Suffering a work-related injury can be overwhelming, but having your workers’ compensation claim denied can make an already difficult situation even more stressful. If you're a worker in New Jersey and you’ve been injured on the job, you rely on workers’ comp benefits to cover your medical bills and lost wages. A denial can feel like a dead end, but it’s important to know that you still have options. Denials are not the final word; you have the right to fight back and pursue the benefits you deserve.

At Lee Law Firm, we help injured workers across New Jersey challenge denied claims and get their lives back on track. If your claim has been denied, here's what you should do next.

Why Are Workers’ Compensation Claims Denied?

Workers’ compensation in New Jersey is designed to provide benefits regardless of fault. However, that doesn’t mean your claim is automatically approved. Insurance companies often look for any reason to deny a claim, especially if they think they can avoid paying out benefits. Common reasons for denial include:

• Failure to report the injury on time: In New Jersey, you must report your injury to your employer within 14 days. Delays can be used against you.
• Lack of medical evidence: If your claim lacks proper documentation, treatment records, or diagnosis, the insurer may reject it.
• Disputes about how the injury happened: If your employer or insurer believes the injury occurred outside of work, they may contest the claim.
• Pre-existing conditions: The insurer might argue that your injury isn’t work-related but is instead due to a prior medical issue.
• Missed deadlines or incomplete forms: Workers’ comp requires accurate and timely paperwork. Errors or omissions can lead to denials.

Whatever the reason for your denial, it’s important to act quickly to protect your rights.

Step 1: Review the Denial Letter Carefully

Your first step should be to carefully read the denial letter you received from the workers’ compensation insurance company. This letter must explain why your claim was denied and what evidence or information was used to reach that decision. Understanding the reason behind the denial is essential for building your appeal.

Keep this letter in a safe place. You’ll need it for reference as you move forward with your case.

Step 2: Speak with a Workers’ Compensation Attorney

You are not required to handle a denied claim on your own. In fact, doing so could hurt your chances of success. An experienced workers’ compensation attorney can review your case, help you gather additional evidence, and represent you during the appeals process.

At our firm, we begin with a thorough consultation to understand the full scope of your injury and determine the best legal strategy. We’ll also help you avoid common mistakes that could further delay your benefits.

Step 3: File a Formal Claim Petition

If your claim is denied, you have the right to file a formal claim petition with the New Jersey Division of Workers’ Compensation. This must be done within two years of the date of injury or the last payment of compensation, whichever is later.

A claim petition formally starts the legal process to challenge the denial. You may be required to attend a pretrial conference, followed by hearings where both sides present evidence. Your attorney can submit medical records, testimony, employment documentation, and expert opinions to support your case.

Step 4: Request an Informal Hearing (Optional)

In some cases, it may be helpful to request an informal hearing with a workers’ compensation judge. This process is less formal than a trial and can sometimes lead to a favorable resolution without the need for litigation.

During the informal hearing, a judge reviews your case and offers non-binding recommendations to resolve the dispute. While not required, informal hearings can be useful for simpler disagreements or for starting negotiations with the insurance company.

Step 5: Prepare for a Formal Hearing or Settlement

If your claim cannot be resolved informally, the case proceeds to a formal hearing, where a judge will decide the outcome based on the evidence presented. These hearings are similar to a trial and require thorough preparation. Your lawyer will present your case, cross-examine any witnesses, and argue on your behalf.

In many cases, claims settle before reaching a full hearing. Settlements can include ongoing benefits, a lump-sum payment, or an agreement to pay for future medical care. A knowledgeable attorney will help you evaluate any settlement offers to ensure they are fair and meet your needs.

How Long Does It Take to Appeal a Denied Workers’ Comp Claim?

The length of the appeals process varies. Informal hearings may resolve disputes in a matter of weeks, while formal litigation can take several months or even longer depending on the complexity of your case. Delays can also occur if additional medical exams or expert reports are needed.

The sooner you act, the better your chances of a timely and successful resolution. Waiting too long can damage your case and reduce your chances of receiving the full benefits you're entitled to.

Call Lee Law Firm if Your Workers’ Comp Claim Was Denied

A denied claim doesn’t mean your case is hopeless. Many denials are overturned on appeal, especially when workers have legal representation. Whether you’re dealing with a paperwork error, a disputed diagnosis, or an unfair claim rejection, you deserve to have someone in your corner fighting for you.

At Lee Law Firm, we understand how devastating a denied workers’ comp claim can be. You’re already dealing with pain, lost income, and stress; you shouldn’t have to battle the system alone. We’ll guide you through every step of the process, making sure your rights are protected and your case is built on strong legal footing.

If your workers’ compensation claim has been denied, contact us today for a free consultation. We’ll review your situation, explain your options, and fight to get you the benefits you deserve. You don’t have to face this challenge alone; let us stand with you and help you move forward with confidence.