You got hurt at work, you filed a workers’ compensation claim, and . . . your employer denied your claim. The process seemed easy enough at first, but now you are facing medical bills that you can not afford to pay and your employer has told you that you need to get back to work as soon as possible. It doesn’t seem fair, and at this point, you are worried about your health and your job security.
What are your options?
While collecting workers’ compensation benefits after a job-related accident is supposed to be a straightforward process, many employees find that the process is a struggle. Their employers deny their claims with little explanation – or no explanation at all – and then they are left wondering what to do next. Although there are valid reasons for denying workers’ compensation claims, unfortunately many employers deny their employees’ workers’ compensation claims in bad faith. If you believe that you may have received a bad-faith denial, here is what you need to know.
When Can an Employer Rightfully Deny a Workers’ Compensation Claim in New Jersey?
As we mentioned, there are some circumstances in which employers will be justified in denying their employees’ claims for workers’ compensation benefits. The most common example of this is when an employee’s injury is not job-related. Workers’ compensation only covers injuries sustained within the course and scope of employment. If you were off the clock, or if you were doing something you shouldn’t have been doing while you were on the clock, then you most likely do not have a claim for benefits.
Other examples of valid justifications for workers’ compensation denials include:
- Willful misconduct or horseplay
- Self-inflicted injuries
- Intoxication or illegal drug use
- Failure to follow the procedures for filing a claim
- Waiting too long to file a claim
What Are Some Examples of Bad-Faith Workers’ Compensation Denials?
Just as there are several valid reasons for the denial of a workers’ compensation claim, there are several examples of bad-faith denials as well. Once an employee files a claim according to the necessary procedures, the employer has a legal responsibility to investigate and evaluate the claim in good faith. Any deviation from this responsibility can result in a bad-faith denial. Some examples of bad-faith practices that employers may try to use to avoid the payment of benefits include:
- Falsely accusing the employee of willful misconduct, horseplay, or self-infliction
- Threatening or implying that the employee will be demoted or fired
- Failing to conduct a timely and adequate investigation
- Misrepresenting the employee’s rights under New Jersey Law
- Unreasonably delaying payment of benefits
- Intentionally offering significantly less than the full amount to which the employee is entitled
- Denying payment of benefits without written justification
What Are Your Rights If Your Employer Denied Your Workers’ Compensation Claim in Bad Faith?
If you get hurt at work, you file your workers’ compensation claim on time, and you comply with the requirements for submitting your claim, you should be able to begin collecting benefits fairly quickly. You also should not be forced to jump through unnecessary hoops, and you should not be pressured to return to work before your doctor says that it is safe for you to do so. If you have been denied benefits despite meeting all of the necessary qualifications, you should promptly speak with an attorney about challenging the denial.
In New Jersey, there are processes in place that injured workers can use to make sure they receive the benefits to which they are legally entitled. In cases involving bad-faith denials, the first step is typically to file a formal claim petition with the New Jersey Division of Workers’ Compensation (DWC). If the DWC sides with your employer, then you can take your case to court. There are multiple levels of appeals for workers’ compensation denials in New Jersey. While it may be frustrating to go through the process, enforcing your right to workers’ compensation benefits could be essential to your long-term well-being.
For more information about what to do if your workers’ compensation claim has been denied, you can read:
- What to Do When Your Employer Is Uncooperative with Workers’ Comp Claim
- What If Your Workers’ Compensation Is Denied?
- When Should You Contact a Workers’ Compensation Attorney?
Speak with a Workers’ Compensation Lawyer in New Jersey Today
Have you been wrongfully denied workers’ compensation benefits in New Jersey? If so, our attorneys can assert your legal rights and help you collect the benefits to which you may be entitled.
Petro Cohen Petro Matarazzo has been consistently recognized as one of New Jersey’s leading firms in the area of workers’ comp. The firm received the highest rating by Martindale-Hubbell – the world’s foremost authority on law firm credentials – in Professional Excellence and Ethical Standards and Legal Ability.
The hard working attorneys at Petro Cohen have earned this outstand reputation by helping our clients overcome a limitless number of challenges time and time again. You can rest assured they will work hard for you to get the medical treatment you need and the compensation you deserve.
In addition to the firm’s stellar reputation, the department head, Frank Petro, is respected locally, regionally, and nationally as a leading attorney in this specialized field. He has been recognized as an outstanding attorney by Best Lawyers® every year since 1995 and by Super Lawyers® every year since 2005. Moreover, he has achieved a rating of “Superb” on the leading lawyer-review website, Avvo®, the highest achievable rating.
Along with Stephen M. Matarazzo, Suzanne Holz Meola, Terri Hiles, Steven Lubcher, and Daniel Rosenthal, our New Jersey workers’ comp attorneys have more than 100 years of combined experience, having successfully handled thousands of litigated workers’ comp cases throughout New Jersey. This experience and winning track record means that you are going to have a skilled New Jersey work injury lawyer who will work for you.
To get started with a free, no-obligation consultation, call us at 888-675-7607 or request an appointment online today.