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Is a denied workers’ comp claim the end of the road?

On Behalf of | Apr 15, 2021 | Workers' Compensation

Suffering an injury at work was not on your agenda. Unfortunately, circumstances beyond your control in the workplace might have resulted in your suffering harm. While the setback was undoubtedly disheartening, you anticipated your employer’s workers’ compensation insurance to cover your medical bills and lost wages.

Rather than obtain the approval for coverage you expected, your workers’ comp claim came back denied. Understandably, you may be very worried.

What can you do?

Before you begin to picture your financial future in shambles, assess the situation objectively. A good starting point is determining why your New York employer or the insurance company denied your claim. Some common reasons for denial include the following:

  • Missed the deadline for reporting the claim to the employer
  • Missed the deadline for filing the claim
  • The injury may not be compensable under New York workers’ comp rules
  • Medical treatment for the injury was not sought
  • Employer says the injury was not suffered while on the job
  • Not enough evidence was provided to prove the injury resulted from work-related duties

If you do not believe any of these reasons applies to your situation, look at your denial information closely. Your employer or the insurance company should have provided a reason for denial, which could relate to those examples given here, or even other reasons.

Fighting a denial

Often, a denial is not the end for a workers’ comp claim. If the insurance company denies a claim, it should trigger a hearing by the Workers’ Comp Board regarding the denial. You need to follow up with the Board to make sure this is happening. At this point, you also should hire an attorney to help you with the controverted and denied claim, as it will likely need to be litigated.

You can also gather as much information as possible about the injury-causing incident, any forms or communication with the employer, and the medical treatment you received for the injury.

Denials can be very stressful. If you need help, contact an experienced workers’ compensation attorney.