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What action can I take if my workers' compensation claim is denied?

In the event an individual suffers an injury while at work or while performing work-related duties, he or she is entitled to receive worker's compensation. Worker's compensation benefits cover the financial costs associated with medical care and lost wages that result from a work injury.

The vast majority of New Jersey employers are required to carry worker's compensation coverage. In cases where an individual suffers a work-related injury, it's important to notify an employer about the injury as soon as possible. An employer is then required to report the injury to its insurance provider who will review the claim. 

In some cases, an individual's claim may be denied or an insurance provider may refuse to cover certain medical expenses. When this occurs, it's wise to seek the advice and assistance of an attorney who handles denied workers' compensation claims. 

A workers' compensation claim may be partially or wholly denied for one of several reasons including: 

  • Dispute over whether the injury was job-related
  • Dispute over the severity of the injury 
  • Dispute over type and cost of medical treatment 
  • Dispute over the awardence of temporary or permanent disability status and payments

Workers' compensation laws are complex and include numerous restrictions, requirements and time limits that must be followed. It's important, therefore, that injured workers who are dealing with a denied claim seek the advice and assistance of an attorney. 

An attorney who handles workers' compensation matters will advocate on an injured worker's behalf and present compelling medical evidence as to why he or she should be awarded benefits. 

Source: Department of Labor and Workforce Development, "Injured Workers," 2014

Department of Labor and Workforce Development, "Filing a Claim," 2014

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