Common Reasons Workers’ Comp Claims Are Denied — And How to Fight That Denial
December 10, 2025
Workplace injuries can create serious challenges for employees, especially for those in public service roles. When a workers’ compensation claim is denied, it can leave injured workers struggling to cover medical costs or lost income.
Understanding the main reasons claims are rejected and the options for appeal can make a significant difference in your recovery and financial stability. If your claim has been denied, you can visit our contact page to schedule a consultation and discuss your next steps.
Common Reasons for Workers’ Compensation Claim Denials
Workers’ compensation benefits are meant to cover medical care and lost wages from work-related injuries, but not every claim is approved. Some of the most frequent reasons for denials include:
Missed Deadlines
Employees must report work-related injuries to their employer within a specific timeframe. In New Jersey, this is generally within 14 days. Failing to report on time or to complete required forms properly can result in a denial. A workers’ compensation lawyer can ensure all necessary filings meet the legal deadlines and requirements.
Disputed Cause of Injury
Employers or insurers often argue that an injury did not occur while performing job duties. This dispute is typical among public employees, such as firefighters or police officers, who face cumulative trauma or repetitive strain injuries. Collecting detailed medical records and witness statements helps establish that your injury arose from work-related activities.
Pre-Existing Conditions
Insurance providers sometimes claim that your injury stems from a pre-existing condition instead of a workplace incident. Under New Jersey law, however, an aggravation of an existing injury caused by job duties may still qualify for compensation. A workers’ compensation attorney can help demonstrate that your work directly contributed to or worsened your condition.
Lack of Medical Documentation
Insufficient medical proof is another frequent cause of claim denial. To prevent this, seek immediate medical attention and follow all prescribed treatments. Thorough and consistent documentation of your injury helps support your claim and prevent disputes over its validity.
How to Challenge a Workers’ Compensation Denial
Receiving a denial notice is discouraging, but it is not the end of your case. New Jersey law allows workers to appeal and present additional evidence to support their claim.
File a Claim, Petition, or Request an Informal Hearing
If your claim has been denied, you can file a claim petition or request an informal hearing before a judge at the New Jersey Division of Workers’ Compensation. Informal hearings are often quicker and may help resolve the dispute without a lengthy trial. The practice areas page explains how our attorneys assist injured employees through each step of this process.
Collect and Organize Evidence
Accurate and complete documentation is key to a successful appeal. Include medical reports, witness statements, workplace incident logs, and any prior communication with your employer or insurer. A knowledgeable work injury lawyer can coordinate the evidence and handle the appeal process efficiently.
Obtain Legal Representation
Employers and insurance companies typically have legal counsel representing their interests. Having an attorney of your own ensures that your rights are protected and that you receive fair treatment throughout the appeal.
Why Public Employees Face Extra Challenges
Public employees such as police officers, firefighters, and emergency personnel face unique risks in their line of work. Their injuries may develop over time from physical strain, hazardous conditions, or repeated exposure. These factors can make it harder to prove that the injury is job-related, which often leads to higher rates of claim denials.
A public employee workers’ compensation lawyer can help explain the nature of your work and show how it contributed to your injury. At The Law Offices of Feeley & LaRocca, we represent public employees throughout New Jersey and ensure they receive the benefits and support they have earned through their service.
For immediate assistance, contact our firm via the contact page to discuss your situation and legal options.
Building a Strong Case for Your Appeal
Challenging a workers’ compensation denial requires persistence and experienced legal help. At The Law Offices of Feeley & LaRocca, we are committed to guiding injured workers through the appeals process and helping them recover the benefits they need. Our firm has helped numerous clients secure compensation for medical treatment, rehabilitation, and lost income. To read about others’ experiences, visit our testimonials page.
If your workers’ compensation claim has been denied, our firm is ready to help you appeal the decision and pursue the benefits you deserve. Contact us today through our contact page to schedule a consultation and take the first step toward recovery.