If you're injured on the job, you may be entitled to workers' comp benefits in New Hampshire for medical treatment, lost wages, and other injury-related expenses. But what if your workers’ comp claim is denied? This article explains why your employer's insurer might reject your claim and how you can challenge that decision.
New Hampshire law bars workers' compensation for injured employees who don't meet reporting and filing deadlines:
In the case of injuries or occupational illnesses that develop over time, both the two-year and three-year time periods start when you learn about the nature of your condition and its connection to your work. For details on the filing process, see How to File a Workers’ Compensation Claim in New Hampshire.
Your employer's insurance company is likely to deny your claim if it doubts whether your injury or illness was work related. This can sometimes be a grey area of the law, so you may have to provide evidence to prove that you were hurt while you were working and because of your job activities or conditions.
New Hampshire law also lists some specific examples of injuries or illnesses that aren't covered by workers' comp, including:
strictly mental or psychological conditions that are caused by stress or by the employer's legitimate personnel actions (like work evaluations or job transfers)
self-inflicted injuries and injuries caused by the worker’s serious, willful misconduct (including intoxication)
heart conditions, unless a workplace injury contributed to or aggravated the condition, or
injuries that happen while employees are participating in volunteer recreational activities.
You have the right to appeal if the insurance company denies your workers’ comp claim. The New Hampshire Workers’ Compensation Division (WCD) has two levels of review over claims disputes: an administrative hearing and an appeals board review.
You can request a hearing by submitting a petition to the WCD within 18 months after the insurer denies your claim. The petition must be in writing and explain why you are entitled to benefits. Send a copy of the petition to the insurance company. The agency will schedule a hearing for a date no later than six weeks after it received the petition.
At the hearing, a hearing officer will consider the evidence and question witnesses. The officer could also ask you to provide more information and temporarily put the hearing on hold. (Learn more about what to expect at your workers' comp hearing.) Within 30 days after the hearing, the officer will issue a decision.
If you’re unhappy with the hearing officer's decision, you can appeal within 30 days to the New Hampshire Workers' Compensation Appeals Board. A panel of three administrative officers will hold a full hearing and give you another opportunity to present your evidence. However, you’re limited to the evidence that you already provided to the hearing officer; you can't bring up new information.
If the appeals board rules against you, your final option is to appeal to the New Hampshire Supreme Court. In its decision, the appeals board will tell you when you need to file that court appeal.
The workers' comp appeals process can be challenging to figure out on your own. An experienced workers' comp lawyer can help you navigate the process, gather the right kind of evidence to support your claim, prepare you for the hearing, and counter the insurance company's arguments. Learn more about what a good workers' comp attorney can do for you and how much workers' comp lawyers cost in New Hampshire.