Reasons for Denial of NYS Worker’s Comp in Rochester

by | Jul 3, 2014 | Lawyers

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The worker’s compensation system in America was designed to offer benefits to employees injured on the job, without their having to prove negligence by coworkers or employers. When a worker is denied such benefits, they have the legal right to appeal the claim. You can click here to learn the various reasons for denial and read a list of steps you can take to appeal a court’s decision.

Why your Worker’s Compensation Claim may be Denied

There are many reasons for the denial of NYS Worker’s Comp in Rochester, such as:

* An injury that did not happen during the course of employment

* An injury caused by a pre-existing condition

* A dispute as to where/when the injury happened

* A doctor’s assertion that the injury did not cause disability

* A dispute as to whether you were actually injured

How to Appeal a Worker’s Compensation Claim Denial

Unless you’re a federal government employee, the method by which you can appeal your denied NYS Worker’s Comp in Rochester NY claim will vary. However, there are a few steps everyone can take when seeking a review:

* Call the insurance company to learn the reason for denial (it may be simple, such as omitting a document when filing)

* Ask the company to reconsider the denial

* File an appeal within the deadline

* Hire a worker’s comp attorney to help you with your appeal and to protect your legal rights

How an Attorney can Help

Your worker’s comp lawyer receives payment based on the benefits you get; attorney’s fees are not relevant in these cases. Your lawyer will find out why your claim was denied, and he or she will gather the necessary documentation, contact potential witnesses, and call medical experts if the need arises.

Many worker’s compensation claims are denied for medical reasons. Your lawyer may have your injuries independently evaluated, or they will ask your doctor to review your case to determine whether a detailed report is necessary. A lawyer can determine whether additional proof is required to document your work-related injury, and he or she can help you take your case to your state’s appeals court.

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