Injured employees rely on workers’ compensation benefits to pay for their medical expenses and time missed from work. It is not unusual for a workers’ compensation claim to be initially denied. Oftentimes, it is simply due to miscommunication. In other cases, however, workers’ compensation claims are rejected for unfair and complicated reasons.
Some denied claims can be reversed when handled by an experienced lawyer. A knowledgeable lawyer can help avoid any further delays, protect your rights, and pursue the compensation you need and deserve after a workplace accident.
How Do I Know Why My Claim Was Denied?
Once a workplace injury is reported to the employee’s supervisor, the claim is turned over to the employer’s insurance provider. In straightforward cases, the insurance provider pays for economic losses that are directly related to the employee’s workplace injury. Unfortunately, there are numerous circumstances when an injured worker’s claim may also be denied.
Common reasons for the denial of a workers’ compensation claim include:
- Employee did not seek immediate medical care, causing the insurer to question the legitimacy of the workplace injury.
- Employee neglected to report the injury or submit a workers’ compensation claim within the designated deadline.
- Employee had a pre-existing medical condition and failed to report it.
- Employee neglected to fill out the claim forms correctly or include all requested documentation.
- Employee’s injury is not work-related.
Workers’ compensation claim denial notices should include the reason for the decision, whether it be forgetting to include a medical report or failing to file the claim on time. If you receive a claim denial notice, you should immediately consult with an experienced attorney who can discuss your potential legal options.
Can I Appeal the Decision?
The denial of a workers’ compensation claim is understandably frustrating, especially with a painful injury and building financial pressures. It is not wise to complain to your employer, their insurer, or your health care provider after getting notice of a claim denial. At this point, it is in your best interest to retain experienced legal counsel.
The Division of Workers’ Compensation in the State of New Jersey has a specific process for appealing a claim denial. If your claim is initially denied, the only option is to file a claim petition, which must be filed by a qualified attorney. After the claim petition is filed, the case will be assigned to a Workers’ Compensation judge who will decide whether or not your claim is valid.
Why Should I Hire a Workers’ Compensation Lawyer?
It is critical for any employee who suffered a workplace injury to consult with knowledgeable lawyer as soon as possible. In the majority of workers’ compensation cases, the injured worker is in need of proper medical treatment. Workplace injuries are what prevent countless employees from being able to get back to their jobs. A dedicated attorney can help you receive appropriate medical treatment for your injuries so you can focus on healing.
An attorney can take care of your workers’ compensation case from start to finish. They can file your claim in a timely manner, pursue maximum compensation, and handle appeals on your behalf.
Tinton Falls Workers’ Compensation Lawyers at the Law Offices of Michael S. Williams Help Employees Handle Claim Denials
If you were injured because of a work-related accident, do not hesitate to contact our Tinton Falls workers’ compensation lawyers at the Law Offices of Michael S. Williams for help with an appeal. Call us at 732-351-2800 or complete our online form to schedule a free consultation. We are located in Tinton Falls, New Jersey, and we assist clients in Shrewsbury and Monmouth County.