In New York and elsewhere, the laws surrounding workers’ compensation are usually straight-forward. If you suffer an injury in and of the course of employment or are stricken ill while on the job, you have the legal right to file a claim for benefits. However, there are times when things may not go the way you thought they would, and you need to work with NY workers compensation lawyers. It is important to know when you should turn to NY workers compensation attorneys. Being represented by counsel is always advisable.
If your employer’s insurer refuses to accept your claim, the first thing you would want to do is contact an attorney to explore your legal options. There are various reasons for a carrier to not accept a claim. If the carrier controverts (does not accept a claim), there are specific forms that are required to be filed. In addition to these initial forms there are certain medical documentation that is needed to proceed with your claim. Consulting with NYC area workers compensation lawyer will greatly assist you in attempting to get your claim established and traversing the confusing legal system. A legal team can boost your chances, if development of the record is needed an attorney can handle depositions of medical experts and lay witnesses, as well as assisting with your potential testimony. These are situations that warrant help from NYC area workers compensation attorneys.
Your Claim was Denied
There are various reasons why the insurance company might deny your claim. One of the most common is that the insurer believes your injury or illness occurred not while you were on the job. Another common reason is they believe you filed too late. When this happens, you can file for a hearing to have an administrative Judge review the merits of your case.
Partial Disability Rating Disputed
Workers’ compensation benefit awards are given for temporary total or partial disabilities. Temporary partial disabilities can be denoted as a percentage from 0-100% depending on whether you can perform any time of work. Depending on the rating your treating doctor finds greatly affects the amount of benefits you can be entitled to. Sometimes, the insurer may disagree with the rating you are given by the doctor you have seen and request that you have an independent medical exam with a doctor it selects. In this case, the new doctor will give you a lower disability rating, which results in the insurer stating it will pay you less in benefits. If you’re dissatisfied with the new amount, workers compensation lawyers in NYC area can help you.
You Have a Preexisting Condition
It is not unusual for insurance companies to deny your workers’ comp claim if you have a preexisting medical condition that affects the same body part injured while you are on the job. The insurer will claim that you already had the injury and refuse your claim, especially if your injury developed slowly over a period. Having an experienced attorney will be able to assist you in complex litigation regarding intricate medical issues.
Inability to Get Treatment
If you are having difficulty getting the treatment you need approved, the insurer may deny the request from a treating physician. The carrier may deny such request for several reasons. Workers compensation attorneys in NYC area can ensure that you get the necessary treatment in a timely manner.
Your Ability to Work is Affected
If your injury or illness has rendered you permanently unable to work ever again, you will need the maximum benefits available. Insurance companies do not like paying the maximum, which means getting an attorney can help you get it.
Getting Other Government Benefits
A lawyer is also necessary if you are already receiving other government benefits such as Social Security Disability or SSDI. If you are receiving other benefits, your workers’ comp benefits may be affected. An attorney can help by ensuring that you get an amount that is accurate for you in relation to both your SSDI benefits and your workers’ comp benefits.
You are Having a Hearing
At various times throughout your claim, there may be hearing in front of an administrative law judge. While you may represent yourself at these hearings, it is always advisable that you be represented by counsel. These hearings may involve complex legal issues that the insurance carrier will attempt achieve the best possible result for their client. Being unrepresented may significantly impact your legal rights going forward.
If you are in the New York City, New York area and need legal help in your workers’ comp case, contact Rella & Associates at your earliest convenience.