If your wear and tear workers’ comp claim was denied in New Jersey, you’re likely feeling overwhelmed. This is a common roadblock, but not the end. Many valid claims for gradual-onset injuries are denied initially. Insurance companies often rely on confusion or missing documentation to justify these denials. Fortunately, New Jersey law allows for appeals, and with the right strategy, you may still qualify for benefits.
Below, we explain what steps to take immediately after a denial, why these claims are denied, and how Petro Cohen, P.C. can help you pursue the compensation you deserve.
What to Do Next After a Denied Wear and Tear Injury in Workers’ Comp
If your wear and tear workers’ comp claim was denied, here are the steps you should take right away. Acting quickly preserves your rights and strengthens your chance of success on appeal.
Request the Denial Letter
Ask for the official written explanation of why your claim was denied. This document helps identify the issue and whether it’s a lack of evidence, missed deadlines, or a dispute over the cause of injury.
Organize Your Medical Records
Gather every piece of medical documentation related to your injury:
- Diagnostic imaging and lab results,
- Primary care and specialist reports,
- Therapy progress notes, and
- Prescription records.
This information helps show your injury exists and outlines the treatment it has required.
Outline Your Job Duties
Write a detailed summary of your daily tasks. Focus on physical activities such as:
- Lifting, bending, or climbing.
- Repetitive hand motions or use of tools; and
- Hours spent standing or walking on hard surfaces.
This information helps demonstrate how your work caused or aggravated your condition.
Identify Witnesses
Speak with coworkers who have seen you perform your job or observe your symptoms. Their statements may reinforce your explanation of how your injury developed.
Contact a Workers’ Comp Attorney If Your Wear and Tear Workers’ Comp Claim Is Denied
Legal help is especially important for denied wear and tear claims. A qualified attorney can:
- Review your denial and determine the best response,
- Coordinate additional medical evaluations,
- File a formal claim petition with the New Jersey Division of Workers’ Compensation,
- Represent you in hearings or settlement conferences, and
- Push back against unfair tactics or mischaracterizations by the insurer.
Getting legal help at this stage can make the difference between a denied claim and a successful appeal.
Are Wear and Tear Injuries Covered by Workers’ Comp in NJ?
Yes. New Jersey workers’ compensation law recognizes that injuries can result from repetitive tasks performed over time. This type of condition, often called a repetitive stress injury in workers’ comp, can be denied even if it is legally compensable.
Examples of covered injuries include:
- Carpal tunnel syndrome from typing or assembly work,
- Rotator cuff damage from overhead lifting,
- Back strain from long hours of standing or carrying loads, and
- Knee problems from repetitive squatting or climbing.
So, can wear and tear injuries be covered by workers’ comp? Yes, but these cases often require more documentation than acute injuries. That’s why legal support is crucial.
Why Are These Claims Denied?
Insurance companies deny wear and tear claims for several reasons, including:
- Lack of clear medical documentation. Doctors may not initially link your condition to work without prompting.
- Delayed reporting. If you waited to notify your employer, they may argue the injury happened elsewhere.
- Alternative explanations. Insurers often claim your injury was caused by age, hobbies, or preexisting conditions.
- Clerical or procedural errors. Missing forms or filing deadlines can lead to automatic denials.
If your repetitive stress injury workers’ comp claim was denied, you still have the right to challenge that decision through an appeal or formal hearing.
If your employer or insurer claims your condition is age-related or not work-related, that does not mean the denial is correct. A New Jersey workers’ compensation lawyer can review your claim and determine whether an appeal is worth pursuing.
Frequently Asked Questions About Denied Wear and Tear Workers’ Comp Claims
Can wear and tear injuries be covered by workers’ comp in New Jersey?
Yes. New Jersey workers’ compensation law covers injuries caused by repetitive tasks over time. These injuries are compensable if medical evidence shows the condition was caused or worsened by your job duties.
Why are wear and tear workers’ comp claims often denied?
These claims are often denied because insurers argue the injury is age-related, preexisting, or not work-related. Delayed reporting or weak medical documentation can also lead to denial.
What if my repetitive stress injury workers’ comp claim was denied?
A denial does not mean your claim is over. You may have the right to appeal by filing a claim petition and presenting additional medical and job-duty evidence to support your case.
How long do I have to appeal a denied workers’ comp claim in NJ?
In most cases, you have two years from the date you knew your injury was work-related to file a formal claim. Acting quickly improves your ability to gather evidence and protect your rights.
Do I need a lawyer if my wear and tear claim was denied?
Yes. Denied wear and tear claims are medically and legally complex. A workers’ compensation attorney can gather evidence, coordinate medical opinions, and represent you in hearings or settlement negotiations.
How Petro Cohen, P.C. Can Help
Petro Cohen, P.C., is a leader in handling denied claims for wear and tear workers’ compensation in NJ. Our team understands the complex medical and legal documentation required to prove a repetitive stress injury is work-related.
We take a hands-on approach by:
- Gathering expert medical opinions,
- Coordinating with your treating doctors to solidify the work connection,
- Preparing evidence and testimony for your hearing, and
- Working to complete all procedural steps accurately and on time.
Being told your wear and tear workers’ comp claim was denied is discouraging. But it does not have to be the final answer. With experienced legal guidance, many claims are successfully appealed and result in full or partial benefits for injured workers across New Jersey. Speaking with a workers’ compensation attorney early can help protect your rights and improve your chances of success.
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