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I received a rejection of my claim for workers’ compensation benefits. What can I do?

Navigating the workers’ compensation process in Pennsylvania can be difficult, particularly for those who are enduring the after-effects of a severe workplace injury. If a claim is initially denied, the applicant has the option of launching an immediate appeal with the PA Workers’ Compensation Appeal Board. This quasi-judicial administrative group is responsible for reviewing the decisions made by workers’ compensation referees – and can only overturn their decisions in limited circumstances.

If you receive a negative decision from the workers’ compensation referee, it is imperative to launch your appeal as quickly as possible. Under the current rules and regulations, appellants have just 20 days from the circulation date listed on the judge’s order to send in the  paperwork necessary for an appeal. The time limit begins on the date stamped on the judge’s order, and the appeal is deemed “submitted” based on the postmark date on the envelope. If the postmark is more than 20 days from the judge’s order, the appeal will be considered waived.

To launch an appeal, an appellant must state the particular grounds of appeal, that is, precisely what is being questioned about the judge’s decision. The statement must address both factual and legal reasons for the original decision to be considered in error; “general allegations are insufficient.”

In addition to the actual appeal, additional documentation is required to ensure that the paperwork is complete. The appealing party, for instance, is required to ensure that all parties listed on the circulation sheet of the judge’s order are provided with notice of the appeal. In addition, the appealing party must arrange for mailing of the original appeal plus two copies to the Board.

If you are dealing with a rejection of workers’ compensation benefits, don’t delay. For skilled assistance with an appeal, contact one of our knowledgeable attorneys at Louis P. Lombardi, II & Associates. Serving clients throughout the Philadelphia metropolitan area, we can be reached at 610.239.7600 or 888.818.4343.