What to Do If Your Workers’ Comp Claim is Denied


You have unfortunately suffered an injury while at work, resulting in you not being able to work like you used to. Your first step was notifying your employer’s insurance company of the injury in the hopes of being granted workers’ compensation.

Unfortunately, your workers’ comp has been denied, which can be because the insurance company does not think you were injured at work or that it came about because of a preexisting condition.

Luckily, here in the state of New Jersey you have two different appeal options at your disposal. Those options are an informal hearing or a formal hearing.

An informal hearing is a way to possibly resolve the matter without having to go through formal litigation. You will first submit an Application for Informal Hearing with the New Jersey Division of Worker’s Compensation [DWC]. Once your application is processed the DWC will tell you when and where the informal hearing will take place.

The hearing itself is a lot more like a mediation than anything. A judge will ask you and your employer questions about the matter and evaluate any medical history or other documents you have provided. The judge will determine a recommendation to how your claim should be resolved. As it turns out, that recommendation is not binding, meaning neither you nor your employer has to heed the recommendation if you do not see fit. If this is the case, you will proceed with a formal claim.

A formal claim begins with a Claim Petition form with the DWC. It must be filed within two years of the injury or the last compensation payment you received from the insurance company. Once the petition is filed you will be assigned a formal hearing date.

Formal worker’s comp hearings are just like regular trials. Both sides will testify and present evidence — you needing strong and compelling evidence of your necessity for worker’s comp. The judge will make a decision and unlike an informal claim, the decision is binding to both sides. Either party may appeal the decision though. That appeal can only go to the New Jersey Appellate Division of the Superior Court.

As evident from the aforementioned, the process to appeal a denied worker’s comp claim is not easy and extremely tedious. That is why it is in your best interest to seek the help and legal guidance of an experienced lawyer. The lawyers at Silverman & Roedel LLC routinely represent those injured while working at their jobs. Contact their office today at 973-772-6411 today for a free consultation.

The articles on this blog are for informative purposes only and are no substitute for legal advice or an attorney/client relationship. If you are seeking legal advice, please contact our law firm directly.