New York City Workers’ Compensation Appeals Attorneys
Appealing a Denied Workers’ Compensation Claim in New York
It is not uncommon for the Workers’ Compensation Board to disallow a claim or otherwise rule in a way that severely harms an injured worker. These decisions can seem devastating, but they may be challenged outside of the Workers’ Compensation Board.
New York State law gives victims the chance to appeal a denied or disallowed workers’ compensation claim. An appeal can be requested by the worker who was injured, the employer, or the insurance provider. It is important to note that an appeal must be requested within 30 days of the Board’s unfavorable decision.
If your workers’ compensation claim has been denied, or if the Workers’ Compensation Board has made an unfavorable decision in your case, reach out to our team at Schotter Millican. Navigating the workers’ compensation appeals process can seem daunting—but it doesn’t have to be. Our New York City workers’ compensation appeals attorneys can guide you through the process, represent your best interests, and protect your rights every step of the way.
Why Are Workers’ Compensation Claims Denied?
Workers’ compensation claims are denied or disallowed for a variety of reasons.
Some of the most common reasons the Workers’ Compensation Board denies or disallows claims include:
- Disputes regarding whether the injury/illness was work-related
- Allegations of preexisting injuries or medical conditions
- Ineligible workers, including those classified as independent contractors
- Failure to notify the employer of the injury/illness within the applicable timeframe
- Failure to seek/receive medical treatment
- Mistakes on filing paperwork or failure to file on time
- Violation of company policies, leading to injuries (i.e., intoxication, roughhousing, etc.)
While some workers’ compensation claims are denied for legitimate reasons, employers and their insurance companies often dispute valid claims. In any case, you have the right to appeal a denied claim, regardless of the reasons for the denial.
It is very important that you work with a knowledgeable workers’ compensation attorney, as the appeals process can be challenging without the help of a skilled legal professional. At Schotter Millican, we have a long history of appellate wins. Our New York City workers’ compensation appeals lawyers know how the process works and what it takes to successfully represent you at workers’ compensation appeals hearings and proceedings.
How Does the New York Workers’ Compensation Appeals Process Work?
If you wish to appeal a denied workers’ compensation claim or any unfavorable decision by the New York Workers’ Compensation Board, there are several things you should know:
- You must file your appeal within 30 days of the Board’s unfavorable decision
- If you wish to appeal an administrative law judge’s review of your claim, you must also do so within 30 days of the judge’s unfavorable decision
- An injured worker, an employer, or an employer’s insurance provider may file an appeal; medical service providers may not file a workers’ compensation appeal
- Injured workers are permitted to file an appeal regarding a self-insured employer or employer’s insurance provider’s payment of medical bills to a medical provider
Furthermore, if you work with an attorney (as is recommended), you must use the current Application for Board Review (Form RB-89) when filing your appeal. This form must be fully and correctly filled out with information such as the WCB case number, the claim administrator’s claim number, the insurer’s name, the date of injury, the type of application being made, issues for review, the basis for review, and more.
We strongly encourage you to reach out to a workers’ compensation appeals attorney, like those at Schotter Millican, who can aid you in this process. Our team offers complimentary case evaluations and can assist you in English, Spanish, and Polish.
An Overview of the New York Workers’ Compensation Appeals Process
Every workers’ compensation case is different, and the exact processes involved in appealing a denied claim may vary from case to case.
Below, we have provided a general overview of the New York workers’ compensation appeals process so that you can know what to reasonably expect:
- If you are injured at work or suffer a job-related medical condition, you should notify your employer right away, but no more than 30 days after the incident. Next, you should file a New York Employee Claim Form (Form C-3). This is your official workers’ compensation claim and, ideally, should initiate prompt payments of your benefits.
- If you do not begin receiving workers’ compensation benefits, or if your claim is denied or disallowed by the Workers’ Compensation Board, you may need to file an appeal. The first step in the appeals process is requesting a “Board panel hearing” before three administrative law judges. At this hearing, the panel will hear information about your claim and decide on your case.
- If you disagree with the panel’s decision after the Board panel hearing, you may escalate your appeal by requesting a full Board review of your case. The Board may not grant you a full review, as it has the discretion to approve or deny requests for full Board reviews.
- If the Board denied your request for a review, or if you disagree with the Board’s ruling following a full Board review, you may be able to take your case to court. Our attorneys at Schotter Millican can assist you in bringing your claim to the Appellate Division if necessary. This is a rare step, but one that occasionally must be taken in the pursuit of an injured worker’s full and fair benefits.
Not every unfavorable decision by the Board is so wrongly decided that it is worth the time and expense of appealing to a higher court. Our firm, however, has appealed dozens of unfavorable Board decisions and has won many of these appeals, helping not only the individual clients whose cases we appealed but injured workers throughout the state who now benefit from the precedents our victories set.
Schotter Millican Is Ready to Fight for You
At Schotter Millican, we are dedicated to helping injured workers throughout NYC get back on their feet. Our attorneys are proudly pro-worker and pro-labor and have been representing individuals and families in Brooklyn, Manhattan, Queens, and the surrounding communities for years. If you are having any issues recovering your workers’ compensation benefits, get in touch with us today to learn how we can help.
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