There are times when a New Jersey employer is permitted to deny your workers compensation claims. For example, they are not required to pay your claim when your injury is self-inflicted, or the result of horseplay or willful misconduct.
Some employers claim you’ve engaged in behavior that can result in a denial, and do so in bad faith. It’s important to know when they can, when they can’t, and what you can do about it if your claim is denied.
Valid Justifications for Denial
A New Jersey employer may deny your claim when any of the following are true:
- The injury is not job-related.
- You engaged in willful misconduct.
- You engaged in assault or horseplay.
- You were under the influence.
- You did not follow the proper procedures for filing your claim.
- You missed claims deadlines.
If you are certain you have a legitimate, job-related injury and are equally certain you filed the claim on time, then your employer may be denying the claim in bad faith. You’ll have to take some additional steps to protect your rights.
When You Are Denied in Bad Faith
You can turn to the New Jersey Division of Workers Compensation and form a formal claim petition. The DWC will review the facts of your case. If they side with you then the employer has to pay the claim. It may also be possible to request an informal hearing with a DWC judge so that the judge can look at the evidence you provide and make a recommendation that can help your attorney negotiate with your employer.
If they do not side with you, then you may need to take your case to court.
You’ll want to retain a workers compensation attorney at the start of this process, rather than after you’ve already been denied by the DWC. You can get an attorney at any time, but starting earlier tends to convey benefits in terms of your case readiness and your ability to fight back.
You can strengthen your case by providing evidence that you did as you were supposed to. For example, you can provide a copy of the incident report to show that you reported the injury on time, or evidence that shows that your injury was job related.
Need help? Reach out to Talone Law today.