NY Workers' Comp Claims
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Denied (controverted) Claims -
Rocket Docket is the new expedited hearing procedures for denied claims. Denied claims are handled quickly, it is important to cooperate with State Insurance Fund's investigators to gather the neccessary evidence to support the denial. Read more about what to expect
Cases are reviewed to determine if they qualify under NYS Workers Compensation Law. On some cases questions may be raised as to the compensability of the claim. Further investigation may be warranted and the case may be denied. While a claim is denied, an injured worker may still be eligible for benefits until a Judge makes a final ruling.
If you have reason to believe a claim is questionable, notify Keevily at 914-381-5511, immediately. NYSIF must file Form C-7 on or before the 18th day of disability, within 10 days after the employer learns of the alleged accident or within 25 days after notice of indexing by the WCB. While a claim is controverted, a claimant may still be eligible for benefits until a judge makes a final ruling.
Why a Claim May Be Denied
- Accident or occupational disease did not arise out of and in the course of employment;
- Notice: Claimant did not report the accident to the employer within 30 days;
- Causal relationship: Injury sustained was not caused by the accident;
- Coverage: NYSIF did not provide coverage to employer at the time of the accident;
- Employer-Employee relationship: Claimant is not an employee of the employer, is an independent contractor or never worked for the employer;
- Timely filing: Claimant did not file a report of injury or illness within two years of the accident;
- Jurisdiction: Claimant did not have the accident under the jurisdiction of New York State WCL;
- Prima facie evidence: Claimant has not provided medical evidence that establishes causal relationship.
If you suspect a new claim should be denied follow the steps give us a call to discuss the reasons you feel the claim should be denied, our knowledgeable staff will be happy to answer all your questions and provide guidance.
Keevily Safety Group Claims Team
- Barry Hartglass, Supervisor(914) 412-0550
- Janice Robinson, Claims Specialist(914) 412-0572
- Richard Whitehill, Sr. Claims Specialist(914) 412-0509
- Genevieve Keller, Sr. Claims Specialist(914) 412-0563
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