In New York, almost every worker is eligible for workers' compensation benefits when injured at work. With few exceptions, an injured worker is entitled to benefits for any illness or injury sustained on the job.
Despite the fact that you are entitled to benefits, even if you were "at fault", it's off-topic that more than 10% of workers' compensation claims are turned down, depriving these employees of the compensation required for appropriate medical care and related expenses while they heal.
Fortunately, there are circumstances when you can appeal a workers' comp denial decision. We'll explain in what cases you can file for an appeal in the following article.
If you need help with your workers' comp case, we suggest that you set up a consultation with the NY workers comp lawyers at Brandon J. Broderick, Attorney at Law. Our team can assist you in exploring your options, especially if you've been denied benefits.
Common Reasons Why A Workers' Comp Claim is Denied
Before explaining situations where you may be able to appeal a rejected workers' comp claim, here's some of the top reasons why your employer or their workers' compensation insurance company may deny your claim. This includes:
- Pre-existing condition or injury
- Lack of evidence to support you claim
- Failure to file before the time limit
- Inconsistencies in your reports
- Failure to seek medical treatment
- Incorrect information on forms
Can I Appeal A Workers' Compensation Claim Denial?
A workers' compensation denial must be appealed within 30 days of the filing date of the judge's decision, per Workers' Compensation Law § 23. This is why it's important to seek legal help. Letting a deadline pass may forfeit your right to appeal a decision and not receive benefits.
To resolve these issues, legal action and possibly a trial are necessary. Being well-prepared for any situation is enhanced by having legal representation.
Numerous workers' compensation claims are rejected because of minor things like incomplete information or failing to meet requirements. If you hire legal counsel for your initial file, you can steer clear of these problems.
Workers Comp Benefits: What Is Covered?
Most illnesses, accidents, and injuries related to a workplace are covered by workers' compensation insurance. All workplace accidents and injuries are not, however, covered by workers' compensation.
In order for workers' compensation insurance to provide benefits for an illness or injury, the following must apply:
- The worker is covered by the law
- The injury or illness is directly connected to the worker's responsibilities
- The accident happened while the worker was carrying out tasks related to their job
- Within 30 days following the illness or injury, the employee gave written notice to the employer of the accident that caused it
- The report from the treating physician indicates that the illness or injury was brought on by an incident or accident at work
The employee may be eligible for one or more benefits offered by workers' compensation insurance if their claim is accepted, including the coverage of their medical costs and lost wages. This could include death benefits and rehabilitation treatments and services.
A worker may be eligible for disability benefits if an illness or accident sustained at work renders them permanently handicapped. The total number of weeks that an employee is eligible to receive disability benefits has no limit.
Depending on the disability and severity, workers who become partially disabled are entitled to cash benefits. When the patient achieves Maximum Medical Improvement (MMI), which is thought to happen no later than two years following the date of the injury, the degree of the handicap is assessed.
Call Our NY Workers Comp Lawyers Today
If you've had your workers' comp claim denied or been hurt at work and are filing for workers' compensation, it may benefit you to seek the legal help from our team of NY Workers Comp Lawyers. The Brandon J. Broderick Law Firm can provide you with the support you need.
Please contact us today! We provide free consultations to discuss your case and give you peace of mind.