Founding Attorney
When you’re hurt on the job, you expect workers’ compensation to be there. It’s supposed to cover your medical bills, replace some of your lost wages, and give you time to recover without worrying about your paycheck.
But for too many workers, especially in construction, that promise falls apart. Claims get denied—often unfairly. We’ve worked with countless injured laborers and tradespeople who did everything right, only to be told they’re not eligible for benefits.
We know this system. We’ve spent time on job sites and in courtrooms. Let’s look at the most common reasons workers’ compensation claims are denied and how you can protect your rights.
1. Delayed Injury Reports or Incomplete Paperwork
In New York, you’re required to notify your employer about a work-related injury within 30 days. However, the reality is that many workers try to push through the pain, hoping it will subside. By the time they report it, the clock has already started working against them.
Paperwork issues are another primary reason claims get denied. If you leave out important details, don’t include medical documentation, or miss a required form, the insurance company may reject your claim.
Always report an injury as soon as possible and get a copy of any paperwork you submit. Even if it seems minor at first, documentation protects you down the line.
2. Employer Disputes the Claim
We’ve seen it happen time and again—an injured worker reports an incident, and the employer tries to downplay it or deny it ever happened. They might argue that:
- You weren’t on the job at the time
- The injury didn’t occur on their property
- You were doing something unsafe or unauthorized
It’s frustrating, especially when you know the truth. Workers’ comp is supposed to be a no-fault system, which means you’re entitled to benefits even if the accident was partly your fault. But that doesn’t stop some employers from trying to protect their insurance rates.
3. Pre-Existing Conditions or Medical Disputes
Insurance companies are quick to blame injuries on old conditions. If you’ve ever had a back problem, joint pain, or prior injury, they may say your current pain has nothing to do with your job, even if a workplace accident clearly made things worse.
Other times, the problem is a lack of medical evidence. If your doctor doesn’t clearly state that the injury is work-related, or if your medical records are inconsistent, the claim may be denied.
Be honest with your doctor and make sure they understand how the injury occurred. Follow through on all appointments and don’t skip treatment.
4. Missed Deadlines or Procedural Mistakes
There are strict deadlines for workers’ compensation claims in New York. In most cases, you must file a claim within two years of the injury. That may sound like plenty of time, but missed steps along the way, such as not notifying your employer, skipping follow-ups, or failing to submit medical forms, can be used to reject your case.
An attorney can help you avoid these traps and make sure everything is filed properly from the start. If your claim is denied, they can help you appeal within the time allowed.
5. You Have a Valid Claim, But They Still Said No
Sometimes, claims are denied for reasons that make no sense. The paperwork is fine. The injury is apparent. You reported it properly. Yet the insurance company says “no” anyway.
This is where having the right legal help matters. You have the right to request a hearing and present evidence. You can bring in medical records, witness testimony, and legal arguments that challenge the denial. And if you’re a construction worker injured due to unsafe equipment or conditions, you may have a third-party lawsuit in addition to your comp claim.
Get Legal Help From a Firm That Understands Worksite Injuries
At Michael LoGiudice, LLP, we know what it’s like to work in tough conditions. We’ve handled claims for roofers, laborers, electricians, and drivers across New York who were injured while doing honest work. When the system turns its back on you, we don’t.
If your workers’ compensation claim was denied, let’s talk. We’ll review your case, explain your options, and help you take the next step. The consultation is free, and we don’t get paid unless you win. Contact us today.