If a workplace illness or injury raises questions about whether you qualify for workers’ compensation benefits, you probably already sought medical attention. Your employer should already be aware of your condition and will cover your time away from work.
What might a claim involve?
There are multiple moving parts to a workers’ compensation claim – many of which may be in the works without your required participation.
For example, suppose you miss at least one day of work or require medical care. In that case, your employer has up to 10 days to notify their insurance company, after which the involved carrier will inform you of your rights and local network providers.
Lacking an immediate claim approval is no reason to lose hope. Many questions could delay the benefits process, and a “No.” isn’t necessarily the final determination in a case.
Options after a denial of benefits
Your employer’s insurance carrier will let you know if they need more information to begin paying your benefits. Meanwhile, the New York Workers’ Compensation Board will become involved if disputes arise.
Resolution may then include a course of action such as:
- A written agreement, approved by the Board
- A conciliation decision, offered by a Board attorney
- A hearing, potentially including your testimony, before a workers’ compensation law judge
If you disagree with a judge’s decision, you have 30 days to file an appeal and request further review of your claim. However, it would be in your best interest to verify that your initial application is detailed and accurate. Doing so could increase your chances of receiving the compensation you need as quickly as possible.