Skilled, Experienced Representation In Complex Personal Injury Matters

What to do if a workers’ compensation claim is initially denied?

On Behalf of | Apr 29, 2020 | Firm News

People in New Jersey work many different types of jobs. Some are similar to others, but there are many different physical demands of the various jobs. Some people work at a desk in an office setting, some work in labor intensive construction jobs, others may drive trucks or other vehicles to deliver goods, there are also many people in restaurant jobs, healthcare and many others.

While the skill sets and physical demands of each type of job differ, they all have one thing in common, which is they need to be able to work in order to earn their money. If people are injured while working, it can make it impossible to work for a period of time and people may lose significant amounts of income. People who are injured while working may be entitled to workers’ compensation benefits though, which can pay for medical expenses and a portion of the workers’ wages.

These benefits are usually paid for through workers’ compensation insurance and those companies do not necessarily always want to pay every claim. They may deny an initial claim or dispute the extent of the injury and deny the length or amount. This can put workers in a difficult position, but they do have options to challenge the initial denial.

Informal Claims

One option is that the worker, employer or the insurance company can request an informal hearing in front of a judge. At the hearing evidence will be presented regarding the extent of the injury, the medical treatment necessary and other aspects. However, this is a process used to help the two sides try to reach agreements. The decisions and suggestions from the judge are not binding. People can always decide to proceed with a formal claim if they do not like the decisions.

Formal Claims

Formal claims are filed in court and would be heard by a judge. There is usually a pretrial hearing in these matters and many times the two sides can reach agreements at that hearing. However, if they cannot, the there will be a trial. At the trial the judge will hear testimony from the workers, the employers, medical providers and others. The testimony will state the extent of the injuries, the medical treatment needed to treat the injuries, the length of time before people can return to work and other issues. In these matters, the decision of the judge is binding, people can appeal the decision though.

Whether people in New Jersey use the informal or the formal process, it can be complicated and will require having medical evidence in addition to evidence about how the injury occurred. These can be very complicated cases as a result. Experienced attorneys understand the process and complexities of these matters and may be a useful resource.

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