A workplace injury or accident can be a financial and emotional nightmare for a New Jersey resident. When a worker cannot do their job because of harm that they sustained while engaged in their employment, they may be able to seek compensation through workers’ compensation. A workers’ compensation attorney can be a valuable ally before and during the workers’ compensation claims process.
However, not all individuals who get hurt at work and file for workers’ compensation are awarded financial support. Many have their claims rejected and are forced to seek appeals. Common grounds for workers’ compensation claims’ denials are addressed in this post, but as with all the posts on this blog, no reader should presume the information contained herein is legal advice or guidance.
Denials based on reporting or technical requirements
For some individuals, workers’ compensation claims are denied because they are deficient from a technical standpoint. For example, a claim filed after its deadline may be rejected based on that grounds. Similarly, a worker who fails to report their injury to their employer may later be precluded from filing a workers’ compensation claim for their losses.
Denials based on the source or type of injury
For a worker to receive benefits through workers’ compensation, their injury or loss must be tied to their employment. After reviewing a claim, a request for workers’ compensation may be rejected because it occurred outside the scope of the worker’s job. In some cases, a rejection may be based on a finding that the worker’s injury happened because of horseplay or that they were off the clock when it happened.
Not all injuries are compensable through workers’ compensation. Generally, if a worker does not have to seek medical help for the treatment of their injury, the injury is not eligible for workers’ compensation. Also, certain injuries or conditions may be precluded from workers’ compensation by state law.
One of the best ways to avoid a workers’ compensation claim denial is to prepare a strong and clear original claim. While workers can take this process on by themselves, they can find knowledge and guidance when they choose to seek the counsel of workers’ compensation attorneys. Those lawyers can then also support them if their claims require further clarification or appeals.