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What are your options if your claim for benefits is denied?

On Behalf of | Nov 30, 2021 | Workers' Compensation |

Being injured at work is no picnic and in fact a severe injury can lead to temporary or permanent disability that prevents you from working for a period of time. When this happens, you may want to pursue workers’ compensation benefits. Sadly, not all claims for benefits are approved the first time around. Fortunately, New Jersey’s workers’ compensation system has two options for workers who want to contest a denial of benefits: an informal hearing or a formal hearing.

Filing an informal claim following a workplace injury

If you disagree with a decision made regarding your award or denial of workers’ compensation benefits an informal hearing can be held. An informal hearing can resolve an issue in a more expedient manner than a formal hearing. Some issues that may be resolved through an informal hearing involve temporary benefits, medical treatment and permanent benefits. Note that the judge’s suggestions in an informal hearing are not binding. This means that if you disagree with the decision, you can pursue a formal claim. You can be represented by an attorney at an informal hearing.

Filing a formal claim following a workplace injury

If you dispute a decision made regarding your award or denial of workers’ compensation benefits, you have within two years of your injury to file a formal claim with the Division. Now, it is possible to resolve your claim via mutual agreement during the pretrial period and, in fact, most claims are resolved this way. If your case does go to trial, you can give testimony as can medical professionals and lay witnesses. You can be represented by an attorney at a formal claim hearing. After all testimony and evidence is presented, the judge will make a binding decision. If you disagree with the judge’s decision, you can appeal your case to the Appellate Division of the Superior Court.

Learn more about your rights as an injured worker

Injured workers have the right to contest decisions made regarding their claim for workers’ compensation benefits. Whether they decide to pursue an informal claim or a formal claim depends on the circumstances surrounding their particular case. Still, it is good to know that an initial denial does not have to be the end of the story and there are options that could help an injured worker receive the benefits they deserve.

 

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