Denied Workers' Compensation Claims in Queens

How to Overturn a Workers' Comp Claim Denial

Experiencing a work-related injury is stressful enough without having to worry about your workers' compensation claim being denied. Unfortunately, insurance companies deny workers' compensation claims all the time for a variety of reasons. If your workers' comp claim has been denied, you are not alone, and there are steps you can take to fight back.

Navigating the workers' compensation system can be complex, especially when facing a denial. Seeking guidance from experienced legal professionals like those at Harris Firm, LLC can help injured workers understand their rights and options for appealing a denied claim.

Call (718) 487-8669 or complete an online contact form today to schedule a free consultation and learn how we can help you with your denied workers' compensation claim.

Why Was My Workers' Comp Claim Denied?

There are several reasons why your workers' compensation claim may have been denied. Understanding why your claim was denied can help you figure out how to proceed.

Some of the most common reasons workers' comp claims are denied include:

• Failure to Report the Injury Promptly: In New York, injured workers must report their injuries to their employer within 30 days of the accident or as soon as reasonably possible. Failure to report the injury in a timely manner can lead to a denial of the claim.
• Disputes over Causation: The insurance carrier may dispute whether the injury or illness is directly related to the workplace. They may argue that the injury was a result of a pre-existing condition, occurred outside of work, or was not caused by work-related activities.
• Lack of Medical Evidence: Insufficient medical evidence supporting the injury can result in a denial. This could include medical records that do not clearly link the injury to the workplace or a lack of documentation detailing the severity of the injury.
• Failure to Seek Medical Treatment: If an injured worker fails to seek timely medical treatment for their injury, it may raise questions about the severity of the injury or whether it was actually caused by a workplace incident.
• Employment Status Disputes: Independent contractors or individuals not classified as employees may be denied coverage under workers' compensation insurance. Similarly, if there is a dispute regarding whether the injured individual was an employee at the time of the injury, the claim may be denied.
• Missed Deadlines or Paperwork Errors: Missing deadlines for filing paperwork or making errors on forms can lead to a denial. It's crucial to ensure that all paperwork is completed accurately and submitted within the required timeframes.
• Allegations of Misconduct: If the injury occurred while the employee was engaging in misconduct, such as violating safety regulations or being under the influence of drugs or alcohol, the claim may be denied.
• Statute of Limitations: In New York, injured workers generally have two years from the date of the injury to file a workers' compensation claim. Missing this deadline can result in the claim being denied.

These are just a few reasons why your workers' compensation claim may have been denied. If your claim was denied and you are not sure why, our firm can help. We can review the details of your case, including your employer's denial letter, and help you understand your options.

What to Do If Your Workers' Comp Claim Is Denied

If your workers' compensation claim was denied, you have several options. The best way to proceed will depend on why your claim was denied and how much time has passed since the denial.

Here are a few steps you can take if your workers' compensation claim is denied:

1. Review the denial letter. When an insurance company denies a workers' compensation claim, they are required to send you a letter explaining why. This letter will provide important information about how to appeal the denial.
2. File an appeal. If your claim was denied, you have the right to appeal the decision. The denial letter will explain how to file an appeal and the deadline for doing so. You should start the appeals process as soon as possible to avoid missing any important deadlines.
3. Build a case. To successfully appeal a denied workers' compensation claim, you will need to provide additional evidence to support your claim. Working with an experienced workers' comp attorney can help you build a strong case and improve your chances of success.
4. Consider a settlement. If you are unable to overturn your denied workers' compensation claim, you may be able to settle with the insurance company. A settlement is a one-time lump sum payment that can help you cover your medical expenses and lost wages.
5. Sue your employer. In some cases, you may be able to sue your employer if your workers' compensation claim was denied. Suing your employer can be a complex process, and you will need to prove that your employer was negligent. Our team can help you determine if filing a negligence claim is the right option for you.

Again, the best way to proceed will depend on the specific details of your case. Our team can help you understand your options and guide you through the process.

How Our Team Can Help

At Harris Firm, LLC, we understand how difficult it can be to have a workers' compensation claim denied. Here's how we can help:

• Legal Expertise: We have extensive knowledge and experience in workers' compensation law. We understand the intricacies of the system and can assess the specifics of your case to determine the best course of action.
• Appeals Process: We will guide you through the appeals process step by step, ensuring all necessary paperwork is completed accurately and submitted on time. This includes gathering evidence, medical records, and witness statements to strengthen your case.
• Representation: We will represent you during hearings and proceedings, advocating for your rights and presenting compelling arguments to the administrative law judge or appeals board.
• Negotiation: In some cases, we may negotiate with the insurance company or employer outside of court to reach a settlement that meets your needs. We will work tirelessly to secure the maximum compensation available to you.
• Court Litigation: If your case requires litigation, we are prepared to vigorously represent you in court. We will build a strong legal strategy, present evidence, and argue your case before a judge or jury if necessary.
• Protecting Your Rights: Throughout the process, we will protect your rights and ensure that you are treated fairly under the law. We are dedicated to advocating for injured workers and will fight tirelessly on your behalf.

We know that you are likely facing mounting medical bills and lost wages, and we are here to help. Our team can guide you through the process of appealing a denied workers' compensation claim and fight to get you the benefits you deserve.

Contact us at (718) 487-8669 to schedule a free consultation with one of our experienced workers' compensation attorneys.