Denied?
That's not the end.
Insurance carriers deny workers' comp claims they shouldn't deny — all the time. Most denials in New York are challengeable. The question is which kind of denial you're facing, and what your specific facts look like.
Identifies Denial Type
Late notice, causation, contractor classification, intoxication, statute, going-and-coming, "no medical evidence." Each has its own challenge strategy.
Beatability Score
How hard or easy this kind of denial typically is to challenge under NY law, based on the controlling statutes and case law.
Specific Next Steps
What evidence you need, what hearings to request, and what the carrier will probably argue back. Calibrated to your specific facts.
FROI-04 Translator
Plain-English breakdown of what the formal denial form is actually saying, and what the carrier will be required to prove.
Who should use this
Anyone who's received a Form FROI-04 controverting their workers' compensation claim, or whose carrier has stopped paying benefits and now claims the case "isn't compensable." Especially useful if you got the denial less than 30 days ago — the early window matters.
What it doesn't do
It can't litigate the case for you. It can tell you what kind of fight you're in and roughly what the win-rate looks like, but the actual case is built with medical evidence, witness statements, and hearings. Use this to decide whether the fight is worth having.
This page last reviewed: