Workers’ compensation insurers are for-profit entities looking for ways to delay, deny, and otherwise limit your workplace injury claims. They are not public insurers but rather those that profit by charging NJ employers high premiums while reducing their payouts.
If you suffered from a disabling workplace injury or illness in New Jersey, you need help getting the benefits you deserve. Discuss your case for free with the experienced workers’ compensation lawyers at Ginsberg & O’Connor today.
Most Common Reasons WC Insurers Deny, Reduce, or Delay NJ Claims
Our experienced WC attorneys commonly see the following reasons for denials and/or delays in New Jersey workers’ compensation cases. While some are valid and others can be reversed, many are designed to discourage you from pursuing the compensation you deserve after a workplace accident.
Disqualification
Workers’ compensation insurance is particular. It only covers work-related injuries or illnesses suffered by employees, not independent contractors. For example, you may claim WC benefits if you’re injured in a car accident while running work-assigned errands but not during your morning commute to Philadelphia. You may obtain a direct denial if the WC insurer determines that you do not qualify for WC benefits, but we can challenge the insurer’s factual findings in such cases.
Insufficient Evidence
You have the initial burden of showing that you qualify for WC benefits in New Jersey. This means submitting all necessary paperwork when you file your claim. In many cases, your employer must also certify the claim and provide insurers with your wage information. Most initial workers’ comp claims must include the following:
- Claim form
- Employer incident report
- Initial medical records
- Accident/police report
- Wage information
Most delays, as opposed to denials, occur when the insurer claims it does not have enough evidence to process your claim. However, they often do. Many adjusters will demand evidence beyond the basic documents required to qualify for benefits to find ways to deny your claims entirely. If your WC insurer is requesting burdensome and unnecessary additional information, our workers’ comp lawyers can review your submissions and, if appropriate, force a decision.
Pre-Existing Condition
The primary tactic WC insurers use to deny claims is by alleging that you did not suffer a disabling injury or illness at work. They may also claim that an injury or disease was pre-existing or age-related. Our experienced attorneys work with distinguished medical and occupational experts to prove our clients’ entitlement to benefits in such cases.
New Jersey Workers’ Compensation Benefits
In NJ, injured workers can obtain coverage for all reasonable and necessary medical treatments and medications. Workers suffering from serious work-related injuries or illnesses – such as brain trauma, fractures, spinal cord damage, or cancer – can also obtain temporary, permanent partial, or permanent total disability benefits to cover a portion of their lost wages. Families of workers killed in workplace accidents can also demand death benefits with legal help.
Workers’ Compensation Denial Lawyers in New Jersey
Although mandatory in the State of New Jersey, don’t be surprised by unexpected workers’ comp denials and administrative delays. Our experienced NJ workers’ comp lawyers can help you file a claim, appeal denials, and maximize the benefits you’re entitled to in appropriate workers’ compensation cases. Contact us online or call 856-727-1991.