Was Your Workers' Compensation Claim Denied?


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May 09, 2016

Were you injured in a workplace accident or are you currently suffering from an disease related to your occupation? Logical thinking would be, “My claim will definitely be accepted.” However, what if it is denied? Who do you turn to next?

To help you understand Workers' Compensation further, we will provide a list of which workers are covered under workers’ compensation. In New York, nearly all employers are required to provide workers’ compensation coverage.

If you work for a for-profit business, are a school teacher, a domestic worker who works at least 40 hours a week or a worker compensated by a nonprofit organization, you should be covered. Those who are NOT covered by New York’s workers’ compensation law, include:

  • People who volunteer for nonprofit organizations
  • Members of the clergy
  • People who engage in amateur athletic activities
  • People who teach for a nonprofit religious or charitable organization
  • People who receive charitable money from religious and charitable organizations
  • New York City firefighters, sanitation workers and police officers
  • People who do casual chores for private residences (domestic workers)
  • Real estate salespersons
  • Certain insurance agents

Sometimes, a worker’s claim will be denied because the insurance company believes that the worker was under the influence of drugs or alcohol, or intentionally being reckless when he or she was injured. In such cases, the worker’s claim may be denied and an appeal may be frivolous

Workers' Compensation Hearing and Appeals Process

If  your worker’s claim is denied, he or she has the right to appeal the decision. In this situation, the Board may conduct a hearing, which is overseen by a Workers’ Compensation Law Judge. After listening to the testimony and reviewing the evidence, the judge shall determine if the worker is entitled to benefits.

If the worker is not satisfied with the results of the hearing, he or she has 30 days to appeal the decision. This is accomplished through a Board review. A Board Panel decision can be appealed to the Supreme Court, whose decision can be appealed to the Court of Appeals.

Whether you believe you deserve Workers' Compensation due to an accident or exposure on the job or that your hearing will not be heard, contact us today for a free consultation and we will see to it that the right decision is made! We have offices across Long Island to help people from across New York.