Workers’ compensation provides financial assistance to employees who sustain work-related injuries or diseases. It covers medical bills, rehabilitation fees, and missed wages. Most New Jersey employees, including full-time, part-time, and seasonal workers, are eligible. The goal is to help injured workers recover without financial strain. However, not all claims succeed, and understanding the reasons for denial can help you navigate the process.
1. Late reporting
Timely reporting is crucial. New Jersey law requires you to report your injury to your employer immediately but no later than 90 days after the incident. Delays can lead to doubts about the injury’s legitimacy, resulting in a denied claim.
2. Lack of medical evidence
Medical documentation supports your claim. Insurers may deny the claim without detailed medical records or if the injury does not align with the reported incident. Always seek immediate medical attention and maintain thorough records of your treatment.
3. Disputed injury origin
Your employer or insurer might argue that your injury did not occur at work. They might deny your claim if the injury happened outside the workplace or during non-work-related activities. Clear evidence and witness testimonies can strengthen your case.
4. Pre-existing conditions
If you have a pre-existing condition, insurers might claim your current injury relates to that condition rather than a workplace incident. While pre-existing conditions can complicate claims, demonstrating how work aggravated the condition can help.
Can you file for an appeal?
If your workers’ compensation claim faces a denial, you can try to file for an appeal. In New Jersey, you can file a formal claim petition or an application for an informal hearing with the Division of Workers’ Compensation. You may want to seek help from a legal professional who can guide you through the appeal process, helping you present a compelling case to secure the benefits you deserve. Prompt action is essential in appealing a denial to protect your rights and interests.