What Do I Do If Workers Comp Denies My Claim in New Jersey?

Atlantic City Workers Compensation Attorney Can Help You Appeal a Denial

Engineers pointing while discussing at construction site against clear skyWorkers compensation exists to provide for the basic needs of the injured party until he or she is able to return to work. However, sometimes the insurance company will deny your workers comp benefits. What do you do if insurance denies your claim? How do you pay for your lost wages and medical treatment?

Fortunately, you have options. By enlisting the help of a qualified team of New Jersey workers compensation attorneys, you may be able to reverse a workers comp denial. At Targan & Pender, P.C., we have over 60 combined years of experience helping people fight for the workers compensation benefits they deserve.

Why Did Workers Comp Deny My Claim?

There are several reasons why the insurance company might deny a workers comp claim after a workplace injury. Here are just a few of them:

  • You must submit your workers comp claim within two years of your injury. Failure to report the injury in time will lead to a denial of benefits.
  • There is insufficient evidence of an on the job injury to grant benefits.
  • There are no witnesses to corroborate your report.
  • Willful misconduct caused the injury.
  • You improperly filed your workers comp claim.
  • The injury was not work-related.
  • You filed the claim after leaving the job.
  • The injury report and the medical records conflict.

However, by keeping good records of the injury and following proper procedure, you can minimize the potential for a workers comp denial. An Atlantic City workers compensation attorney can help you file your original claim and also appeal a wrongful denial.

What Happens During the Workers Comp Appeals Process?

There are two options for appealing a workers comp denial in New Jersey.

  1. You can request an informal hearing through an Application for an Informal Hearing.
  2. You can request a formal hearing through a Claim Petition.

An informal hearing is the quickest method of appealing a denial. In order to apply for an informal hearing, you or your attorney must submit an Application for an Informal Hearing to the Division of Workers Compensation. After that, a judge in your area will be assigned to your case. Then, you will typically receive a written notice of your first hearing date within a few weeks.

Unlike a formal hearing, an informal hearing is more like a mediation session. You, your workers compensation attorney and the other parties involved will meet with the judge to discuss the disputed issues of your case and try to come to an agreement. However, the judge will not make a ruling but will instead offer suggestions. If you cannot reach an agreement, you still retain the option to request a formal hearing if you wish.

Alternatively, if you elect to pursue a formal hearing, you will submit your Claim Petition and a judge will hear your case. Getting a formal hearing is a slow process, and you may not see a judge until many months after you submit a Claim Petition. However, once you get to the courtroom, a formal hearing resembles a trial, with opposing parties presenting evidence and hearing witness testimony.

These hearings are often complicated, so it is a good idea to get an attorney to help you prepare and to argue your case to the judge. After your lawyer presents evidence of your workplace injury and witnesses testify on your behalf, the judge will rule on your case. If the hearing results in another denial, you can continue appealing the case up to state court.

Denied Workers Comp? Call Our Atlantic City Work Injury Attorneys for a Free Consultation

If an insurance company has denied your workers compensation claim, you have options. Our Atlantic City workers comp attorneys know how the system works. We know the tactics insurance companies use to deny claims. And we have the tools and skills necessary to fight back for our clients. You should not be responsible for the medical bills and lost wages that result from your on the job injury.

Remember this: if you suffered a workplace injury, time is of the essence in filing your workers comp claim. The longer you wait, the more lost wages you will have and the higher your medical bills will be. Therefore, if you would like to schedule a free consultation with one of our New Jersey workers comp lawyers, you can reach out to us by calling (609) 348-1106 or you can fill out our online case review form. We do not charge for consultations. Additionally, we operate on contingency fees, meaning that you will not owe us anything unless we are successful in obtaining benefits for you.