As lawyers who help employees recover workers’ compensation benefits, we usually address issues such as determining eligibility for workers’ compensation and tips for avoiding on-the-job injuries. But, an equally important issue for injured workers is understanding when and how employers fight employees’ claims for compensation.
In New Jersey, workers’ compensation is a no-fault system, and nearly all employers are required to maintain insurance to compensate employees’ claims. But, this does not mean that it is easy for injured workers to receive the compensation they deserve. To the contrary, in order to keep costs down and protect bottom lines, employers and their insurance companies frequently challenge employees’ claims for benefits.
How Employers Fight Employee Claims for Workers’ Comp Benefits
While the no-fault nature of New Jersey’s workers’ compensation system means that your employer does not have to be at fault in order for you to be entitled to compensation, it does not mean that any and all work-related injuries and illnesses are compensable. When you file a claim for workers’ compensation benefits, your employer and its insurance company may assert one or more of the following defenses.
● Willful Misconduct or Horseplay – Employers can deny claims for injuries that result from violations of company policy, horseplay, and other forms of willful misconduct.
● Self-Inflicted Injuries – Your employer may try to argue that your injuries were self-inflicted in order to avoid liability for workers’ compensation.
● Intoxication or Illegal Drug Use – If you suffered injuries because you were drunk or working under the influence of illegal drugs, your employer may be able to deny your claim for benefits.
● Causes Unrelated to Employment – Your employer or their insurance company may also claim that your illness or injury did not occur within the course of your employment.
● Failure to Follow Necessary Procedures – In order to receive benefits, employees must follow certain procedures, including notifying their employers of their injuries and seeing their employer’s approved medical providers. If you make a mistake in the process of filing your claim, your employer may seek to deny your claim for benefits entirely.
While these are all potentially valid defenses to liability for workers’ compensation, employers and their insurance companies often use them overzealously in order to deny or reduce the value of legitimate claims.
In these types of cases, the facts are rarely as straightforward as employers and their insurance companies make them out to be. Without help, you may find yourself without the benefits you need to cover your medical expenses and lost wages. As a result, if you are considering filing for workers’ compensation, it is best to have a knowledgeable and experienced legal team on your side.
Contact the New Jersey Workers’ Compensation Attorneys at Petro Cohen, P.C.
The attorneys at Petro Cohen, P.C. represent individuals in workers’ compensation claims and disputes throughout New Jersey. If you need to file for benefits, or if you have already filed and your claim has been denied, contact us now for a free consultation.