5 Things to Prevent a Workers’ Compensation Disqualification in New York
All employees in New York have the right to file a workers’ compensation claim if they are injured on the job. All claims are processed by the workers’ compensation board. The board will determine the worker’s benefits based on the evidence and information provided by the injured worker. Unlike most lawsuits, the injured employee does not have to prove that their employer was negligent in order to receive compensation in a workers’ compensation case.
Workers’ compensation benefits are available if the injury occurred while the employee was on the job, even if the worker was responsible for the accident. Nonetheless, it is possible that a claim is denied. Because the system does not require the injured worker to demonstrate negligence, some people attempt to take advantage of this and file fraudulent claims. Even if the workers’ compensation board thoroughly examines each claim, it is possible that they will make a mistake and deny a legitimate claim.
Fortunately, even if your workers’ compensation claim is initially denied, you can file an appeal. You may be able to obtain the compensation you deserve with the assistance of an experienced workers’ compensation attorney.
How to Prevent My Workers’ Compensation Claim from Getting Denied?
The workers’ compensation system is designed in such a way that the worker should be able to begin receiving benefits and medical care within a few weeks, allowing them to return to work as soon as possible. Employees are not eligible for workers’ compensation benefits in certain situations. For example, if the worker was injured while under the influence of drugs or alcohol, if the injury was caused by horseplay, if the worker intentionally injured themselves, or if the employee was doing something illegal when they were injured. If none of these scenarios apply to you, your claim should be approved without issue. However, even if the process appears to be simple, injured workers must follow certain steps to avoid having their workers’ compensation claim denied.
5 Things to Prevent a Workers’ Compensation Disqualification in New York
Not reporting the injury to your employer:
It is critical to notify your employer or direct supervisor of the injury as soon as possible. You have 30 days under the law to report an injury to your employer. However, it would be preferable if you could report the injury on the same day it occurred. Allowing time to pass after a slip and fall accident can be a costly mistake.
The insurance company or your employer may allege that your injuries did not occur at work if you take too long to report the injury. Finally, make sure to report the accident in writing. This way you will have solid evidence about the report. Your report should include relevant information such as the date and time of the accident and the injuries you suffered.
Not providing accurate information:
When filing a workers’ compensation claim, you must complete an affidavit and other paperwork. The information you provide must be accurate. The board may deny your claim if you disclose false information.
You must provide accurate information about your income, and if you have more than one job, you must also mention it. Include information about any other activities in which you participate, such as volunteering, personal projects, and so on. If you have another job or other sources of income, it should not affect your claim in most cases. However, if you lie about your income or your activities, you may face a denial.
Working when you should be resting:
If you work or engage in activities that you should not be doing due to your injuries while receiving workers’ compensation benefits, your benefits may be terminated. If your employer or insurance company discovers that you are working, they have the authority to report you to the board. If the doctor determines that you are unable to work and are receiving cash disability benefits, your payments may be canceled. In some cases, the board may even decide that you must repay the benefits you received.
Lack of evidence:
Even if you do not have to prove that another party was negligent in order to file a workers’ compensation claim, it is critical to have evidence that the accident occurred while you were working. Your employer or insurance company may claim that the injuries you sustained did not occur while you were on the job. It is important to note that you do not have to be in the office at the time of the accident to file a workers’ compensation claim. If you were injured while conducting business at another company’s offices, purchasing supplies or materials for your job, or running an errand for your boss, this also counts as a workplace injury. Photos, videos and statements from witnesses are important pieces of evidence.
Not seeking medical attention:
The first thing you should do after an accident is visit a doctor. Even if you have a minor injury, you should get checked and keep a copy of your medical records. If you do not see a doctor after an accident and your injury worsens after a few days or weeks, the insurance company may claim that the injury did not occur at work.
Can My Employer Dispute My Workers’ Compensation Claim?
Employers and their insurance companies can, in fact, dispute a workers’ compensation claim. As previously stated, if the employee lacks evidence that they were injured at work, the employer and their insurer may claim that the injury occurred while the employee was not working. Employers can also contest claims if the worker was injured at work while under the influence of drugs or alcohol, doing something illegal, horseplaying, or intentionally injuring themselves.
What Are My Options if My Workers’ Compensation Claim was Denied?
If your workers’ compensation claim is denied, you may file an appeal. You must file an appeal with the workers’ compensation board within 30 days of the denial. You must submit a written request to the workers’ compensation board. Following that, three members of the panel will reconsider your claim. The panel has the authority to overturn, confirm, or modify the judge’s decision. If your appeal is denied, you have another option. You may file an appeal with the Supreme Court of New York’s Appellate Division. Keep in mind that the outcome of your Supreme Court appeal is final and cannot be appealed.
New York Workers’ Compensation Attorney
A workplace injury can have serious consequences for you, both physically and financially. We understand how important it is for you to receive the compensation you deserve for your injuries at Greenberg & Stein. When a workers’ compensation claim is denied, most people may feel overwhelmed. While the frustration is understandable, not all hope is lost; there are other options.
The first thing you should do is consult with an experienced workers’ compensation attorney. Workers’ compensation attorneys are available at our firm to assist you. Our legal team has extensive experience assisting clients whose claims have been denied and helping them get the compensation they deserve. Call us at 888-716-3843 to schedule a free consultation to review your case.