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What if my workers' compensation claim is disputed?

For New York State residents who are injured on the job or suffer a condition because of their work and it prevents them from working, workers' compensation benefits can be a lifeline. They can cover for lost wages, medical expenses and more. However, there are times when there is a disagreement regarding the claim and it will be disputed. For those who file a workers' compensation claim and face a situation in which the insurer disputes it, it is critical to have legal assistance from an attorney who specializes in workers' compensation claims.

If the insurer disputes the claim, it generally means that it does not agree that a work injury occurred, that it has not insured the employer, or there is another justification. Workers should understand that this does not mean that the case is over. The Workers' Compensation Board will have a hearing on the matter. At the hearing, a judge will examine the case with the medical records, wages the worker earned when working, and any other factor relevant to the claim. A decision will be made as to whether the worker should get workers' compensation or not.

Once the decision is made, the claimant or the insurer can file an appeal. It must be in writing and be done within 30 days of when the case was filed. The appeal will be reviewed by three Board members. It can be changed, rejected or there can be a request made for more hearings. While the case is in dispute, the claimant can ask to get disability benefits while it is heard.

When the workers' compensation claim is disputed by the insurer, it can be a worrisome time for the claimant. The prospect of not getting the benefits can cause significant problems and the person might not know what to do if the claim is rejected. When seeking workers' compensation benefits, it is imperative to have legal help from the start to deal with any eventuality. A lawyer who is experienced in workers' compensation benefits should be contacted immediately.

Source: wcb.ny.gov, "What to Expect When You File a Claim -- If Your Claim Is Disputed," accessed on May 16, 2018

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