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Appeals sometimes necessary for worker’s comp

| Dec 30, 2020 | Workers' Compensation

Injuries happen at work in even the most seemingly safe settings like an office. Those severely injured will often file a worker’s comp claim to get benefits while they are out of work. These can help provide necessary financial support to the worker’s family and payment of medical bills. Unfortunately, the employer or the insurance carrier will sometimes deny the claim or offer insufficient disability benefits. It can force the worker to pursue an appeal.

Appealing a denied claim

New Jersey workers have a right to appeal the denial. The Division of Worker’s Compensation has two options for appealing a denied claim:

  • Informal hearing: This involves one or multiple hearings in front of a judge where the worker and their attorney advocate for more benefits. At the same time, a lawyer for the insurance company argues their case. The judge makes a recommendation for settling the dispute, but either party can reject the decision and request a formal hearing. The informal hearing is the quicker option.
  • Formal hearing: A request for this hearing must be filed within two years of the injury (or awareness of it connecting to work). The case is assigned to a worker’s comp district office in the county where the worker lives, and the first hearing is held about six months after filing the petition. The hearing is conducted much like a regular trial with witnesses, and the judge will issue a ruling. The award would include specific benefits and possible penalties to the other side. If one side disputes the ruling, the next step is the New Jersey Appellate Court.

What about settling?

As with other legal disputes, there is the possibility of settling the matter before a decision is issued. It often happens before the formal hearing, but the worker is under no obligation to accept it. It is usually best to discuss this option or others after the initial denial with a knowledgeable worker’s compensation attorney practicing here in New Jersey. Their experience and knowledge can provide insight into the claim’s potential strengths and whether pursuing an appeal is a wise decision.