Content reviewed by:
Alex Shulman
Navigating the workers’ compensation process can be complex, especially if your employer’s insurer denies your claim, or any part of it. When this happens, a successful hearing is necessary to address the carrier’s denial and secure the benefits you deserve.
Having an experienced attorney advocate on your behalf is crucial. Improve your odds of securing a successful outcome by partnering with our skilled New York workers’ compensation lawyers. Call (212) 221-1000 or contact us online to schedule a free consultation.
Pre-Hearing Conference
If your employer’s insurance company chooses to deny your claim, they must file a notice of controversy formally notifying you and the New York Workers’ Compensation Board of its decision. The next step is a pre-hearing conference before a Workers’ Compensation Law judge or conciliator, which should be scheduled within 30 days, to determine whether you have enough evidence to proceed to a formal hearing. During this phase, both parties can submit documents and evidence arguing for or against the denial of your claim.
What To Expect at a Workers Compensation Hearing in New York?
The next step of the resolution process is a formal hearing, attended by you, your lawyer, the insurance company’s lawyers, and any relevant witnesses. Often testimony will be taken and evidence presented. Your lawyer will argue the case for establishing your claim. Important issues will include:
- Your employment at the time of the injury
- What you were doing at the time of the accident and how the accident happened
- What injuries you sustained and how they occurred
- When and how you notified your employer of your injuries
- Your physical limitations and ability to work after the injury
- Medical treatment you received
After both sides argue their positions, the judge will decide how to proceed. If their decision is favorable, your benefits may be awarded. However, if the original denial is upheld and the claim is disallowed, your attorneys can appeal that determination. Similarly, if your employer’s insurer disputes the establishment of the claim or award of benefits, they may appeal those findings. In either situation, the case may proceed to the appeals stage.
Appealing Workers’ Compensation Decisions
If either side disagrees with the decision rendered in the hearing, they can appeal to a Board Panel consisting of three Commissioners. After review, the Panel may uphold the lower decision, reverse it, or modify it, potentially sending the case back for rehearing.
Decisions by the Board Panel can be appealed to the Full Board. Matters may at times be appealed outside of the New York State Workers’ Compensation system, with appeals to the Appellate Division or State of New York Supreme Court, although such cases are rare and usually involve significant legal implications or serious errors.
We Can Help with Your Workers’ Compensation Dispute
Litigating disputed claims and appealing workers’ compensation decisions can be highly complex and requires a skilled attorney to ensure your interests are adequately represented. At Shulman & Hill, our experienced workers’ compensation attorneys know how to navigate the process. You can count on us to do everything in our power to make sure you get the benefits you deserve.
We are standing by to answer your questions and ensure you understand your legal rights. Call (212) 221-1000 or contact us online to schedule a free, no-obligation consultation.
Further Reading
- 4 Things You Should Do After an Injury at Work
- Do I Have to be a U.S. Citizen to Receive Workers’ Compensation?
- Can You Use PTO While on Workers’ Compensation?
- How To Fill Out a Workers’ Compensation C-3 Form
