workers’ compensation process.
Workers who need benefits have the right to an appeal
Insurance companies and employers reporting workplace incidents to their insurance companies may have a financial incentive to see those claims denied. For an employer, a claim might mean higher premiums on their coverage. For an insurance company, a big claim can mean financial losses. To protect workers from unfair denials, Pennsylvania has both courts and an appeals board that review claims by workers who need benefits.
What does an appeal involve?
To successfully appeal a denial of your claim, you need to follow the right procedures. Validating that you have properly filed the necessary reports and paperwork is an important step. So is carefully reviewing your medical documentation and expanding it if necessary.
Sometimes the denial is merely the result of inaccuracies or omissions in the original application. Such mistakes are easy to fix during an appeal. You can present the new documentation to a judge. Even if the judge rules against you, you can appeal their decision to Pennsylvania’s Workers’ Compensation Appeal Board.
Getting legal assistance with your appeal can also be a good decision, especially if you tried to handle your initial application alone. Instead of giving up, look at your rejection as an invitation to fight for yourself and the benefits that will help you during this difficult time.
