Reviewing the Requirements for a Claim with a Workers’ Compensation Attorney in Queens County, NY

by | Apr 19, 2016 | Lawyers

New York workers have the right to acquire workers’ compensation benefits after an on-the-job injury. However, there are strict guidelines for filing a claim. If for any reason t the human resources department fails to follow these requirements, the claim could be denied. A workers’ compensation attorney in Queens County, NY can help workers in the case they are denied appropriate benefits.

What Is an Eligible Injury?

An eligible injury consists of any injury that prevents the worker from performing their job duties. This doesn’t include injuries in which the worker could perform light-duty tasks and continue to generate an income. They include permanent disabilities or long-term injuries that could prevent the worker from returning to work quickly or at all. The employer’s insurance coverage identifies the exact circumstances that outline an eligible injury.

Reviewing Deadlines for Claims

For most claims, the attending doctor must submit the medical report within a ten-day period. If they don’t submit this report, the insurer may deny coverage. Hence, the worker must ensure that the report is filed to fulfill these requirements and secure benefits.

The Claim’s Adjuster’s Assessment

The claimss adjuster reviews the documentation for the worker’s injury to They determine if the injury matches the criteria as outlined in the insurance policy. If for any reason the injury isn’t considered eligible for extended monetary benefits or further medical treatment coverage, the claimss adjuster will deny the claim.

When Benefits Are Denied

When benefits are denied by the insurer, the worker has the right to file an appeal through court. This hearing allows them to present information to the judge and to make a final rendering. If the hearing doesn’t provide necessary benefits, the worker has the right to file a lawsuit against their employer.

New York workers are protected under state and federal laws that prevent employers from taking advantage of them when they sustain a work-related injury. According to these laws, the employer must provide medical benefits and a portion of their wages if they are unable to return to work. Employees who need to hire a workers’ compensation attorney in Queens County, NY for these purposes should contact the Law Office of Steven R. Smith or visit online to read additional information today.

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