The Cassidy Law Firm Blog

You got hurt at work. You followed the rules, reported the injury, and expected your medical bills and lost wages would be covered. But instead of approval, you received a denial letter. Now what?

A workers’ compensation denial can be frustrating, especially when you’re dealing with pain, missed paychecks, and uncertainty about your future. But a denial isn’t the end of the road—it’s the start of your right to appeal. In New Jersey, injured workers have options, and knowing what to do next can make all the difference.

Here’s what to expect and how to respond if your workers’ compensation claim is denied.

1. Understand Why Your Claim Was Denied

The first step is figuring out why your claim was rejected. Your denial letter should include a reason, and it’s essential to read it carefully. Common reasons for denial in New Jersey include:

• Missed deadlines for reporting the injury.

• The injury didn’t happen at work (according to the insurer).

• Lack of medical evidence linking your injury to your job.

• A claim that the injury was due to horseplay or substance use.

• Disputes over whether the treatment you received was authorized.

Sometimes the issue is a paperwork error. Other times, it’s a disagreement over facts. Either way, you have the right to challenge the decision.

2. Talk to a Workers’ Compensation Attorney

Once you’ve reviewed the denial, it’s a good idea to speak with an attorney who understands New Jersey’s workers’ compensation system. An attorney can:

• Review your claim file and denial notice.

• Identify any missing documentation or technical errors.

• Help you gather medical records and other evidence.

• File an appeal or formal claim on your behalf.

At The Cassidy Law Firm, we help workers across New Jersey—including in Shrewsbury and surrounding areas—stand up to insurance carriers and assert their rights. We know how the system works and what it takes to move your case forward.

3. File a Formal Claim Petition or Request for Hearing

If your initial claim is denied, you have two options in New Jersey:

• File a Claim Petition: This starts a formal legal process that can lead to a trial before a workers’ compensation judge.

• Request an Informal Hearing: This is a faster, less formal meeting with a judge who may help resolve the issue without a trial.

Both options must be filed within two years of the injury or the last compensation payment, so timing is crucial. A lawyer can help you decide which route to take based on your situation.

4. Collect and Organize Supporting Evidence

A successful appeal often hinges on strong documentation. Here’s what can help:

• Medical records from all treating providers

• Statements from doctors linking your injury to your job

• Incident reports or witness statements

• Any communications with your employer or insurer

• Pay stubs or tax documents showing lost wages

If your employer denies that the injury occurred on the job, even photos or video footage of the worksite may be helpful. The more evidence you have, the stronger your case.

5. Be Prepared for a Hearing or Trial

If your case moves to a formal hearing or trial, it will be heard by a New Jersey workers’ compensation judge. You may need to testify about:

• How the injury happened

• What symptoms did you experience

• What treatment did you receive

• How has the injury affected your ability to work

A judge may also hear from doctors or other experts. Having legal representation at this stage ensures that your case is presented clearly and effectively.

6. Know What Benefits You’re Entitled To

If your appeal is successful, you may be entitled to:

• Medical treatment at no cost to you

• Temporary disability payments while you’re unable to work

• Permanent partial or total disability payments

• Reimbursement for out-of-pocket expenses

The amount and type of benefits depend on the severity of your injury and its long-term impact on your ability to work.

Denied Doesn’t Mean Defeated

A denied claim is not a final decision—it’s a hurdle you can overcome. With the proper support and legal guidance, many workers successfully appeal denials and get the benefits they need.