What Happens If a Work Comp Judge Decides Against Me? Can I Appeal?

If you lose a case before a Pennsylvania Workers’ Compensation Judge, you have a right to appeal within 20 days of the date of the decision. (20 calendar days, not business days) The appeal is heard by the Workers’ Compensation Appeal Board (WCAB).  The Board is primarly an appellate body review Judge’s decisions on legal issues, but sometimes has original jurisdiction. The Board consists of at least three, but a max of 15 members appointed by the governor.

Procedurally, once the appeal is filed, an oral argument is scheduled. The moving party is to submit its Brief at the hearing, and usually extra time is permitted for the responding party, to submit its Brief. Then the parties submit their Briefs and await a decision, which can take 6 to 12 months approximately.

There are various bases on which to file an appeal to the WCAB.  You can assert that the decision is not in conformity with the terms of the Pennsylvania Work Comp Act.  Another basis is tha the WCJ committed an error of law. You can argue that the findings of fact are not supported by sufficient, competent evidence. Another avenue is asserting that the findings of fact or decision was procured by coercion, fraud, or the improper conduct of a party. A rather common basis to appeal is alleging that the Decision is not a “reasoned decision” which provides for meaningful appellate review.

The Scope of Review of the WCAB is the same as the Commonwealth Court (the Court above the WCAB)- the WCAB can look into whether any conclusions are errors of law or whether the findings support legal conclusions. The WCAB can also determine if the reasoned decision standard was met.

Practically speaking, it is quite difficult to get the WCAB to overturn a Decision. If there are facts which support the conclusions, the decisions tend to be affirmed. Many claimants believe that if there are also facts that support his or his case, that the WCAB will reverse the decision. This is not true. If there is sufficient, competent evidence supporting the findings, even if there is some evidence supporting the claimant’s case, the decisions will be affirmed. The WCAB is bound by the credibility determinations made by the WCJ (Judge).  Unless there is an abuse of discretion, those determinations won’t be overturned by the WCAB. What is more common is a remand-which means the WCAB sends the case back to the WCJ to re-issue the decision, commenting on evidence that may not have been considered or weighed properly.

This is not to say that appeals are a waste of time. Indeed, some appeals are successful and end up changing the law via the Commonwealth Court or Pennsylvania Supreme Court. And, sometimes, the mere filing of an appeal can help settle a case. Each case must be evaluated on its own merit.

If you would like more information about Workers’ Compensation, call or email us 7 days a week at (215) 206-9068 or Michael@CardamoneLaw.com