Denied Workers’ Compensation Benefits In New Jersey? Here’s What You Should Know About the Appeals Process

May 27, 2020

You expect your employer and their workers’ compensation policy to cover your expenses if you are ever injured on the job. Unfortunately, that is not always the case. There are many reasons why your workers’ compensation claim might be denied. If you are denied, you will have to go through an appeals process. Understanding what that means and what to expect can be helpful as you begin to navigate your claim.

Reasons Why You Were Denied Workers’ Compensation

Before submitting an appeal, it is important to know why you were denied in the first place. Here are a few of the most common reasons why you might be denied:

• You failed to report the injury: New Jersey law requires that you notify your employer of the injury within 90 days. Failing to do so will lead to a denied claim.
• Your injury didn’t occur during work responsibilities: In order to receive workers’ compensation, you must have been injured while working and while completing an expected task. Pre-existing conditions that are not work-related are not covered under workers’ compensation.
• Lack of documentation: If you are missing any paperwork or required documentation in your application, your claim will most likely be denied.
• Your injury is not significant enough: Workers’ compensation is meant to cover workplace injuries that require extensive medical care and potential time off of work. A minimal injury that does not require any medical care or that will not affect your income is unlikely to be approved for workers’ compensation.

If you are unsure why you were denied, it can be helpful to reach out to a workers’ compensation lawyer. They will evaluate the details of your case and determine the cause for denial.

How to File an Appeals Process in New Jersey

If you believe that your workers’ compensation claim was wrongly denied, then you will want to file an appeal with New Jersey. You have one of two options:

• Application for an Informal Hearing: An application for an informal hearing requests an informal appeal. This might be a good option if your application is missing a few forms. A judge will be assigned to your case and will review the documents. They will give their recommendation for remediation.
• Formal Claim Petition: A formal claim petition requests a formal hearing for your workers’ compensation appeal. This form must be filed within two years from the date of the injury or from your last workers’ compensation payment. In a formal claim petition, you can expect a formal trial. Some workers will choose to file a formal claim petition if the application for informal hearing is also denied.

Because an application for an informal hearing is less formal, you may or may not choose to work with a workers’ compensation lawyer. However, if you opt for a formal claim petition, the services of a workers’ compensation lawyer will be invaluable to your case. They will help you navigate the claim and prepare for your case by collecting all of the necessary documentation.

If you have already been denied, it is a good idea to work with an experienced workers’ compensation lawyer. Otherwise, you risk extending the process even more. Waiting too long can make you ineligible for compensation benefits.

Contact a Morris Township Workers’ Compensation Lawyer to Discuss Your New Jersey Workplace Injury Case

A workplace injury can be devastating, particularly if it prevents you from returning to work for an extended period of time. Although New Jersey Workers’ Compensation laws are supposed to provide you with reimbursement for medical expenses and replacement pay for missed time at work, it is not always easy to get the Workers’ Comp benefits you deserve. That is why you should speak with a knowledgeable Workers’ Compensation lawyer about your situation and get guidance throughout the claims process. The experienced Workers’ Compensation attorneys at Hoyt & Hoyt, PC represent clients in Mount Olive, Rockaway, Edison, and all across New Jersey. Call (973) 292-2299 or fill out our online contact form today to schedule a free consultation about your work injury case. Our main office is located at 67 East Park Place, 5th Floor, Morristown, NJ, 07960, and we also have an office in New Brunswick, New Jersey.

The articles on this blog are for informative purposes only and are no substitute for legal advice or an attorney-client relationship. If you are seeking legal advice, please contact our law firm directly.