The workers’ compensation program can pay for your medical care and missed wages if you get injured on the job or develop a work-related health condition. However, employers and their insurance companies will try to limit payouts and could deny benefits if you do not strictly comply with their procedures.
Fortunately, when you disagree with the insurer’s decision regarding your workers’ compensation claim, you have the right to file an appeal. There are strict deadlines and steps you must take to achieve a positive outcome, and the help of a workers’ compensation attorney with experience is essential. A Scranton workers’ compensation appeals lawyer could review your circumstances and help you build the most robust case possible to support your claim for benefits.
An appeal is a request for the Workers’ Compensation Appeals Board to review a decision a judge has previously made. Claims are often denied because of a procedural error in the application paperwork, or the employer claims the worker’s injuries occurred outside their job duties. A worker can file an appeal to overturn a denial or when they receive some benefits but not enough to cover what they believe is the scope of their injuries.
According to 77 Pennsylvania Statute § 853, the worker and their employer both have the right to file an appeal. An employer may file an appeal if they want a judge to reconsider evidence that challenges the notion the worker was injured at work or indicates the worker was under the influence of drugs or alcohol at the time of their accident.
At an appeal, the employer, their insurer, and the injured employee all have the right to legal representation. Injured workers should have a determined Scranton attorney representing them to ensure the workers’ compensation appeal proceedings are fair.
When a workers’ compensation judge issues a decision, all involved parties have 20 days to file an appeal. The appeal asks the Workers Compensation Appeals Board, a panel of Workers’ Compensation Commissioners, to decide whether the judge who presided over the initial hearing erred in their decision.
The Appeals Board hearing can be either virtual or in person. The Board does not hear new evidence and will only consider written briefs and oral arguments. If the Appeals Board agrees that the judge made a mistake of law in the original ruling, it can overturn the claim denial.
If the Appeals Board decides to affirm the judge’s initial ruling, it is possible to file an appeal with state and Supreme Courts. However, courts continue to base their decisions on the record of the case and will not hear new evidence. A seasoned Scranton attorney could use available evidence to present the best possible case in your worker’s compensation appeal.
If you had a hearing before a workers’ compensation judge and are unhappy with the results, you do not have to give up. You could ask the Workers’ Compensation Appeals Board to review the judge’s decision.
A Scranton Workers’ Compensation appeals lawyer is familiar with the complexities of these proceedings and knows how to craft a winning argument. You only have a short time after the judge issues a decision to file an appeal, so reach out to our capable legal team immediately.
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