Denied Benefits? Steps to Take When Your New Jersey Workers’ Comp Claim is Rejected
A workplace injury can disrupt your life in an instant, but when your workers’ compensation claim is denied, the stress and uncertainty can feel overwhelming. Injured New Jersey workers rely on these benefits to cover medical bills, lost wages, and other costs while they recover. If you’ve been denied, it’s important to understand why and what steps you can take to fight back.
This guide breaks down the most common reasons for claim denials, explains your rights under New Jersey law, and provides actionable advice to help you navigate the appeals process.
Common Reasons Workers’ Comp Claims Are Denied
A denial doesn’t mean your case is closed. In fact, many claims are rejected due to errors, misunderstandings, or insufficient evidence. Here are the most common reasons for denied benefits in New Jersey:
Failure to Report the Injury on Time
New Jersey law requires employees to notify their employer of a workplace injury as soon as possible—ideally within 14 days. However, you do technically have up to 90 days. Regardless of this time frame, delayed reporting can raise questions about whether the injury happened on the job.
Missing or Incomplete Medical Documentation
Workers’ comp claims hinge on clear, detailed medical evidence linking the injury to your job. If your healthcare provider fails to include essential information or you neglect to follow up on treatment, your claim could be denied.
Disputes About Whether the Injury Is Work-Related
Employers or insurance companies may argue that your injury didn’t occur at work. For example, if you slip in the parking lot before clocking in, the insurer might claim the accident wasn’t job-related.
Pre-Existing Conditions
Insurance companies often deny claims by attributing your injury to a pre-existing condition, even if the workplace accident aggravated or worsened it.
Missed Deadlines
Filing your claim late can result in an automatic denial. Under New Jersey law, you typically have two years from the date of injury to file your workers’ compensation claim.
What Do I Do If My Workers’ Comp Claim Was Denied?
A denial isn’t the end of the road. Follow these steps to appeal the decision and fight for the benefits you’re entitled to:
Understand the Reason for Denial
Your denial letter will include an explanation of why your claim was rejected. Carefully review this document and gather any supporting evidence that addresses the stated reasons.
Request a Formal Hearing
If you disagree with the denial, you can file a formal claim petition with the New Jersey Division of Workers’ Compensation. A judge will hear your case, review evidence, and determine whether you’re eligible for benefits.
Seek Medical Evidence
Your medical records play a critical role in your appeal. Work with your healthcare provider to ensure your documentation clearly connects your injury to your job. You may also need an independent medical examination to strengthen your case.
Gather Witness Statements
Coworkers or supervisors who witnessed your accident can provide valuable testimony. Their accounts can corroborate your claim and establish that your injury occurred in the course of your employment.
Hire an Experienced Workers’ Comp Lawyer
Navigating the appeals process can be complex, and having a legal advocate on your side can significantly improve your chances of success. A lawyer will guide you through the process, collect evidence, and negotiate with insurers on your behalf.
Fighting Denied Workers’ Comp Benefits: What You Need to Know
Deadlines for Appeals
In New Jersey, you have two years from the date of injury—or the last payment of workers’ comp benefits—to file an appeal. Missing this deadline will likely result in losing your right to pursue benefits.
Workers’ Compensation Judges
When you request a formal hearing, your case will go before a workers’ compensation judge. These judges handle employment injury cases and will review evidence from both sides before making a ruling.
No-Fault System
New Jersey’s workers’ compensation system operates on a no-fault basis, meaning you don’t need to prove your employer was negligent to receive benefits. However, you must demonstrate that your injury occurred in the course of your employment.
Unique Examples of Workers’ Comp Denial Cases
Understanding how others have navigated similar situations can provide clarity and inspiration for your own case. Here are two unique hypothetical examples of workers who fought for their benefits after a denial:
Delivery Driver Denied for Parking Lot Fall
A delivery driver in Trenton slipped on ice while unloading a truck. The insurance company denied the claim, arguing that the fall occurred outside the official workspace. With the help of a lawyer, the driver presented evidence showing that the parking lot was part of the employer’s premises, and the denial was overturned.
Factory Worker With Pre-Existing Back Injury
A factory worker in Camden aggravated a pre-existing back condition while lifting heavy equipment. The insurer denied the claim, citing the worker’s medical history. However, the worker’s attorney secured testimony from a specialist who confirmed the accident significantly worsened the condition, leading to a successful appeal.
These cases highlight the importance of persistence and skilled legal representation in overcoming a denial.
How a Workers’ Compensation Lawyer Can Help if Your Claim Was Denied
Filing an appeal can feel daunting, especially when you’re already dealing with the physical and emotional toll of a workplace injury. An experienced workers’ comp lawyer can take the burden off your shoulders by:
- Reviewing your denial letter and identifying the best course of action
- Collecting medical evidence, witness statements, and other documentation
- Representing you at hearings and negotiations
- Ensuring all paperwork and deadlines are handled correctly
A lawyer not only improves your chances of success but also protects you from being taken advantage of by insurance companies that prioritize their bottom line over your well-being.
Your Rights Under New Jersey Workers’ Compensation Laws
As of 2025, New Jersey workers’ compensation laws remain clear: injured employees are entitled to medical care, wage replacement, and other benefits if their injury is work-related. Employers cannot retaliate against employees for filing claims, and any such actions can lead to additional legal consequences.
Remember, you have the right to appeal a denial and to seek representation to ensure your voice is heard.
Call Drazin & Warshaw: Fighting for Injured Workers Across New Jersey
If your workers’ compensation claim was denied, don’t give up. At Drazin & Warshaw, we’ve spent decades helping New Jersey workers fight for their rightful benefits. Our team understands the complexities of the appeals process and is dedicated to protecting your rights every step of the way.
Denied Workers’ Comp Benefits in New Jersey? Call Drazin & Warshaw For Help on Your Appeal
A denied workers’ comp claim doesn’t have to mean the end of your case. Call Drazin & Warshaw today at 732-333-8141 or fill out our secure contact form to schedule a free consultation with one of our experienced workers’ comp lawyers. We represent injured workers in Westfield, Red Bank, Brick, Hazlet and throughout Middlesex, Monmouth, Ocean, and Union Counties.
Your recovery is too important to delay—let us help you secure the benefits you’re seeking to move forward.
Disclaimer: This blog is intended for informational purposes only and does not establish an attorney-client relationship. It should not be considered as legal advice. For personalized legal assistance, please consult our team directly.
