Appealing a Workers’ Compensation Denial in Levittown

Workers’ compensation benefits can provide crucial assistance with covering your related medical expenses and ensuring you can maintain a basic standard of living until you are able to return to work after an on-the-job injury. Unfortunately, not everyone who files for workers’ comp necessarily receives the benefits they request, and many such claims are rejected completely without the claimant receiving any compensation at all.

If you need help appealing a workers’ compensation denial in Levittown, you should reach out to an experienced workers’ compensation lawyer sooner rather than later. Representation from skilled legal counsel could not only help you identify the reason behind your rejection, but also increase your odds of obtaining a favorable resolution to your case through the standard appeal process.

Common Reasons for Workers’ Comp Claim Denials

The most important first step to appealing a workers’ comp denial in Levittown is figuring out why your initial claim was denied in the first place. Unfortunately, the insurance companies that provide workers’ compensation coverage to employers in Pennsylvania will use any excuse available to avoid paying out on an injured worker’s claim, so even a small mistake or violation of state regulations could lead to a denial of benefits.

Some particularly common grounds these companies cite as their rationale for rejecting a workers’ comp claim include:

  • The injured worker failed to file their claim within the applicable statutory deadlines
  • The injured worker did not seek appropriate medical attention or did not follow through with their treatment plan
  • The injured worker’s employer claimed their injuries stemmed from failure to follow safety rules, horseplay, or intoxication on the job
  • The injured worker’s employer claimed their injuries occurred off-site or not during working hours
  • The injury in question stemmed from a pre-existing condition not covered by workers’ comp
  • The worker’s injuries are not as serious as they claimed

It is possible to resolve some of these problems easily by submitting additional documentation or correcting a filing mistake, but others may require much more intensive efforts. A knowledgeable workers’ comp attorney could offer further clarification about what might be necessary for a particular case.

Steps in the Workers’ Compensation Appeals Process

After identifying the issue that resulted in a Levittown workers’ compensation claim denial, the usual next stage to appealing that decision is sending a Claim Petition to the Pennsylvania Bureau of Workers’ Compensation, a division of the Department of Labor & Industry. Once the Bureau receives this claim, a Workers’ Compensation Judge (WCJ) will be assigned to the case and the parties will litigate the matter, with the WCJ ultimately deciding whether to approve or deny the Claim Petition.

If an injured worker receives another denial from the WCJ, they can elevate their appeal to the Workers’ Compensation Appeal Board (WCAB), and then to the Commonwealth Court in Pennsylvania if the WCAB also rejects their claim. The last possible option following a negative outcome in the Commonwealth Court is filing an appeal with the state Supreme Court.

Work with a Levittown Attorney on Appealing a Workers’ Compensation Denial

While it is not strictly required under state law for injured workers to retain legal counsel before contesting a workers’ comp claim rejection, it is almost always a good idea to do so. The process of challenging a denial can be tricky to understand and even harder to achieve a positive outcome, especially if you try to proceed with your case without professional guidance.

Before challenging a workers’ compensation denial in Levittown on your own, consider contacting a qualified workers’ compensation lawyer for assistance. Call today to schedule a meeting.


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