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What to do after a New Jersey workers’ comp denial

On Behalf of | Apr 10, 2023 | Workers Compensation |

If you’ve experienced a denial of your New Jersey workers’ compensation claim, it can be a stressful and overwhelming experience.

However, don’t lose hope. You have options available to challenge the denial and potentially secure the benefits you deserve.

Understand the reason for denial

Before taking any action, it’s essential to understand why the insurance company denied your claim. The insurance company or your employer must provide a written explanation detailing the reasons for the denial. Common reasons include insufficient medical evidence, missed deadlines or a determination that the injury is not work-related. By understanding the specific reasons for denial, you can better address the issues and prepare for the next steps.

Request an informal hearing

If you disagree with the denial, you can request an informal hearing with the New Jersey Division of Workers’ Compensation. This informal hearing is a less formal process than a formal hearing and provides an opportunity to resolve the dispute quickly. During the hearing, a judge will review the case, listen to both sides and recommend a resolution. Keep in mind that the judge’s recommendation is not binding, and you can still proceed to a formal hearing if you’re unsatisfied with the outcome.

Prepare for a formal hearing

If you’re unable to resolve the dispute through an informal hearing, you can request a formal hearing with the Division of Workers’ Compensation. This process is more formal and similar to a court trial. You’ll need to present evidence, such as medical records, witness testimony and documentation related to your employment and injury. The judge will then make a decision, which is legally binding.

Stay organized and proactive

Throughout the process, it’s crucial to stay organized and proactive. Keep copies of all documents related to your claim, including medical records, correspondence with the insurance company and any evidence supporting your case. Make sure to meet all deadlines and requirements set forth by the Division of Workers’ Compensation.

Facing a workers’ comp denial can be a challenging experience, but by understanding your options and taking the appropriate steps, you can improve your chances of securing the benefits you need to recover and move forward.