Workers' comp claim denied in New York: what to do next

If the insurer disputes your claim, it must file a notice of controversy with the Board and tell you why. The Board then handles the case and schedules a hearing if needed.

Your employer's insurer, not the state, usually decides first. If they deny or delay, the free help listed here can explain your options.

Checked against official sources: October 31, 2026.

Deadlines are strict. If you are near one, call the state agency or free help today.

If your claim is denied or delayed in New York

Who decides

New York State Workers' Compensation Board (Workers' Compensation Law Judges; appeals to a three-member Board panel)

First step

If the insurer disputes your claim, it must file a notice of controversy with the Board and tell you why. The Board then handles the case and schedules a hearing if needed. You can ask the Board to act on an issue by filing a Request for Assistance by Injured Worker, and you can call the Board's Advocate for Injured Workers for free help.

Source: Form RFA-1W

Form

Request for Assistance by Injured Worker (Form RFA-1W)

Deadline

The Employee Claim must be filed within 2 years of the accident. An appeal of a judge's decision to a Board panel must be filed within 30 days. You can object to an administrative decision at any time before it becomes final (at least 30 days after it is filed).

Source: Form C-3; Form RB-89

Medical disagreements

If the insurer denies a treatment your provider asked for, read the denial notice; you or your provider may be able to ask the Board to review it and present evidence. The insurer may send you to an independent medical examination (IME); you must get notice at least 7 business days before the exam, you may bring someone with you, and you may videotape it.

Health care and IME information (WCB)

Appealing the decision

Application for Board Review to a three-member Board panel within 30 days; then full Board review or an appeal to the Appellate Division, Third Department, within 30 days after the panel decision is served.

Source: Form RB-89

Make sure your Employee Claim and a medical report are on file with the Board.
If the insurer does not pay, file a Request for Assistance by Injured Worker to ask the Board to act. Some issues are settled by an administrative decision or conciliation; others go to a hearing.
A Workers' Compensation Law Judge holds a hearing (in person or virtual) and issues a written decision.
If you disagree, file an Application for Board Review within 30 days of the judge's decision; a three-member Board panel reviews it.
After the panel's decision, you can ask for full Board review or appeal to the Appellate Division, Third Department, within 30 days.

Law: N.Y. Workers' Comp. Law §§ 23, 25(2)(a)

Source: wcb.ny.gov

Sources

The official sources for New York are listed on the New York page.

National rules that may also matter

Not covered by state workers' comp?

These federal programs and laws cover some groups of workers instead of, or in addition to, state workers' compensation. If one of them may apply to you, check its rules and deadlines too. They are different from your state's.

Federal Employees' Compensation Act (FECA): Civilian employees of the federal government, including Postal Service employees. Official page

Longshore and Harbor Workers' Compensation Act (Longshore Act): Maritime workers such as longshore workers, harbor workers, ship repairers, shipbuilders and ship-breakers, hurt on navigable waters of the United States or on an adjoining pier, wharf, dry dock, terminal or other area used to load, unload, repair or build ships. Some groups are excluded. Official page
Longshore maximum and minimum for October 1, 2026 to September 30, 2027 (fiscal year 2027): maximum $2,163.92 a week, minimum $540.98 a week.

Law: 33 U.S.C. 906(b); DOL Longshore NAWW table

Defense Base Act: Civilian employees working outside the United States on U.S. military bases or under a contract with the U.S. government for public works or national defense. Claims are handled by the Longshore program. Official page

Federal Black Lung Program: Coal miners who are totally disabled by black lung disease (pneumoconiosis) from coal mine work, and survivors of miners whose deaths were caused by it. Official page

Energy Employees Occupational Illness Compensation Program: Current or former employees of the U.S. Department of Energy and its contractors and subcontractors, and certain uranium miners, millers and ore transporters, who became ill from toxic exposures such as radiation, beryllium or silica at covered work sites, and their survivors. The program is set up by the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). Official page

Railroad workers (Federal Employers' Liability Act): Employees of railroads in interstate commerce. Instead of a workers' compensation claim, a federal law lets an injured railroad worker sue the railroad for damages caused by its negligence.

Seamen (Jones Act): A seaman injured in the course of employment may bring a lawsuit against the employer, with the right to a jury trial, under the same federal rules that apply to railroad workers.

National help

Your state workers' compensation agency answers questions about claims. Many have a free help line, an ombudsman or information officers for injured workers.

The Legal Services Corporation funds 129 nonprofit legal aid organizations in every state, D.C. and the territories. Enter your address on its website to find one near you. You can also look up legal information and free forms at LawHelp.org. Whether a local program handles workers' compensation cases varies.

LawHelp.org