After a work accident, the last thing you expect is to be told that your workers’ compensation claim has been denied. The emotional and financial toll of an injury is already overwhelming, and a denied claim can be devastating. But knowing why an employer’s insurance company may deny claims can help you avoid common missteps and ensure you receive the compensation you need to recover.
It didn’t happen on the job
One common reason for denial is if the injury or illness didn’t occur at work. Workers’ compensation only covers incidents that happen while performing job duties. You may not be eligible for these benefits if you get hurt during a personal errand or outside work hours.
If you’re unsure whether your injury is work-related, you can consult your doctor and your employer to determine the cause of your condition.
You are exempt from coverage
In New Jersey, workers’ compensation insurance covers most workers. However, some workers are exempt from coverage. This can include:
- Independent contractors
- Certain agricultural workers
- Casual employees
- Sole proprietors with no employees
If you’re unsure about your exemption status, check with your employer or the New Jersey Department of Labor and Workforce Development.
There are reporting mistakes
Reporting mistakes can also jeopardize your benefits. Some of these missteps include not reporting the incident to your employer or a doctor failing to send the necessary reports to the insurance carrier or your self-insured employer.
To avoid reporting mistakes, tell your employer about your condition as soon as possible and follow up with your doctor.
Avoiding denials
To give yourself the best chance of getting the benefits you deserve after a work-related injury or illness, be sure to:
- Confirm your injury happened at work or as a result of your job duties
- Verify your employment status and coverage
- Report injuries immediately
- See a doctor right away and tell them it’s a work-related injury.
- Familiarize yourself with reporting requirements and deadlines
By taking these precautions, you can increase the likelihood of a successful claim. You can also consult a workers’ compensation attorney who can help you file a claim or dispute a denial, should one occur.