Getting hurt on the job is hard enough. When your workers’ compensation claim is denied, the situation can quickly become overwhelming. Suddenly, you may be facing unpaid medical bills, lost income, and uncertainty about how you’re supposed to recover without support.

At WRKRS Law Firm PLLC, we represent workers across New York whose legitimate workers’ compensation claims were denied by insurance companies. A denial does not mean the end of your case. In many situations, it’s just the beginning of the legal process — and one where having the right guidance makes all the difference.

Why Workers’ Compensation Claims Get Denied

Insurance companies deny claims for many reasons, and not all of them are valid. Understanding the reason for the denial is the first step toward challenging it.

Common reasons include:

• The employer disputes that the injury is work-related
• The injury was not reported in time
• The insurance carrier claims a pre-existing condition
• Lack of medical evidence connecting the injury to the job
• Allegations that the injury occurred outside of work

Insurers often look for any excuse to limit payouts, even when injuries are legitimate.

Late Reporting Is a Common Issue

New York law requires workers to notify their employer of a workplace injury within a specific time frame. When reporting is delayed, insurance companies may argue the injury did not happen at work.

However, delayed reporting does not automatically disqualify a claim. Many workers delay reporting because:

• Symptoms did not appear immediately
• They believed the injury was minor
• Fear of retaliation
• Lack of knowledge about reporting requirements

These explanations can often be addressed with proper legal advocacy.

Disputes Over Whether the Injury Is Work-Related

One of the most common denial arguments is that the injury did not occur during the course of employment.

Insurers may claim:

• The injury happened off the job
• The injury occurred during a break
• The worker was performing a non-work activity
• The injury was caused by a pre-existing condition

Even if you had a prior condition, New York law allows workers’ compensation when work activities aggravate or worsen that condition.

Medical Evidence Plays a Critical Role

Workers’ compensation cases rely heavily on medical documentation. If insurers believe the medical evidence is incomplete or unclear, they may deny the claim.

Problems often arise when:

• Medical reports lack detail
• Doctors do not clearly connect the injury to work duties
• Independent medical exams contradict treating physicians
• Workers stop treatment too early

Consistent medical care and clear documentation are essential to proving your case.

What Happens After a Claim Is Denied

A denial does not end your right to benefits. Instead, it triggers the opportunity to challenge the decision through the New York Workers’ Compensation Board.

The process may involve:

• Filing an appeal or request for a hearing
• Presenting medical records and testimony
• Employer and insurer evidence
• Hearings before a Workers’ Compensation Law Judge

This process can feel intimidating, but you do not have to navigate it alone.

Steps to Take Immediately After a Denial

If your claim is denied, your next steps are critical.

You should:

• Carefully review the denial notice
• Continue medical treatment if possible
• Save all medical records and correspondence
• Avoid giving recorded statements without legal advice
• Contact a workers’ compensation attorney immediately

Delays or missteps can make it harder to reverse a denial.

Independent Medical Examinations (IMEs)

Insurance companies often require injured workers to attend Independent Medical Examinations. Despite the name, these exams are conducted by doctors hired by the insurer.

IMEs may:

• Downplay the severity of your injury
• Claim you are fit to work
• Dispute your treating doctor’s findings

WRKRS Law Firm prepares clients for IMEs and challenges biased reports when necessary.

What Benefits Can Still Be Recovered

If a denial is overturned, workers may be entitled to:

• Payment of past and ongoing medical bills
• Temporary disability benefits
• Permanent disability compensation
• Reimbursement for out-of-pocket expenses

In many cases, benefits are paid retroactively once the claim is approved.

How WRKRS Law Firm Fights Claim Denials

At WRKRS Law Firm PLLC, we understand how insurance companies operate — and how to hold them accountable.

Our team:

• Investigates the true reason for denial
• Gathers medical and employment evidence
• Works with treating physicians
• Represents clients at hearings
• Challenges insurer tactics and delays

We use a strategic, detail-focused approach to give every case the strongest possible chance of success.

Denial Does Not Mean Defeat

A denied workers’ compensation claim can feel discouraging, but it does not define your case or your future. Many denied claims are later approved with proper representation and evidence.

At WRKRS, we believe injured workers deserve persistence, transparency, and justice. If your workers’ compensation claim was denied, now is the time to take action.

Contact WRKRS Law Firm PLLC for a confidential consultation. We’ll explain your options, fight for your benefits, and stand with you every step of the way.

Because at WRKRS, workers don’t give up — and neither do we.