Facing a denial of your workers’ compensation claim in Pennsylvania can be disheartening. However, you can take proactive steps to address the situation.
Understanding what to do after a workers’ compensation claim denial can help you file an appeal.
Review the denial letter
Upon receiving the denial letter, carefully read it to understand the specific reasons for the rejection. It should outline the basis for the denial, such as insufficient evidence, missed deadlines or other specific issues. Knowing why your claim received a denial lets you respond effectively.
Gather additional evidence
For denial due to insufficient evidence, gather any documentation that supports your claim. This may include medical records, witness statements and other evidence. Your claim must clearly show the extent of your injuries and the fact that they occurred at work.
Consult your employer
Discuss the denial with your employer to clarify any misunderstandings. Let your supervisor know that you intend to appeal the decision and ask whether you need to complete any forms or internal procedures. Open and clear communication can improve your chances of a successful appeal.
File an appeal promptly
Pennsylvania gives employees limited time to file a workers’ comp appeal. Be sure to adhere to these deadlines to avoid further complications. Filing an appeal promptly demonstrates your commitment to pursuing the claim. It may increase the likelihood of a favorable outcome.
Attend the hearing
If the initial appeal is unsuccessful, you may have the option to attend a hearing. During the hearing, you can present your case and provide more evidence to support your claim.
The Bureau of Labor Statistics reports that 2.8 million Americans experienced nonfatal work-related illnesses and injuries in 2022 alone. For guidance on the appeals process and assistance with your case, reach out to the state Bureau of Workers’ Compensation. They can provide information on your rights and responsibilities during the appeal process.
