Why Was My New York Workers’ Compensation Claim Denied?

Like every other state, New York has specific rules and laws on how Workers’ Compensation claims can be filed. If a claim does not meet these strict standards, it will be denied. Although you have the option to appeal the board’s decision, it will be up to you to provide steadfast proof of your claim. Here’s a look into the key reasons of workers’ compensation denial in New York.

Not Notifying Your Employer

For your claim to be filed successfully, you need to notify your employer as soon as possible and no later than 30 days. It is essential to notify your employer of a work-related injury as soon as it occurs so the problem can be taken care of immediately, so no one else gets injured.

Filing a Claim That Goes Outside New York’s Statute of Limitations

If you wait too long to file your claim, it may be reported outside New York’s statute of limitations. If you don’t file your claim in a timely fashion, you will miss out on the opportunity to be compensated for your injuries and lost wages.

Self-Inflicted Injuries

Any self-inflicted injuries that occur during work hours or on property owned by your employer will not be compensated. This would be classified as fraud, and it may disqualify you from receiving benefits in the future.

For any Injuries Caused Under the Influence of Alcohol or Drugs

If you received your injuries while under the influence of drugs and alcohol, you can expect your claim to be denied. This may be true even if you are taking medications that have been prescribed to you. It all depends on the known side effects of a particular drug and whether or not you were under a doctor’s care at the time of the accident.

Injuries That Are Not Linked to Your Work

If you have injuries that are not directly related to your work or that occurred after your initial claim and have nothing to do with tasks you performed while on the job, you will not be compensated for them, and your claim will be denied.

Failure to Continue with Your Medical Treatment

If you were under a doctor’s care for injuries you received on the job and failed to maintain the treatment program, your claim may be denied, and your benefits will cease. It is up to you to continue receiving treatment for your injuries until the doctor releases you to go back to work.

Injury is Less Serious than Originally Claimed

If you make your injury out to be more severe than it is, your claim will be denied. Being able to work and continuing to pursue your Workers’ compensation benefits may be considered fraud, and your claim will be denied.

If the Actual Cause of the Injury Cannot Be Determined

If a third-party medical examiner cannot verify that the injuries you have received are work-related, your claim will be denied. In this case, it may be best if you have witnesses who saw the accident occur and are willing to testify on your behalf.

Being Willfully Negligent or Reckless During Work

If it is determined that you were negligent or reckless in any way, the Workers’ compensation board will deny your claim. This may include trying to work too faster or performing actions in such a manner that you were taking on more risk than necessary.

It is essential for New York residents to know the various reasons why a Workers’ compensation claim may be denied. Although some things are out of your control, it is up to you to do everything within your power to follow the rules and laws pertaining to Workers’ compensation claims. If you still have questions, call our insurance professionals at Kneller Insurance Agency today and talk to one of their knowledgeable agents!

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