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Protecting The Injured

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Why was your workers’ compensation claim denied?

Workers’ compensation benefits can supplement your income when you suffer a work-related injury in New Jersey. However, to utilize your benefits, you must first file a claim with your employer.

If your employer denies your claim, you may feel uncertain and frustrated. Knowing some of the common reasons why employers will sometimes deny a claim can help you decide what to do next.

Fabricated facts

If you fabricated parts of your story, your employer may refuse to give you workers’ compensation benefits. You have to provide ample proof that your accident and the subsequent injury resulted from a work-related hazard or situation.

If you arrived at work under the influence of drugs or alcohol, your employer may contend that you should take responsibility for your injury. Similarly, if you did not follow safety requirements or engaged in reckless behavior, these could also jeopardize your benefits. Lying about how your injury happened or where it happened may not only result in a denied claim but potential legal consequences for fraud as well.

Overlooked requirements

Overlooking requirements are another reason your employer may deny your claim. By law, you only have a specific period of time in which you can file a claim. Your effort to inform your employer of your situation as soon as possible can give you the best possible chance of getting benefits. Your employer may also require you to seek medical treatment from specific health care providers within the network their insurance company uses. Seeing doctors outside of this network may result in a rejected claim.

A denied claim does not have to conclude your effort to get benefits. According to the State of New Jersey Department of Labor and Workforce Development, you have the right to file a claim petition. This allows you to dispute the denied claim and provide context about your situation.

Working with an attorney may help you to identify ways to strengthen your case. Presenting your situation in as much detail as possible may help you achieve a more desirable outcome.