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What to Do If NJ Workers’ Comp Claim Is Denied

Work Injury Claim Form marked, "Declined".

When an injury occurs in the workplace, the impact goes far beyond physical pain and suffering. Your livelihood, emotional well-being, and financial stability can all be put on the line. New Jersey has specific laws in place that allow injured employees to receive workers’ compensation benefits for medical expenses and lost wages. However, receiving these benefits isn’t always straightforward. What if your employer or their insurance provider denies your claim? Fortunately, New Jersey law provides a structured process for resolving such disputes, which includes both informal hearings and formal claim petitions.

When Your Workers’ Compensation Claim Faces Rejection

First and foremost, don’t panic. While a denied claim might initially seem like a closed door, it’s more of a hurdle—one that you can overcome with the proper guidance and approach. Once your claim has been denied, you can opt for an informal hearing or proceed to file a formal claim petition. Each pathway offers its pros and cons, and the choice often depends on the specifics of your situation.

Potential Reasons for Claim Denial

Before delving into the options available for disputing a denial, it’s helpful to understand why claims are often rejected in the first place. Common reasons include:

  • Incomplete or incorrect paperwork
  • Missed deadlines for filing the claim
  • Lack of medical evidence linking the injury to workplace activities
  • Employer disputes, claiming the injury did not occur during work or within the workplace
  • Failure to report the injury to the employer promptly

Understanding these common pitfalls can help you build a more robust case when you decide to appeal the denial.

Informal Hearings: A Step Toward Resolution

An informal hearing serves as an initial step for dispute resolution between you and your employer or their insurance carrier. It offers a less confrontational avenue where both parties can discuss their concerns in a moderated environment. A compensation judge is in charge of this hearing. One critical thing to remember is that the judge’s decision is not legally binding. That means that, even after the informal hearing, either party can still pursue a formal claim petition. The crucial caveat is to initiate this within the designated statutory two-year time period, which can vary depending on the specifics of your case.

The Path of Formal Claim Petitions

If you opt for a more structured and legal pathway, filing a formal claim petition with the Division of Workers’ Compensation becomes the next logical step. Upon filing, a hearing is generally scheduled within six months. It’s worth noting that a significant number of formal claim petitions are resolved through settlements before they ever reach the trial stage. If a settlement isn’t feasible, a trial is then held, culminating in a binding decision by the judge. If the verdict isn’t in your favor, you have the option to appeal the decision to the Appellate Division of the Superior Court.

Employer Retaliation: Know Your Rights

It’s unfortunate but essential to acknowledge that some employers may retaliate against employees for filing a workers’ compensation claim. Such actions could include termination, demotion, or creating a hostile work environment. It’s crucial to understand that employer retaliation for filing a workers’ compensation claim is illegal under New Jersey law. If you experience any form of retaliation, documenting the incidents and seeking legal advice immediately is imperative.

Role of Legal Representation in a Workers’ Compensation Claim

Being involved in a workers’ compensation dispute doesn’t mean you have to navigate the complexities alone. You have the right to legal representation. Having an attorney by your side can greatly improve your chances of making informed and beneficial decisions for your case.

At New Jersey Workers Compensation Lawyer, attorney Dan Santarsiero focuses on advocating for individuals who have been injured on the job. Our aim is to make sure you and your family receive every benefit you’re entitled to. From guiding you through informal hearings to representing you in formal claim petitions, we’re committed to protecting your rights and well-being throughout this difficult process.

Key Takeaway:

A denied workers’ compensation claim can certainly introduce an element of stress and uncertainty into an already challenging period in your life. However, it’s not the end of the road. New Jersey law offers avenues to resolve disputes, either through informal hearings or formal claim petitions. Remember, you don’t have to walk this path alone. Legal guidance can prove invaluable in making sure your rights are upheld and that you’re not left shouldering the burden of medical bills and lost wages without the support you’re entitled to.

Contact New Jersey Workers Compensation Lawyer Today For a Free Consultation About Your Workers’ Compensation Dispute

In a world where legal complexity often adds to the pain of a workplace injury, you deserve an ally who doesn’t just talk the talk but walks the walk. At New Jersey Workers Compensation Lawyer, attorney Dan Santarsiero is committed to making your path to recovery less burdensome. From the moment you’re injured to the day you receive your rightful benefits, we stand by your side, providing unyielding representation, compassionate counsel, and a commitment to safeguarding your rights.

Why choose us? We don’t just see a case; we see a human being in need of support and advocacy. We understand the pressure of medical bills, the strain of not being able to work, and the emotional toll it all takes. Our goal is to relieve these burdens, allowing you to focus solely on your recovery.

Don’t just take our word for it. Let our proven track record speak for itself. Reach out to us for a consultation, and let us show you how we can turn the odds in your favor. At New Jersey Workers Compensation Lawyer, we’re not just attorneys; we’re your strongest allies in the fight for your rights and well-being.