Nearly all employees in the state of New Jersey are eligible for workers' compensation insurance. With very few exceptions, under workers' compensation, regardless of your possible involvement in an accident, you are entitled to receive benefits following a job-related illness or injury. However, almost 10% of workers' compensation claims are rejected. This can be financially devastating to an injured employee, who is left to pay for medical care and lost wages while unable to work.

Just because your claim is denied, that doesn't mean you don't have any options. In New Jersey, like many other states, you do have the option to appeal a workers' compensation decision.

If you have questions about your workers' comp claim or you were denied, contact our New Jersey workers' compensation lawyers at Brandon J. Broderick. We can evaluate your case and help you file an appeal if appropriate.

Filing an Appeal After Your Workers' Compensation Claim is Denied

You probably can't afford to wait if your claim is questioned or even denied by your employer or insurance provider. For this reason, the Division of Workers' Compensation in the state of New Jersey offers an appeals process for injured workers who have been denied workers' comp benefits. If your claim is denied, you have two options: submit a formal claim petition or a request for an informal hearing.

During the review process, the appeals division takes into account a number of factors, including:

• Whether the claim is based on an illness or injury sustained at work.
• The types and quantity of medical treatments needed.
• Whether the employee needs benefits for a temporary disability.
• If benefits for the dependents of a permanently disabled worker are needed.
• If benefits for the dependents of a worker who has died from work-related causes.

While you have the option to file an appeal on your own, most injured workers hire a lawyer to guide them through the procedure.

How The Informal Hearing Works

An informal hearing offers a quicker and informal way to handle your appeal. You must fill out an Application for an Informal Hearing and submit it to the Division of Workers' Compensation in order to request an informal hearing.

You will be informed in writing of the day and time of your initial hearing after a judge is assigned to your case. To give the insurance company and your lawyer adequate time to evaluate the case and get together all the evidence, additional hearings may occasionally be required.

In the end, the judge will announce a recommendation for resolving your case. However, either party is free to reject the judge's suggestions. You may request a formal hearing if the informal hearing doesn't result in a resolution.

Requesting a Formal Hearing

By submitting a Claim Petition form to the Division of Workers' Compensation, you can request a formal hearing. Depending on when you last received benefits from the insurer, you have two years from the date of your injury to file your petition.

If you suspect you may have an illness related to your job, you have two years from the time you first became aware of the problem to report it to your employer. It's important to understand that asking for an informal hearing has no bearing on the two-year timeframe.

After you file your petition, a judge in the workers' compensation district office in the county where you reside will be assigned to hear your case. The hearing will be held in the county where your employer is located if you reside out-of-state. The official hearing takes place about six months after the petition's filing date, as opposed to informal hearings, which typically take place within a few weeks.

Both sides present evidence and witnesses to testify at the official hearing, similar to a trial. Witnesses may be co-workers, your doctor, or people around you regularly, such as your family.

The judge will declare a judgment in writing following the presentation of all the evidence. If the judge agrees with your claim, he or she will likely determine specified benefits and perhaps impose penalties. You may appeal the judge's decision to the state courts of New Jersey in the Appellate Division of the Superior Court if they do not rule in your favor.

Resolve With A Settlement

Your employer might make you a settlement offer after you submit a claim petition. Although you are not required to accept a settlement offer, doing so could be a good way to resolve your dispute. Generally, a settlement is agreed upon before claims are taken to a formal hearing.

Before accepting a small settlement, you should discuss it with a workers’ comp lawyer. You have to know what your damages are and if the settlement offer is enough to cover your losses.

When To Consult a New Jersey Workers' Compensation Lawyer

You should carefully consider speaking with a lawyer knowledgeable in New Jersey workers' compensation law if you are thinking about appealing a claim that has been denied. If you choose to represent yourself, there's a lot you may not know about the appeals process.

The lawyers at Brandon J. Broderick, Attorney at Law, have years of experience under their belt in various workers' compensation matters. We have advised you as to what the best steps to take are.

Contact us to schedule a free consultation with Brandon. We serve New Jersey, New York and the surrounding states.