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Why are Workers Compensation Claims Denied in New Jersey?

Workers compensation provides important protections for both employers and workers. Even when employees suffer injuries due to their own carelessness, they can still obtain benefits to pay for the costs associated with their injuries. The coverage also protects employers by prohibiting workers from filing lawsuits when unsafe conditions or other circumstances cause accidents. This does not mean claims can never be denied, but all too often unfair denials result in extensive out-of-pocket costs to injured employees. Before accepting a denial as inevitable, it makes sense to seek advice from an experienced workers compensation attorney who can often help protect your rights.

In accordance with the State of New Jersey Workers’ Compensation Law, there are a number of types of claims that your employer or the insurance company may deny, such as for the following:

  • Injuries sustained outside the workplace, as long as they did not occur during the course of employment
  • Pre-existing medical conditions, provided they were not aggravated by the work effort
  • Injuries resulting from horseplay on the part of the employee filing the claim
  • Accidental injuries sustained while the employee is under the influence of alcohol or drugs

Some employers and their insurers may try to keep claims experience low by denying valid claims. When this occurs, injured employees may accept these denials out of concern for their jobs — or because they do not have the resources to launch a battle against powerful corporate concerns.

Before accepting a decision that seems inevitable, consider scheduling a free consultation with a New Jersey workers compensation attorney. Your lawyer can explain the whistleblower laws that protect you from losing your job and review the details of your claim. If you have a legal right to compensation, he or she may be able to informally intervene to get your claim back on track, or even take legal action to help you secure the full benefits you deserve.

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