What Happens If Your Workers’ Compensation Claim Is Denied?

Being injured at work is already stressful. You’re forced to leave work for a period of time while recovering from your injuries. And if you’ve applied for New York’s workers’ compensation benefits, you know how time-consuming the process is. Getting your claim denied makes the process that much more difficult.

Thankfully, a claim denial doesn’t mean it’s over. You still have plenty of options to appeal and get approved if you act quickly.

Why Do Workers’ Comp Claims Get Denied?

Unclear Injuries

In some cases, there may be disputes over whether your injury actually happened at work. Your employer’s insurance company might argue that it happened while you were off-site or outside of your actual schedule.

Having clear evidence of your work schedule and the accident location is one of the most important steps to avoid this from happening. It makes it harder for an adjuster to disprove that you were there and the injury actually happened while you were at work.

Not Enough Evidence

As in any other legal case, strong evidence is the main factor in a successful claim. Some applicants may lack sufficient documentation. Maybe they have gaps in treatment, vague doctor’s reports, or simply not enough strong evidence. Regardless of the reason, this makes it much harder to get your benefits approved.

Pre-Existing Conditions

Previous illnesses or injuries add more complexity to legal cases. Your employer might argue that the injury predated the current accident and is unrelated to it. However, many medical conditions can worsen following a workplace incident.

In this case, an experienced lawyer can establish a connection between your injuries and what happened. They can help you organize your evidence and demonstrate how the workplace incident worsened your condition.

You Missed A Deadline

You have 30 days from the date of the accident to report it to your employer and up to two years to file a claim with the Board. In most cases, missing these deadlines may result in your claim getting dismissed. Always stay on top of your paperwork and do it as early as possible to avoid any issues.

What Getting Denied Actually Means

Just because you’re denied initially doesn’t mean you’ve lost your chance to get benefits. In these cases, the insurance carrier disputed your claim and won’t approve your case. After you file an appeal, you’ll have a hearing with the Workers’ Compensation Board and present your evidence. The judge will then make a final decision and decide whether you receive benefits.

Roughly two-thirds of initial denials are approved within the first year. That said, filing an appeal is worth it. It’s a challenging process, but you’ll still have a chance to get compensated for your injuries.

How Our Lawyers Help With The Appeals Process

A denial doesn’t mean a claim approval isn’t possible. However, we don’t recommend you go through the appeals process alone. Our Long Island workers’ compensation attorneys can handle the necessary paperwork and push back against your employer’s insurance company. Whether it’s building a stronger case or addressing any documentation errors, we’re here to help start the process as quickly as possible. Contact us at 855-338-1207 to schedule a free consultation with us today.