If you have been injured at work, you are entitled to workers’ compensation benefits under New York law. These benefits may include medical treatment, lost wages, and vocational rehabilitation. However, sometimes your workers’ compensation claim may be denied, leaving you without the support you need to recover. If your claim has been denied, you have the right to appeal. In this blog post, we will outline the steps you need to take to appeal a denied workers’ comp claim in New York.
Step 1: Understand the Reasons for Denial
The first step in appealing a denied workers’ comp claim is to understand the reasons for denial. There are many reasons why a claim may be denied, including incomplete or inaccurate information, missed deadlines, or disputes about the cause or extent of the injury. Once you know why your claim was denied, you can begin to gather evidence and build a case to support your appeal.
Step 2: File a Notice of Claim
The next step is to file a Notice of Claim with the Workers’ Compensation Board (WCB) within two years of the date of injury. This is a formal document that notifies the WCB that you are appealing the denial of your claim. You can file this notice either online, by mail, or in person at your local WCB office. Be sure to include all relevant information, such as your name, address, date of injury, and the reason for denial.
Step 3: Gather Evidence
Once you have filed your Notice of Claim, it’s time to gather evidence to support your appeal. This may include medical records, witness statements, and any other documentation that demonstrates the nature and extent of your injury. You may also want to consult with a workers’ compensation attorney to help you build a strong case.
Step 4: Attend a Hearing
After you file your Notice of Claim, the WCB will schedule a hearing to review your case. This hearing will be conducted by a workers’ compensation judge who will listen to both sides of the case and make a decision based on the evidence presented. You will have the opportunity to present your case and any evidence you have gathered, and to cross-examine witnesses presented by the insurance company. Be sure to bring copies of all your evidence to the hearing and dress appropriately.
Step 5: Wait for a Decision
After the hearing, the judge will issue a decision in writing. If the judge finds in your favor, you will be entitled to the workers’ compensation benefits you have been seeking. If the judge denies your appeal, you have the right to request a review by the Workers’ Compensation Board’s Appeal Board. If the Appeal Board also denies your claim, you may be able to appeal the decision to a New York State court.
Appealing a denied workers’ comp claim in New York can be a complex and time-consuming process, but it is essential if you want to receive the benefits you are entitled to. By understanding the reasons for denial, filing a Notice of Claim, gathering evidence, attending a hearing, and waiting for a decision, you can increase your chances of a successful appeal. If you need assistance with your appeal, consider contacting a workers’ compensation attorney who can guide you through the process and help you achieve the best possible outcome.
Step 6: Request a Review by the Appeal Board
If the judge denies your claim, you have the right to request a review by the Appeal Board. This must be done within 30 days of the judge’s decision. You can request a review by filing a written appeal with the WCB. The Appeal Board will then review the evidence presented at the hearing and issue a decision. If the Appeal Board finds in your favor, you will be entitled to the benefits you have been seeking. If the Appeal Board upholds the judge’s decision, you may be able to appeal the decision to a New York State court.
Step 7: Consider Appealing to a New York State Court
If your appeal is denied by the WCB’s Appeal Board, you may be able to appeal the decision to a New York State court. This must be done within 30 days of the Appeal Board’s decision. You will need to file a petition with the appropriate court and pay a filing fee. A judge will then review the evidence presented at the hearing and issue a decision. If the judge finds in your favor, you will be entitled to the benefits you have been seeking. If the judge upholds the WCB’s decision, you may have the option to file an appeal with the Appellate Division of the New York State Supreme Court.
Step 8: Consult with a Workers’ Compensation Attorney
Appealing a denied workers’ comp claim can be a challenging process, and it’s essential to have an experienced workers’ compensation attorney on your side. A workers’ compensation attorney can help you understand your rights, gather evidence, prepare for your hearing, and represent you at every stage of the appeals process. They can also help you navigate any disputes with your employer or their insurance company.
If your workers’ comp claim has been denied in New York, you have the right to appeal. By following these steps, you can increase your chances of a successful appeal and obtain the benefits you need to recover from your injury. Remember to stay organized, gather evidence, attend your hearing, and consider working with a workers’ compensation attorney who can help you achieve the best possible outcome.
Cole, Sorrentino, Hurley, Hewner & Gambino, P.C. is a law firm that has extensive experience in handling workers’ compensation cases in New York. We can help injured workers in several ways:
Evaluation of Claim: We can review your case and determine if you have a valid workers’ compensation claim. We will assess the strengths and weaknesses of your case and provide you with an honest assessment of your chances of success.
Filing the Claim: We can help you complete the paperwork and file the claim with the Workers’ Compensation Board. This will ensure that your claim is properly documented and filed on time.
Gathering Evidence: We can help you gather evidence to support your claim. This may include medical records, witness statements, and other documentation that demonstrate the nature and extent of your injury.
Negotiation with Insurance Company: We can negotiate with the insurance company on your behalf to ensure that you receive the maximum amount of compensation for your injuries. This may include compensation for medical expenses, lost wages, and other damages.
Appeals: We can help you appeal a denied workers’ compensation claim. We will represent you at the hearing and present evidence to support your claim. We can also file an appeal with the Appeal Board or New York State court if necessary.
Providing Legal Advice: We can provide you with legal advice and guidance throughout the entire workers’ compensation process. We will answer your questions and provide you with the information you need to make informed decisions about your case.
Cole, Sorrentino, Hurley, Hewner & Gambino, P.C. can help injured workers with all aspects of a workers’ compensation claim. We have the knowledge and experience to navigate the complex workers’ compensation system in New York and help you obtain the benefits you need to recover from your injury. If you have been injured at work, don’t hesitate to contact them for a consultation.