Step-by-Step Guide to Workers’ Compensation Claims

If you were hurt at work, your employer’s insurance company is required to issue a document either accepting or denying your claim. If the claim is denied, the insurance company will issue a Notice of Compensation Denial, meaning they will not acknowledge your work injury. If the claim is accepted in full, they issue a Notice of Compensation Payable and are responsible for covering your lost wages and medical bills.

In some cases, the insurer may accept liability only for medical treatment but not wage loss. If that happens, they issue a Medical-Only Notice of Compensation Payable. Which document you receive determines what type of petition needs to be filed in court.

Filing a Claim Petition After a Denial or Medical-Only Notice

If you are out of work entirely and not receiving benefits, or if the insurance company has issued either a Notice of Compensation Denial or Medical-Only Notice, a Claim Petition should be filed. This petition asks the court to award benefits such as wage loss, medical expenses, or specific loss benefits, either for a limited period or on an ongoing basis.

What to Expect Once a Claim Petition Is Filed

Once a Claim Petition is filed, it is assigned to a Workers’ Compensation Judge, usually based on the county where the injured worker lives. Each judge has their own procedures for how they handle litigation. At Stern & Cohen, our attorneys have decades of experience practicing before judges across Pennsylvania and understand these procedures inside and out.

The insurance company has 20 days to file an Answer to the petition. If they fail to do so without good reason, your attorney may file what’s called a Yellow Freight motion, asking the judge to accept the allegations in your petition as true. If granted, this can be a major advantage for the injured worker.

If the insurance company files an Answer on time, the case moves forward to litigation. A trial schedule is issued, usually spanning about 180 days. During this time, evidence is presented, including testimony from the injured worker, depositions of medical experts, and sometimes fact witnesses who provide testimony on issues like wages, notice of injury, or job offers.

Mediation, Evidence, and the Judge’s Decision

Most cases also include a mediation session, where a different judge helps the parties attempt to settle. If the case does not resolve at mediation, the litigation continues. Both sides submit evidence and, eventually, legal briefs summarizing their positions.

After reviewing the evidence and briefs, the judge will issue a written Decision. Outcomes can vary:

• Full grant of the Claim Petition (ongoing wage loss and medical benefits)
• Partial grant (limited benefits or medical treatment restricted to certain conditions)
• Denial (the judge finds no compensable work injury or disability)

If your claim is denied, you have the right to appeal the decision.

Why Experienced Workers’ Compensation Lawyers Matter

The process of litigating a Claim Petition is complex and can feel overwhelming while you’re already dealing with a work injury. Having an experienced workers’ compensation attorney on your side ensures that your case is properly handled from the start and that your rights are protected.

Contact Stern & Cohen today for a free consultation to discuss your workers’ compensation claim.