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Common Reasons for Denials of Workers’ Compensation Claims

When you applied for Workers’ Compensation benefits in New York, you may have felt certain that your claim would be approved and that you’d soon begin receiving the benefits you need to meet your basic living expenses while you’re off work. However, if your application was denied, it can feel like a major blow, and you might be confused as to why it happened. Below you’ll find some common reasons offered for a denial of Workers’ Compensation benefits, and some guidelines on how to avoid letting this happen to you. If your claim is denied, speak with an experienced New York workers’ compensation and disability attorney about how to craft the strongest possible appeal of your denial.

  • Excessive delay between the accident and your application for benefits

New York imposes a two-year time limit between when the accident occurs and when you may apply for Workers’ Compensation benefits. While this may seem like plenty of time, some injuries don’t appear as though they will render you disabled until long after they occur. If your claim is denied for this reason, an attorney may be able to show that you were not aware of the seriousness of the injury until long after it occurred, and that you should still be eligible for benefits.

  • Notice of injury not provided to employer

New York law requires that injured employees provide notice to their employer of any injury received on the job within 30 days of receiving the injury. In fact, an even better practice is to immediately report any injury received at work. Failing to give your employer notice of the injury could cause your claim for benefits to fail.

  • A conflict between how you describe your injuries and what your medical records show

It is important to give a thorough, accurate description of your workplace injury in any statements you make to insurers or in an accident report. Exaggerating the injury, or failing to give a consistent description of the incident that comports with what a doctor reports in an examination will diminish your credibility before the Workers’ Compensation board.

  • Insurance company did not receive the necessary documents or statements

After you file a claim of a workplace injury, your employer’s insurance carrier may request that you give a recorded statement describing the accident causing your injuries, or authorizing them to examine your medical records. If you fail to comply with these requests, the insurer may deny the claim, but you may also feel concerned that providing these items could hurt your claim unjustly. Consult with an attorney about the statement you provide, and on whether there are ways to limit the medical records the insurer receives to those relevant to your claim, rather than the entirety of your medical history.

If you have been hurt on the job in New York and need assistance in receiving Workers’ Compensation or Social Security Disability, contact the experienced disability attorney Peter M. Cordovano at 845-691-4200.

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