Calling a NY workers compensation lawyer may be one of the most critical steps victims of work-related accidents can take. Injuries can consume an accident victim, making many aspects of a person’s life deeply challenging. When the insurance company denies a workers’ compensation claim, victims may be concerned about how they will cover their medical expenses and lost wages. Victims of accidents that happen in the workplace have a right to receive these much-needed benefits. While there are several reasons for a claim denial, working with a lawyer like Polsky, Shouldice & Rosen, P.C. can play an essential role in understanding the reasons for the refusal and the appeals process.
Reasons For Workers’ Compensation Claims Denials
Workers will require the benefits that workers’ compensation provides after a work-related injury. Experiencing complications such as a denial of benefits can be incredibly frustrating for an injured worker. Typically workers are notified of the denial by their employer’s workers’ compensation insurance company. At times, these denial letters may be challenging to interpret, and to ensure the proper course of action is taken, the guidance of a lawyer will be a vital aspect of your case. There are several reasons for a denial of benefits, including:
- You have a pre-existing condition
- You were under the influence at the time of the accident
- You submitted the claim after being fired
- Failure to receive prompt medical treatment
- Your employer was unaware of the accident
- You did not follow the doctor’s after-care instructions
- Your employer disputes the accident or does not believe you sustained injuries while at work
After an injury, victims may have extensive medical expenses and financial losses due to missed time away from work. As a result, you will likely desperately need workers’ compensation benefits. However, know that it’s possible to still receive the benefits you deserve through the appeals process.
Consider a Legal Consultation
If you haven’t already, one of the first steps to take following a denial of benefits is to discuss your case with a NY Workers Compensation Lawyer who has experience in this practice area. Most lawyers offer risk-free consultations which allow injured workers to ask questions related to their case and determine the best approach for receiving the benefits they deserve. Sometimes workers’ compensation cases can be relatively straightforward. However, in situations where the victim received a denial, was severely injured, or is no longer able to work due to the accident, it’s crucial to gain the knowledge and support that a workers’ compensation lawyer offers.
Strategizing Next Steps
After a workers’ compensation denial, it’s essential to understand the steps for moving forward clearly. While it can be disheartening, holding out hope is vital because it may still be possible for many to reach a successful resolution. It’s critical first to understand the reason behind the denial and whether the information provided in the denial letter is accurate. Because of the complexities involved, a lawyer will be necessary to achieve the best possible outcome through the appeals process. The denial letter should provide a deadline for filing an appeal. Typically the deadline to file an appeal is thirty days. The appeals process is initiated with an Application for Board Review. The appeal is reviewed through this process, and the Board’s Panel makes a decision. While this is only the first step of the process, know that victims can take further steps through the appeals process if a favorable determination is not received.
Managing the appeals process requires a legal professional with experience handling workers’ compensation claim denials. It’s imperative to consider help from a lawyer like Polsky, Shouldice & Rosen, P.C. to ensure the outcome you deserve after receiving a denial.
