Workers’ Compensation Appeals Process

June 6, 2024 | Workers’ Compensation

Workers' Compensation Appeals Process

Although workers’ compensation claims and personal injury claims arise from injuries, they are not the same. In a nutshell, you file an administrative claim to win a workers’ compensation case and a civil lawsuit to win a personal injury case. 

Workers’ compensation claims are easier to win, but compensation is limited to economic damages, and not even all of those.

The Appeals Process

Pursuing a workers’ compensation claim means immersing yourself in an administrative process. If you lose and you don’t want to give up, you must appeal through a similar administrative process. You need to move quickly, though, because state deadlines don’t give you much time. 

In Pennsylvania, you only have 20 days after your initial claim denial to file an appeal to the Pennsylvania Workers’ Compensation Appeal Board. 

That’s probably not nearly enough time unless you’ve got a lawyer to help you. You’ve got to meet the deadline, however. If you miss it, you could completely forfeit your claim, no matter how serious your injuries are.

You Probably Won’t Get a Hearing for Your Appeal

In most cases, the Appeal Board issues a decision on an applicant’s appeal without even granting them an appeal hearing. There is one silver lining surrounding this dark cloud, however. 

If the Appeal Board denies your appeal, you can further appeal to the Pennsylvania Commonwealth Court. There, you will enjoy certain rights that you lacked during the administrative process. Another hearing, unfortunately, is not one of them.

Taking Your Case to Court

If the Appeal Board denies your appeal, you have 30 more days to appeal your claim to the Pennsylvania Commonwealth Court. If you lose there, that’s probably the end of the line for your claim. 

It is possible to appeal to the Pennsylvania Supreme Court, but the Supreme Court refuses to even consider most of the cases that parties try to appeal to them. That’s because it is only one court, and there aren’t enough judges to resolve all the cases that come their way from all over Pennsylvania.

The Odds are Against You

Unless the facts of your case are unusual, your chances of winning your workers’ compensation appeal are low. To win your appeal, one administrative tribunal (the Appeal Board, for example) would have to overrule another. Administrative tribunals don’t like to overrule each other, and neither do courts.

Instead, decision-making bodies grant lower authorities a certain amount of deference. That means they assume that the lower court or tribunal was right unless they are presented with convincing evidence otherwise.

Questions of Fact vs. Questions of Law

The first tribunal you appeal to, the Pennsylvania Workers’ Compensation Appeal Board, will grant a great deal of deference to the conclusions of the Workers’ Compensation Judge (WCJ), who originally decided your claim regarding questions of fact. That is partly because the WCJ had a chance to hear the witnesses and assess their demeanor, among other factors. 

  • Matters of Fact: The Appeal Board works strictly with documentary evidence, so they are not in as good a position as the WCJ to ascertain the truth or falsity of factual allegations, such as whether or not your accident happened at your workplace. The Appeals Board will grant almost total deference to the WCJ when it comes to matters of fact.
  • Matters of Law: The Appeal Board considers itself to be in just as good a position as the WCJ. In determining matters of law, such as the interpretation of statutory language or how legal precedents apply to your case. Accordingly, they grant no deference to the WCJ on matters of law. 

An experienced attorney can present your appeal favorably.

No ethical lawyer will provide you with any kind of guarantee. What a good workers’ compensation lawyer will do (hopefully) is thoroughly explore and follow through with your best course of action. 

Promise yourself this much: you won’t give up easily. An experienced workers’ compensation lawyer will teach you everything else you need to know to give your appeal your best shot.

Please contact Marzzacco Niven & Associates at the nearest location to schedule a free consultation today:

York Law Office
2550 Kingston Road, Suite 210A York, PA 17401
(717) 995-8998

Harrisburg Law Office
945 East Park Drive, Suite 103 Harrisburg, PA 17111
(717) 231-1640

Wyomissing Law Office
833 N. Park Road, Suite 103, Room A Wyomissing, PA 19610
(717) 388-2325

Chambersburg Law Office
79 St. Paul Drive, Suite 1 Chambersburg, PA 17201
(717) 388-2378

Carlisle Law Office
354 Alexander Springs Road Carlisle, PA 17015
(717) 995-8732

Carbondale Law Office
30 Lincoln Avenue, Suite 101 Carbondale, PA 18407
(717) 995-8810

Lancaster Law Office
2173 Embassy Drive, Ste 123, Lancaster Pa 17603
(717) 616-2954

Lebanon Law Office
937 Willow Street, Suite D Lebanon, PA 17042-1140
(717) 995-8963