Yes, an employer can deny a Workers’ Compensation claim through their insurance company, but that doesn’t necessarily mean you won’t receive the benefits you’re entitled to under New York law.
While employers or their insurance carriers can challenge your claim for various reasons, New York’s Workers’ Compensation system offers strong protections for injured workers. Understanding how and why claims are denied can make all the difference in securing the compensation you need to recover and move forward.
Having legal support from a New York Workers’ Compensation lawyer can ease the burden during this stressful time and help ensure that your claim is taken seriously and resolved fairly.
What’s at Stake if Your Employer Denies Your Workers’ Compensation Claim?
Suffering an injury at work is more than just a medical concern, as it can throw your entire life into uncertainty. Many injured workers worry about how they’ll pay their bills if they can’t return to work right away. Medical treatments, therapy, and prescriptions can quickly become overwhelming expenses, especially if there’s no paycheck coming in.
The fear that an employer might deny your Workers’ Compensation claim only adds to the stress. Questions like “What if they say it wasn’t their fault?” or “How will I take care of my family?” are common and valid.
In New York, Workers’ Compensation is designed to provide support during this difficult time, regardless of who caused the accident. However, when a claim is disputed, it can delay much-needed benefits.
That’s why understanding your rights can make a major difference. It’s possible to challenge a denial and pursue the financial relief you need to heal and move forward. Our New York Workers’ Compensation lawyers can build a compelling case for your claim.
When and Why Employers Might Deny a Workers’ Compensation Claim
While New York law requires almost all employers to carry Workers’ Compensation insurance, that doesn’t prevent disputes over whether an injury or illness qualifies for benefits.
Employers or their insurance carriers may deny a claim for several reasons. Some of these reasons are valid, and some are questionable.
Common reasons for denial include:
- The employer disputes that the injury happened at work or during work-related duties.
- The injury was allegedly due to pre-existing conditions unrelated to employment.
- The worker delayed reporting the injury, violating the requirement to notify the employer within 30 days (required by the New York Workers’ Compensation Board).
- There are allegations of misconduct, such as being under the influence, engaging in horseplay, or violating safety policies.
Sometimes, claims are denied based on incomplete paperwork or administrative errors. In other cases, denials may stem from an attempt to reduce costs or avoid higher insurance premiums.
While a denial can feel like a setback, it does not mean you’re out of options. New York law allows workers to challenge denied claims through formal processes; having legal representation can help ensure that the real facts are brought forward and your rights are protected.
Know Your Rights Under New York’s Workers’ Compensation Law
New York’s Workers’ Compensation system is designed to protect employees who are injured or become ill on the job, regardless of fault. This means that even if your own actions contributed to the accident, you may still be entitled to benefits. Employers are required by law to carry Workers’ Compensation insurance for their employees, with a few exceptions.
Under N.Y. Workers’ Comp. Law § 18, you must:
- Notify your employer in writing within 30 days of the injury or becoming aware of a work-related illness.
- File a claim with the New York State Workers’ Compensation Board within two years.
Once you have filed a claim, you may be eligible for:
- Coverage of medical expenses related to your injury
- Partial wage replacement for lost income
Having legal guidance from one of our New York Workers’ Compensation attorneys can help ensure that all deadlines are met, your evidence is thorough, and your rights are fully enforced under New York law.
How to Fight a Denial of Your Workers’ Compensation Claim
You can challenge a denied Workers’ Compensation claim in New York through a formal process, beginning with a hearing before a Workers’ Compensation Law Judge (WCLJ).
To succeed, you’ll need to present clear, compelling evidence that your injury is work-related and that you meet all legal requirements for benefits.
Key steps your lawyer may take in proving your Workers’ Compensation claim:
- Collect medical records documenting your injury and treatment
- Obtain a doctor’s opinion linking the injury to your job duties
- Secure witness statements, incident reports, if available
- Provide evidence of lost wages and out-of-pocket expenses
- Prepare for Independent Medical Examinations (IMEs), often required by insurance carriers
The Workers’ Compensation Board will review all submitted materials and, if necessary, schedule a hearing where both sides present evidence. If the Judge rules against you, you have the right to appeal within 30 days.
Building a strong case often requires a thorough investigation and understanding of legal standards. Our New York Workers’ Compensation attorneys will navigate complex hearings and ensure evidence is properly presented.
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How a New York Workers’ Compensation Lawyer Can Help
Navigating a denied Workers’ Compensation claim can feel overwhelming, especially when you’re trying to focus on healing. A Workers’ Compensation lawyer offers more than just legal advice. They become your advocate, ensuring that your rights are protected and your case is handled with the care it deserves.
An attorney can:
- Help gather and organize critical evidence, including medical records and witness statements
- Ensure all forms and deadlines are properly met to avoid administrative delays
- Challenge the insurance company’s findings, including cross-examining doctors in Independent Medical Examinations (IMEs)
- Represent you at hearings and appeals, presenting a compelling case before the Workers’ Compensation Board
- Negotiate settlements, when appropriate, to fight for the maximum compensation benefits available
With an attorney handling the legal challenges, injured workers can focus on their recovery and well-being, knowing their case is being pursued with skill and dedication.
Take the Next Step Toward Recovery After a Claim Denial
Facing a denied Workers’ Compensation claim can be incredibly stressful, especially when you’re already dealing with the physical and emotional impact of a work injury.
But remember: a denial is not the end of the road. New York’s Workers’ Compensation laws are in place to protect you, and there are clear steps you can take to challenge the denial and pursue the benefits you deserve.
You don’t have to navigate this process alone. Our New York Workers’ Compensation lawyers will ensure your case is being handled with care and that your rights, health, and financial well–being are being prioritized.
The legal team at O’Connor Law is here to help you take the next step forward. Contact us today for a free consultation to discuss your case and learn how we can help you move toward recovery.
