What to Do If Your WorkSafeNB Claim is Denied in New Brunswick

Opening your mail to find a denial letter from WorkSafeNB can feel like a heavy blow. 🚫 You are in pain, unable to work, and now wondering how you will pay your bills. It is important to understand that initial denials are incredibly common in New Brunswick, often stemming from simple paperwork errors, delayed reporting, or a lack of clear medical evidence connecting your injury to your job.

Whether you live in Edmundston, Fredericton, or Saint John, the appeals process is designed to give you a second chance. You have rights, and there are legal avenues available to correct mistakes made by the board. This guide outlines the immediate steps you should take to protect your livelihood after a claim rejection.

Step-by-Step Process in New Brunswick

Overturning a denial requires organized evidence and a clear understanding of provincial legislation. 📋 Proceeding strategically will dramatically improve your chances of getting your benefits approved.

Step 1: Read the Decision Letter Carefully

Do not throw the letter away in frustration. Read it thoroughly to find the specific reason for the denial. Did they say your injury is a pre-existing condition? Did your employer dispute your story? Understanding the exact reason helps you know exactly what kind of evidence you need to gather to fight back.

Step 2: Request Your Complete Claim File

You have a legal right to see everything WorkSafeNB has on file about you. 🗄 Contact them and request a copy of your claim file. This will include your employer’s statements, internal notes from case managers, and medical opinions. Reviewing this file often reveals misunderstandings that you can easily clear up.

Step 3: Secure Stronger Medical Evidence

The most common reason for denial is a lack of medical proof. Return to your doctor or ask for a referral to a specialist. Explain that your claim was denied and ask them to write a detailed narrative report explicitly stating that your injury is highly likely the direct result of your specific workplace duties.

Step 4: Get Help and Request a Decision Review

Navigating the appeals system alone is tough. You should contact the Office of the Workers’ Advocate (a free provincial service) or hire a private workers’ compensation lawyer. ⚔ With their help, you will submit a Decision Review Application to the DRO within the 90-day limit. If the review is unsuccessful, you have up to one year to appeal to WCAT.

How Much Does it Cost in New Brunswick?

Do not let a lack of funds stop you from fighting a denied claim. The system is designed to be affordable for workers who are not receiving a paycheque. 💰

• File Request: Requesting a copy of your WorkSafeNB claim file is generally free.
• Workers’ Advocate: The Office of the Workers’ Advocate provides free assistance and representation to eligible injured workers across New Brunswick.
• Private Lawyers: If you choose a private law firm in Moncton or Saint John, they often work on a contingency fee basis. This means they take a percentage (usually 15% to 30%) of any retroactive lump-sum payout you receive if you win. If you lose, you typically do not pay legal fees.

How Long Does the Process Take?

You must act quickly. Once you receive the written denial decision, you have exactly 90 days to request an internal review from the DRO. ⌛ Do not wait until day 89 to start gathering evidence or calling an advocate. If you later appeal a DRO decision to WCAT, you have up to one year to do so. It can take several months to receive a hearing date at WCAT, but a successful outcome can result in retroactive benefits.

Frequently Asked Questions (FAQ)

Author: lawyerinfo.ca