Being injured on the job can have a serious impact on your day to day life. In addition to the pain, you also need to go get medical care and you might not be able to work. With mounting medical bills and the possibility of not receiving your regular paycheck due to missed work, things can get stressful very fast.
Tand and Associates P.C. is here to help you get the workers’ compensation recovery to which you are entitled. Don’t go through this alone. Our workers’ compensation attorneys have a thorough understanding of the complexities involved in the workers’ compensation system. We are here to fight for the benefits you deserve.
What is Workers’ Compensation?
Workers’ compensation is a no-fault insurance program that compensates employees for work-related injuries and illnesses. As long as your injury or illness was not the result of an intentional, self-inflicted act or caused by committing a crime, it should be covered. Expenses that are paid by workers’ compensation include: all health care related to your injury or illness, a percentage of your average weekly wage, and travel expenses to and from your doctor’s appointments.
Employers are not allowed to charge you for this kind of insurance and all for-profit employers are required to carry it. The majority of non-profit employers must also carry workers’ compensation coverage.
What Do I Do If My Workers’ Compensation Claim is Denied?
Workers’ compensation claims are often denied for a range of reasons, including:
- Untimely filing of the claim
- Untimely reporting of the injury
- Failure to comply with insurance company requests
- Contested legitimacy of injury
- Contested location of injury
- Contested cause of the injury or illness
An employer will commonly dispute that the injury occurred at work, especially if there were no witnesses, or that a workplace accident was not the cause of an injury or illness. No matter what the reason for the claim denial, you should receive a formal Notice of Denial which includes the reason(s) for the denial.
In New York, you may appeal claim denials to the Workers’ Compensation Board. The Board claim examiners and conciliators will first try to resolve any issues surrounding the claim. If the Board is unable to do so, hearings will be held in front of a workers’ compensation law judge. At the hearing, testimony will be taken. Also, the judge will review your medical records and wages. The judge will rule on any outstanding issues and determine the amount of any award.
If either party wishes to appeal the judge’s ruling, they are able to do so in writing within 30 days. Three Board members will then review the appeal. The Board members may agree with the judge’s ruling or they may send the case back for more hearings on the issues. They also have the option to reject all or part of the ruling. The decision of the Board members is also appealable. Either party may request that the decision is reviewed by the full Board of Workers’ Compensation members. If the full Board agrees to review the case and they return a decision that either party wishes to contest, an appeal may be made within 30 days to the Appellate Division, Third Department, Supreme Court of the State of New York.
We Fight For the Workers’ Compensation Benefits You Deserve.
The effects of a workplace injuries and illnesses can have serious and widespread effects on your life. Workers’ compensation benefits can help mitigate the damages that you have incurred. The dedicated workers’ compensation attorneys at Tand and Associates P.C. are here to navigate the complicated workers’ compensation system for you and get you the benefits you are entitled to. Contact Tand and Associates, P.C. today.