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Decoding the Adjudication Process for Pennsylvania Workers’ Compensation Benefits

The Pennsylvania workers’ compensation adjudication process can be difficult and stressful for many individuals. In many cases, the more you know, the better off you will be. The Philadelphia workers’ compensation attorneys at Mednick, Mezyk & Kredo have some helpful information about the adjudication process to help you prepare and succeed with your workers’ compensation claim.

Filing a Petition

Upon filing a petition with the Bureau of Workers’ Compensation, your case is handled by one of the over 90 workers’ compensation judges (WCJ) in one of 25 offices throughout the Commonwealth of Pennsylvania. The types of cases that a WCJ may preside over include, but are not limited to:

  • Claims – review of benefits for an injured employee
  • Termination – review to terminate workers’ compensation benefits upon recovery from a work injury
  • Suspension – review to suspend benefits after an injured employee is not yet fully recovered, but has returned to work or are capable of returning to work
  • Review – correct errors in compensation documents (such as average weekly wages)
  • Utilization Review – review of healthcare treatment to determine if it is necessary and reasonable.

There are many more reasons why a WCJ may be necessary. In some cases, they serve as a mediator between two parties, reviewing and either approving or denying a settlement.

Hearing(s) Before a WCJ

At the hearing, the WCJ will request evidence from both parties (you and your employer or their insurance representative). Evidence could include documentation, testimony or both. You may be asked to testify in more than one hearing before the WCJ, depending on the type of petition filed, the WCJ’s understanding of the claim and your attorney’s guidance. After the hearing, one or both parties may need to collect more evidence. Among which could include further medical and treatment records.

After the Hearing and Appealing

After all evidence and hearings have been conducted before a WCJ, they will issue a written decision to all parties. Both you and your attorney will receive this written decision. If you disagree with the WCJ’s decision, you have the option of appealing to the Workers’ Compensation Appeal Board. There are strict time limits for appealing, so it is important to discuss your next steps with your attorney immediately upon receiving your written decision.

When it comes to the Pennsylvania workers’ compensation adjudication process, it is much easier to hire an experienced attorney. They will ensure that all appropriate documentation, medical evidence and information is presented before your WCJ as well as prepare you for your testimony. For a free case evaluation, call us today at 888-807-WORK (9675).