When You’re Denied Workers’ Compensation Benefits

On This Page

1. Learning They Denied Your Workers’ Compensation Benefits
2. Navigating a Litigated Workers’ Compensation Claim in Pennsylvania
3. Appealing the Workers’ Compensation Judge’s Decision
4. Let Berger and Green Fight for Your PA Workers’ Compensation Benefits
5. Talk to a Workers’ Compensation Lawyer in Pittsburgh or Greater Allegheny County

REVIEWED BY

C. William Kenny

December 12, 2023

Board certified by National Board of Trial Advocacy

If you suffer an on-the-job injury or illness in Pittsburgh or greater Allegheny County, but the workers’ compensation insurance company denies your benefits, you can fight back. Call Berger and Green as soon as possible at 412-661-1400 for a free review of your case.

The workers’ compensation attorneys from Berger and Green can help you pursue the benefits you deserve. We will help you litigate the matter and try to reach an agreement in alternative dispute resolution. We will fight for the medical care coverage, partial wage loss, and other benefits you need.

Learning They Denied Your Workers’ Compensation Benefits

When you submit the notification of your injury or your employer submits it for you, the workers’ compensation insurer has 21 days to approve or deny your claim. In most cases, this process goes smoothly, and you get approved quickly. When there is an issue, however, they may deny your claim.

If your employer or the insurance carrier denies your claim — often because they do not believe you are hurt or do not believe it occurred at work — you will receive a Notice of Workers’ Compensation Denial also known as a LIBC-496. They will also file this form with the PA Bureau of Workers’ Compensation.

As soon as you receive this notice, give us a call. We can explain your rights and help you litigate the case to pursue the benefits you deserve.

Navigating a Litigated Workers’ Compensation Claim in Pennsylvania

When you challenge a Pennsylvania workers’ compensation denial, it becomes a litigated claim. We have three years from the date you suffered an on-the-job injury to take action and challenge the claim, but we need to act much sooner to get you the money you need and deserve.

This process begins when we file a Claim Petition (LIBC362). Shortly after filing this petition, we will receive notice of the Workers’ Compensation Judge assigned to your case and the time and date of your hearing. Before the hearing date arrives, we will need to build a solid case to show you suffered work-related injuries and they prevent you from working, or that you could not work for a period because of them.

This evidence could include:

• Your medical records
• Information from your doctor or doctors who treated you
• Eyewitnesses who saw your accident
• Medical expert testimony

Your employer and the insurance company will work together to build their own case, and we will both present them to the Workers’ Compensation Judge during your hearing. Sometimes, multiple hearings will be necessary to present all the evidence.

After the hearing, the Judge will often force us into alternative dispute resolution such as mediation. Sometimes, we can reach an agreement or settlement during this process, and you may walk away with the benefits you need or a lump sum settlement. In other cases, the Workers’ Compensation Judge must decide.

Appealing the Workers’ Compensation Judge’s Decision

If the Judge did not approve you for benefits, we can challenge their decision. Initially, we have 20 days to appeal to the Workers’ Compensation Appeal Board. If that is not successful, we have two further chances:

• We have 30 days from the date the Workers’ Compensation Appeal Board publishes their opinion to appeal to the Commonwealth Court; and
• We have 30 days from the date of the Commonwealth Court opinion to ask permission to appeal to the Pennsylvania Supreme Court

It is important to note that the PA Supreme Court accepts only a few workers’ compensation cases a year. However, we can often get qualifying clients approved for benefits before we need to try to take the case to the Supreme Court.

Let Berger and Green Fight for Your PA Workers’ Compensation Benefits

Most workers’ compensation claims get approved without much thought, but when your employer or the insurer denies your claim, things can get complicated. You do not need to deal with this stress in addition to undergoing treatment for your injuries.

When you enlist the help of the attorneys from Berger and Green, we can handle litigating your workers’ compensation claim on your behalf. We can try to reach a settlement negotiation or take your case in front of the Workers’ Compensation Judge.

We know how to navigate the complex process of challenging a denial or appealing a Judge’s decision. Let us go to work on your Pittsburgh-area workers’ compensation case today.

Talk to a Workers’ Compensation Lawyer in Pittsburgh or Greater Allegheny County

The team from Berger and Green can help you pursue the workers’ compensation benefits you need and deserve after a work-related injury or illness. We serve Pittsburgh, its suburbs, and greater Allegheny County.

Call us at 412-661-1400 today for a free evaluation of your workers’ compensation case.