Workplace injuries can be physically, emotionally, and financially draining. When you file a workers' compensation claim, you expect it to provide financial relief and support during your recovery. However, not all claims are approved. If your workers' compensation claim has been denied in New Jersey, you may wonder what to do next.
Common Reasons for Claim Denials
Lack of Sufficient Medical Evidence
One of the primary reasons for claim denials is insufficient medical evidence. If your medical records don't clearly link your injury to your work, your claim may be rejected. This underscores the importance of seeking prompt and comprehensive medical attention when injured on the job and thoroughly documenting your condition.
Disputes Over Work-Related Nature
Insurance companies may dispute whether your injury or illness is work-related. They may argue that your condition existed before your employment or resulted from non-work-related activities. It's crucial to provide a detailed account of how your injury occurred and gather evidence to support your claim.
Workers' compensation claims involve specific deadlines for reporting injuries and filing claims. Missing these deadlines can result in a denial of your claim. It's essential to report your injury promptly to your employer and file your claim within the required timeframe.
Lack of Witness Corroboration
If there were no witnesses to your workplace accident, the insurance company may question the validity of your claim. Having coworkers, supervisors, or others who can corroborate your account of the incident can strengthen your case.
The Appeals Process
Request a Review
If your workers' compensation claim is denied, you have the right to appeal the decision. The first step is to request a formal review of your case by the New Jersey Division of Workers' Compensation. This initiates the appeals process.
Mediation is a common step in the appeals process. It involves a neutral mediator who helps facilitate communication between you, your attorney, and the insurance company to reach a settlement. While mediation can resolve many cases, it's not always successful.
If mediation doesn't lead to a resolution, your case may proceed to a formal hearing before a workers' compensation judge. During the hearing, both sides present evidence and arguments. The judge will make a decision based on the presented facts and the law.
If you disagree with the judge's decision, you have the right to appeal to the Appellate Division of the Superior Court of New Jersey. This is a higher court where a panel of judges reviews your case for legal errors.
The Importance of Legal Representation
Expertise and Guidance
Navigating the workers' compensation appeals process can be complex, and insurance companies often have experienced legal teams on their side. Seeking legal representation is crucial to level the playing field. An experienced attorney can guide you through the process, gather necessary evidence, and present a compelling case on your behalf.
Protecting Your Rights
An attorney can also protect your rights throughout the appeals process. They ensure that you meet all deadlines, submit required documentation, and adhere to legal procedures, helping you avoid potential pitfalls that could further delay or jeopardize your claim.
Don't let a denied claim deter you from seeking the compensation and support you need to recover from a workplace injury. By taking the right steps and enlisting the help of an experienced attorney at Levinson Axelrod, P.A., you can pursue the benefits you're entitled to and ensure that your rights as an injured worker are upheld.
Call us today at (732) 440-3089 for a free consultation and to discuss your potential options.