workers’ compensation laws were created, injured workers would have to file a lawsuit against
their employers to collect damages when they were injured in a work-related
accident. During this arduous legal process, injured workers had to prove
that their employers were negligent and this was no easy task.
With the arrival of the Industrial Revolution, machine-use exploded and
industrial accidents were common and widespread. Fortunately, lawmakers
realized that workers needed a faster, more efficient way to collect damages
after suffering a workplace injury. With the need for statutory change,
workers’ compensation was born.
Today, workers’ compensation is a no-fault system, meaning an injured
or ill worker can collect workers’ compensation regardless of their
own degree of fault. Even if a worker accidentally injured themselves,
they could still collect
workers’ compensation benefits with no questions asked.
Under the modern workers’ compensation system, when a worker is suffers
a workplace injury or an occupational disease and he or she collects workers’
compensation, they cannot sue their employer. By collecting workers’
compensation benefits, the employer is shielded from employee lawsuits.
Reasons Why a Workers’ Comp Claim Can Be Denied
In New York, most workers are covered by their employer’s workers’
compensation insurance. If a worker was injured on the job, or if their
illness is an
occupational disease, their workers’ compensation claim should be approved.
However, workers’ compensation is not automatically guaranteed. There
are occasions where a workers’ compensation claim is denied, and
sometimes the “reasons” can be called into question by an
experienced attorney. Usually, a workers’ compensation claim is
denied for one of the following reasons:
- The employer or insurance company says the injury is not work-related,
- The insurance carrier says that the illness is not an “occupational
- The employer argues that the worker was under the influence of drugs or
alcohol at the time of injury,
- The employer argues that the worker is not a “covered employee,” or
- The employer argues that the worker intentionally injured himself or herself,
or intended to injure someone else.
If a worker’s claim is denied, the Workers’ Compensation Board
may decide to hold a hearing or series of hearings, which will be heard
by a workers’ compensation law judge, who will review the facts
of the case and decide whether the claimant should receive benefits.
If either side is dissatisfied with the judge’s decision, they have
30 days to file an appeal. At any point in the process, the claimant reserves
the right to an attorney.
If your workers’ compensation claim was denied, we urge you to
contact Katz Leidman Grossman Wolfe & Freund to request a free case evaluation!