One of the first questions I get at nearly every consultation for workers’ compensation is — how long does it take to get benefits. Understandably so. Injured workers still have mortgages, rent, car payments, and other bills to pay. If your injury is accepted by your employer and it’s insurance carrier, then you will likely wait two or three weeks for wage loss benefits to begin. What about if your work injury is denied?
Let’s cut to the case right away, then I will explain. A fully litigated workers compensation claim is not a quick process, it takes a long time. If your claim is denied, by the time you actually get a decision by a workers compensation Judge, you are likely looking at a time frame between 8 and 12 months, depending on the Judge. Let me explain.
A litigated claim (and we use that to mean a Denied claim), commences by me filing a Claim Petition on your behalf. The burden of proof in a Claim Petition lies with the injured worker. I must prove four things in Claim Petition litigation:
1. An injury occurred;
2. in the course of claimant’s employment;
3. the injury disables claimant from performing work, thus wage loss, and
4. that the employer was timely notified of the work injury.
With the new workers compensation integrated software system (WCAIS), a Notice of Assignment to a workers compensation Judge usually occurs fairly quickly. However, it still may be 3 to 4 weeks until your first hearing. That’s right — FIRST hearing. Again, depending on the Judge, you may or may not testify at the first hearing. Some judges simply use the first hearing as a five minute set up the case kind of hearing. Other judges have the claimant testify. dge. So right off the bat there is a 3 week wait for a Judge to get the file and hold a hearing. And the Judges in Pennsylvania do a fantastic job of getting you a quick hearing date.
Under the workers compensation rules established by the Bureau of Workers Compensation, the claimant has 90 days after the first hearing to schedule the medical deposition of a doctor who will say that you were injured, what the injury was, and that you are unable to work. There is usually some type of delay in getting the deposition set up, because of calendar issues and because Doctors are busy. While that is all going on, the Employer has a right and will likely always have you examined by a Doctor of their choosing, referred to as an Independent Medical Examination (IME). That usually must occur within 45 days of the first hearing. After that, your Employer has 90 days after your doctor’s deposition to take the deposition of the employer’s doctor. (There is 7 months right there, between waiting for hearing and time lien for evidence). There may be another status hearing within the seventh months listed above, typically that occurs in the areas I practice, namely in Harrisburg, Chambersburg, Gettysburg, and York workers compensation hearing locations.
After both parties’ medical evidence is completed, the Judge will schedule a final hearing for additional testimony, submission of evidence, and to close the evidentiary record. That final hearing, usually about 6-8 months after the first hearing. After the final hearing, both parties will submit legal briefs to summarize their legal arguments. Most of the time the Judges ask for briefs in 30 or 60 days. So that brings us to 9 to 11 months out from the first hearing. After that, it may take the Judge 1 to 2 months to issue a Decision. Remember, your case is one of many, many cases assigned to that specific Judge.
Now, many cases never get through the whole process. During that time frame, both parties frequently have an interest in resolving or settling the case. That’s a different matter.
If you have been hurt at work in Pennsylvania, do not hesitate to get legal counsel. Your rights are too important. Contact me at Mooney & Associates at 1-877-632-4656 or email me direct at email@example.com. We represent clients in the Greencastle and Chambersburg areas, Shippensburg, Newville, and Carlisle areas, Harrisburg and Perry County areas, Gettysburg and New Oxford areas, Hanover area, and York areas. Call today for a FREE consultation to discuss your rights!