Silverman & Roedel, LLC Discuss What To Do If Your Workers' Compensation Claim Is Denied in New Jersey
CLIFTON, N.J., Oct. 2, 2020 /PRNewswire/ -- You have unfortunately suffered an injury while at work, resulting in you not being able to work like you used to. Your first step was notifying your employer's insurance company of the injury in the hopes of being granted workers' compensation. Silverman & Roedel, LLC, one of New Jersey's leading personal injury and worker's compensation law firms, shares what occurs when your claim has been denied and what your next-steps are.
Compensable vs. Non-Compensable Injuries in New Jersey
There are many reasons for an employer or its insurance carrier to deny a Workers' Compensation claim. A claim may be denied if they believe that:
- Your illness or injury did not occur at work.
- You did not report the injury within the required time.
- You did not file the claim in time.
- Your injury was self-inflicted or that you refused to wear required protective gear.
- You were under the influence of alcohol or drugs.
- You engaged in so-called horseplay.
- You did not obtain medical treatment.
- Your injury was the result of a pre-existing condition.
Some of these assertions are difficult to prove and primarily represent a delaying tactic on the part of the insurance carrier. The hope is that the injured worker will give up, as the appeals process can be complicated.
The Appeals Process in New Jersey
Luckily, here in the state of New Jersey you have two different appeal options at your disposal. Those options are an informal hearing or a formal hearing.
An informal hearing is a way to possibly resolve the matter without having to go through formal litigation. You will first submit an Application for Informal Hearing with the New Jersey Division of Workers' Compensation [DWC]. Once your application is processed the DWC will tell you when and where the informal hearing will take place.
The hearing itself is a lot more like a mediation than anything. A judge will ask you and your employer questions about the matter and evaluate any medical history or other documents you have provided. The judge will determine a recommendation to how your claim should be resolved. As it turns out, that recommendation is not binding, meaning neither you nor your employer has to heed the recommendation if you do not see fit. If this is the case, you will proceed with a formal claim.
A formal claim begins with a Claim Petition form with the DWC. It must be filed within two years of the injury or the last compensation payment you received from the insurance company. Once the petition is filed you will be assigned a formal hearing date.
Formal worker's comp hearings are just like regular trials. Both sides will testify and present evidence — you need strong and compelling evidence of your necessity for workers' comp. The judge will make a decision and unlike an informal claim, the decision is binding to both sides. Either party may appeal the decision though. That appeal can only go to the New Jersey Appellate Division of the Superior Court.
For more information, visit www.silvermanandroedel.com.
About Silverman & Roedel, LLC
Located in Clifton, NJ, Silverman & Roedel, LLC has represented clients in the fields of personal injury, automobile accidents, medical malpractice, social security disability, bankruptcy, and beyond. With over 37 years legal experience, they are dedicated and committed to their clients and seek to achieve the best possible result in each and every case.
Silverman & Roedel, LLC Contact
Pamela Roedel
(973) 772-6411
SOURCE Silverman & Roedel, LLC
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