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My Workers’ Compensation Claim has Been Denied. Now What?

No one wants to get injured at work or be exposed to substances in the workplace that induce illness, even if compensation is available for such unfortunate setbacks.  However, working men and women often end up enduring such harm in the quest to put food on the table and pay the mortgage.  This is precisely why New Jersey law mandates all businesses provide workers’ compensation insurance.  If such laws were not on the books, our state’s workers would not be able to remain financially sound after an injury or illness suffered in the workplace.

There is a chance your workers’ compensation claim will be denied.  The appeals process following such a denial has the potential to cause considerable confusion and frustration.  Hire the right attorney and you will have the hope necessary to stay positive and look forward to a brighter future.

Why was the Claim Denied?

The notice of denial should specifically state why the claim was not approved.  Common reasons for denial include but are not limited to the following:

  • The failure to notify the employer of the injury in the two weeks after the incident
  • The injury stemmed from the employee’s misconduct and is ineligible for coverage
  • The employer’s insurance provider insists the injury or illness is not causally related to workplace duties and subsequently ineligible for compensation

Once there is an in-depth understanding of the nuanced reason(s) for the claim denial, it is time to commence the appeal process.

Filing the Appeal

Those who are denied compensation for their workplace injury or illness are empowered to file an appeal with the goal of obtaining the necessary indemnity payments or other financial support.  The state of New Jersey empowers workers to move ahead with an application that spurs an informal hearing or the filing of a claim petition.

Informal hearings in the state of New Jersey are overseen by a Judge of Compensation.  This judge will eventually provide a verdict that is not legally binding.  The judge’s decisions pertaining to eligibility for workers’ compensation benefits or the level of compensation to be provided are mere suggestions.  The next step is for the employer’s insurance provider to meet with the claimant’s attorney to hammer out an agreement.  However, if such an agreement cannot be reached, the claimant still has the legal right to file a claim petition.

The Formal Claim Petition

Those who elect to file a claim petition through the Division of Workers’ Compensation are required to do so within a two-year period of the point in time at which the incident or illness occurred.  The appeal moves ahead with a hearing in front of a judge.  This hearing typically occurs within six months of the point at which the claim is filed.  Most formal appeals end up settling out of court at this point in the process.  However, there is a chance the case will eventually shift to a formal trial if an agreement cannot be reached.

Schibell Law Attorneys are on Your Side

If you are injured or become ill due to your workplace responsibilities, you might not be able to pay the bills and feed your family.  This is not a time to be self-reliant.  Reach out to our New Jersey workers’ compensation attorneys for assistance during this difficult period of your life.  We will help you obtain the compensation you need and deserve in full accordance with New Jersey laws.  Dial 732-774-1000 to schedule an initial consultation with our attorneys today.

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3459 Route 9 North
Howell, New Jersey 07731

101 Crawford Corner Rd
Bell Works Suite 4333
Holmdel, NJ 07733

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