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For more than a decade, the family of a woman stabbed 20 times — including 10 from behind — has battled to have the Philadelphia medical examiner’s ruling that her death was a suicide overturned.

Ellen Greenberg, a 27-year-old teacher, was found covered in bruises and stabbed to death in her apartment during a blizzard more than a decade ago. Despite the blood-soaked crime scene, evidence her body had been moved and stab wounds to the back of her skull, investigators found "no evidence of a struggle in the kitchen area or anywhere else in the apartment."

Dr. Marlon Osbourne, a former pathologist at the Medical Examiner’s Office in Philadelphia, initially ruled the death a homicide, based on the injuries, then backtracked and revised the manner of death to suicide after conferring with city police, according to a civil lawsuit from Greenberg’s family.

An appeals court heard arguments in a civil lawsuit this week and will decide whether it can move to trial.

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Knife wounds from autopsy, left, wedding photo at right

Left: A computerized rendering showing more than a dozen of Ellen Greenberg's stab wounds. Right: Ellen and then-fiance Sam Goldberg.  (Tom Brennan, Greenberg family)

Lawyers on both sides of the appeal made their cases before a three-member panel of the Commonwealth court Tuesday, Joe Podraza, an attorney for Greenberg’s parents, told Fox News Digital.

"We are cautiously optimistic that the panel will find the estate of Ellen Greenberg may proceed to trial on her mandamus and declatory actions against the City (of Philadelphia) and Dr. Osbourne so that the manner of her death may be changed from suicide to something else," he said. "Only then can we begin to secure justice for Ellen."

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Ellen Greenberg in Penn State hoodie

A younger Ellen Greenberg smiles in an undated photo provided by her childhood friend and Penn State classmate. (Courtesy: Erica Hamilton)

He said he expects the panel to reach a decision in the next three to six months.

"[The] judges were well-prepared and versed about the issues," he said. "The judges also displayed the proper degree of sympathy over Ellen’s death and the terrible circumstances surrounding her death."

Greenberg’s fiancé Sam Goldberg called police on Jan. 26, 2011, to report coming home to find her dead in the kitchen of their Philadelphia apartment, according to court documents. 

According to Podraza, evidence shows that at least two of the 20 stab wounds were inflicted after Greenberg’s heart stopped beating.

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Multiple investigators who reviewed the case told Fox News Digital they disagree with Osbourne’s findings.

SCROLL TO SEE IMAGES FROM THE AUTOPSY REPORT:

A rendering showing more than a dozen of Ellen Greenberg's stab wounds

Another rendering showing more than a dozen of Ellen Greenberg's stab wounds. (Tom Brennan)

"I was startled by the amount of questions that remained," Guy D’Andrea, a former homicide prosecutor with the Philadelphia District Attorney’s Office, told Fox News Digital in September.

Before leaving the DA’s office, D’Andrea performed a review of the case and said he believed "at a minimum" the cause of death should have been "undetermined."

"Reviewing the file and the crime scene photographs and the medical examiner’s photographs, I don’t know how you come to that conclusion (of suicide)," he said.

A computer illustration showing some of Ellen Greenberg's knife wounds

A computer illustration showing two of Ellen Greenberg's knife wounds to the back of her neck and skull. (Tom Brennan)

Four key pieces of evidence caused him to doubt Osbourne’s finding of suicide, he said. A wound to the top of her head, the fact that she was found seated upright, but blood had dripped sideways across her face — indicating that she had been moved — a large amount of bruises at different stages of healing, and the fiance’s claim that he broke the locked door down when crime scene photos show the latch still attached to both the door and the frame.

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A damaged sling latch above an undamaged door lever

Outside investigators said the damage shown to the lock on Greenberg's apartment door is inconsistent with the report it had been kicked in from the outside. (Tom Brennan)

Several forensic pathologists, including Dr. Cyril Wecht, one of the country’s leading experts in the field, reviewed Dr. Osbourne’s findings over the years and found the circumstances "strongly suspicious of homicide."

"In all my years of experience, and all of the homicides that I’ve done, and suicides, I’ve never seen anything like this," he told Fox News Digital earlier this year.

But city officials maintain a comprehensive investigation found no evidence of homicide.

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Separately, after referrals back and forth regarding the case between the Philadelphia district attorney’s office and the state attorney general, the Chester County district attorney’s office has assigned an investigator and a prosecutor to conduct an outside investigation into Greenberg’s manner of death.

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"We will have to wait for the Chester DA’s response to know the next steps," Podraza said of those proceedings. "If she finds a basis to proceed with a homicide investigation, we will have to see if her office keeps it, it goes back to [Philadelphia District Attorney Larry] Krasner, or a special prosecutor is assigned."