How to win a workers’ comp appeal in New York

It’s frustrating to have a valid New York workers’ compensation claim denied, but fortunately, many injured workers have the right to file an appeal with the New York Workers’ Compensation Board. With the help of an experienced New York workers’ compensation lawyer, you have a much stronger chance of winning an appeal than you would if you tried to appeal on your own.

Your lawyer advises you of the best course of action for your specific circumstances, but there’s plenty you can do on your own to put yourself in a better position to have your claim approved.

how to win a workers comp appeal

Understanding why your claim was denied

The denial letter from the New York Workers’ Compensation Board will list the reason or reasons for the claim denial. Creating your appeal starts with knowing why it was denied so you can present information to contest that reason. Common reasons for a claim denial include missing documentation or errors, the severity of the injury, or questionable circumstances surrounding the incident. Sometimes, the employer denies the claim, citing that you weren’t following safety protocols or that there was no employer-employee relationship.

Your lawyer can explain what types of evidence are acceptable to the Board and can help you gather it, including subpoenaing witness testimony or safety records from your employer.

Talk to a workers’ comp lawyer

If you plan to file an appeal, talking to a lawyer should be your next step. They can draft the appeal for you and ensure that no errors or omissions cause the appeal to be delayed or denied. They can also ensure that your evidence is properly presented.

A lawyer may also argue the appeal on your behalf, present your case, and answer questions from the Board.

File your formal appeal

The appeal is time-sensitive, so you need to act fast after receiving the denial letter. You must file an appeal within 30 days. An appeal should contain evidence refuting the reason for the denial, corrections or additions missing from the initial claim, or additional evidence, like a second medical opinion, as to how the workplace accident led to your injury and how badly you were hurt.

Consider a second physician’s opinion

If the only medical care provider you visited was the employer-approved one, schedule an independent medical exam as part of your appeal evidence. Perhaps the first doctor overlooked something in your case or didn’t realize the severity of the injury’s impact on your abilities. If you developed complications from the initial workplace injury or your medical condition has deteriorated due to progressive occupational disease, then new medical records help support your appeal.

Save all documentation related to the case

Keep all your medical records and any correspondence between you and the employer and the NY Workers’ Compensation Board. Any emails, letters, or text messages relating to your claim, no matter where they come from, should be turned over to your lawyer.

Get witness statements

You may not have submitted witness statements as part of your initial appeal, but now, they could be invaluable in getting your claim approved. If your employer denied the claim, citing your negligence or oversight, then the testimony of witnesses who saw what happened can negate your employer’s assertion.

Be patient – and trust your lawyer

The workers’ comp appeal process can be lengthy, and it’s easy to get frustrated. Listen to your attorney and follow their advice. Keep attending all your scheduled medical appointments, including check-ups, physical therapy, and aftercare. Failure to adhere to all follow-up care by your treating physician can jeopardize your claim.

What are my chances of winning my New York workers’ compensation appeal?

The chances of winning your appeal depend on how much additional evidence you’re able to present in your hearing. Your chances may be improved by having a lawyer draft the appeal and organize the evidence. They can present everything logically and may secure an expert to testify about the extent of your injury.

You may also be able to negotiate a settlement before the appeal. If you have additional evidence showing your claim should be approved, then your employer or insurance company may offer a settlement to avoid the hearing. A well-prepared case with strong objective evidence has a high chance of approval.

Help from an experienced NYC workers comp lawyer

Workers’ compensation laws in New York can be complex and subject to change from year to year. If you’re concerned about the outcome of your case or unsure how to file the appeal, we can help. The legal team at The Weinstein Law Group, PLLC can draft, file, and argue your workers’ comp appeal before the judge. You have legal options if your employer or their insurance company denies your valid workers’ comp claim or if they attempt retaliation against you for filing the claim or appeal. We can protect your rights. Contact us today at (212) 741-3800 for a free consultation.