When a workers' compensation claim is denied, it can be of great concern to the injured worker, as well as the family who counts upon the income to survive. There is a possibility of a denial, particularly if an insurance company disputes the fact that the injury actually took place at work. When a valid claim has been denied, you have the right to appeal. A claim that is submitted incorrectly, without adequate supporting documentation, can result in a denial. It is advised that in cases of serious injury, you have legal representation to assist you in filing your claim. This will allow you to ensure that you're the claim filed includes every possible form of compensation for damages, and decrease the possibility of a denial and the need to appeal, which can be a lengthy process.
There are various reasons that a claim could be denied. The insurance company could believe that you had suffered the condition prior to taking on the duties of your current job. Cases in which an existing injury or condition is made worse through the duties of a job should be approved, but may not have been. The insurance company involved could claim that the reason you were injured is that you failed to do the duties of your job correctly, and that your own actions caused your injuries. It can be a problem if a claim is not submitted within the time limits – you have only 30 days to notify your employer that you have been injured.
There are various other reasons that an insurance company may deny a valid claim, and it is fairly common. One may assume that a job-related injury is clear-cut and that the benefits will be forthcoming, only to receive a letter informing you that your claim has been denied. You have the right to contest the denial. A benefits claim that has been denied is extremely worrisome and distressing. Get legal assistance to help you to get the issue resolved. A hearing will be called to resolve the matter. You must request this hearing within 30 days. It is advised that you contact a New York workers' comp lawyer early in the process.
Katz Leidman Grossman Wolfe & Freund is recognized for their many achievements in workers' compensation cases throughout the state.