Receiving a denial for your workers' compensation claim in Pennsylvania can feel like hitting a brick wall. You did everything right, and now you're stuck wondering what went wrong. The good news? A denial isn't the end of the road.
At Handler, Henning & Rosenberg LLC, we've helped injured workers across Pennsylvania win benefits after claim denials through successful appeals. In this guide, we'll break down why claims get denied, what to do next, and how having the right legal support can make all the difference.
Why Workers' Comp Claims Get Denied in PA
Workers' comp claims can get denied for a few common reasons:
- Lack of medical documentation – If your doctor didn’t clearly link your injury to your job, the insurance company may argue it’s not work-related.
- Missed deadlines – Pennsylvania law sets strict time limits. If you waited too long to report the injury or file the claim, they may toss it out.
- Inconsistent statements – If your story changes between your report, medical records, or employer conversations, it can hurt your credibility.
Understanding the reason for your denial is the first step toward fighting it.
First Things First: Read the Denial Letter
Your denial letter should spell out exactly why your claim was rejected. Hang onto it—this document will guide your appeal. Next, start pulling together anything that could strengthen your case:
- Updated medical records
- Second opinions
- Incident reports
- Witness statements
If you haven’t already, this is the time to call a workers’ comp lawyer. At Handler, Henning & Rosenberg LLC, you’ll have access to experienced attorneys like J. Jeffrey Watson, a certified specialist in the practice of workers' compensation law by the Pennsylvania Bar Association's Workers' Compensation Law Section as authorized by the Pennsylvania Supreme Court. With over three decades of experience and a deep understanding of the system, our team knows how to build a strong case from day one. We’ll help you gather what you need and build a clear plan for moving forward.
How to Appeal a Denied Claim in Pennsylvania
To appeal, you’ll need to file a "Petition for Review" with the Workers' Compensation Appeals Board. You have 20 days from the date you receive the denial.
After you file, your case goes to a Workers' Compensation Judge. You’ll present evidence, call witnesses, and argue your side. This is where preparation matters. The insurance company will be ready. You should be, too.
If the first appeal doesn’t go your way, you may be able to take it to the Commonwealth Court of Pennsylvania. Appeals at this level are more complex and require legal precision.
What Evidence Helps Most
The stronger your documentation, the stronger your appeal. Focus on:
- Medical records linking your injury to your job
- Expert medical opinions
- Detailed accident reports
- Statements from coworkers or supervisors
- Records of communication with your employer or the insurer
Good documentation cuts through doubt and helps prove your case.
If Your Appeal Is Denied Again
Don’t panic. You may still have options. A second appeal can be filed to the Commonwealth Court if legal errors were made in your first hearing. This process is more technical, often requiring formal briefs and legal arguments.
At this stage, legal help is critical. Your attorney will know how to frame the legal issues and keep your case moving.
If further appeals aren’t right for you, options like mediation or arbitration can provide another route to resolution. These alternatives may be faster and less stressful than going back to court.
How a Workers’ Comp Lawyer Can Fight a Denied Claim
Appeals aren’t easy. Missing a deadline or making a wrong argument can tank your claim. That’s where an experienced lawyer steps in.
At HHR, we:
- Handle all filings and deadlines
- Help you collect solid evidence
- Represent you at hearings and negotiations
- Deal directly with the insurance company
We know how the system works, and we’re not afraid to push back. One of our clients had their claim denied because of a so-called "pre-existing condition." We gathered records, worked with doctors, and showed how the job made that condition worse. The result? Full benefits.
Another client was denied for lack of evidence. We uncovered emails, got new medical evaluations, and secured a strong settlement on appeal.
These cases prove that denials can be overturned—with the right help.
Help Beyond the Legal Process
While your appeal is pending, financial stress can pile up. Here are a few steps you can take:
- Review your budget and cut unnecessary expenses
- Look into temporary programs like unemployment or public assistance
- Contact local nonprofits that support injured workers
It’s not easy, but you’re not alone. There are resources to help you stay afloat while your case moves forward.
You’ve Got Options. We’ll Help You Use Them.
A denied claim is just a hurdle—not a dead end. With the right legal guidance, you can take back control and fight for the benefits you’ve earned.
If your workers' comp claim was denied in Pennsylvania, call Handler, Henning & Rosenberg LLC at (888) 498-3023. We’ll listen and lay out your options for fighting back.