Way too many injured workers end up dealing with delays, denials, and roadblocks that make the whole Workers' Compensation process feel impossible. Let's walk through the common issues that can throw a workers’ comp case off course—and more importantly, what you can actually do to fix it.
One of the biggest hurdles injured workers face? The insurance company. They’re not necessarily out to get you—but let’s be real, they’re not looking to hand out checks either. Their job is to protect their bottom line, and that often means doing things that stall your case or pressure you into giving up.
Common tactics? Delays, denials, and distractions. They might ignore emails, slow-walk treatment approvals, or start digging into your old medical records. Some even send out surveillance hoping to catch you doing something they can twist against you.
It’s stressful, and it wears people down. A lot of folks end up rushing back to work just to stop the chaos—even when they’re not ready. That’s what we call “starving you back to work.” Payments get delayed so long, people feel like they have no choice but to tough it out, even if it makes things worse.
Getting the medical care you need is a huge part of both your recovery and your comp case. But just because your doctor recommends something doesn’t mean it’s going to happen quickly—or at all.
One common roadblock is the “without prejudice” authorization. It means the insurance company says, “Sure, go ahead with the treatment,” but they’re not locked into paying for it if your case gets denied later. And since most doctors and hospitals won’t take that risk, the treatment often doesn’t happen.
Then there’s all the red tape. In places like New York, doctors have to follow strict treatment guidelines based on your injury. If they want to try something different—like more PT or a less common approach—they have to file a special request (called a variance), and the insurance company has 30 days to approve or deny it.
If they deny it, your doctor can appeal—but that kicks off another round of delays. It gets even messier if the insurance company sends you to an IME (Independent Medical Examiner) who disagrees with your doctor.
Even if you're doing everything right, the legal side of a comp case can move painfully slow. Hearings aren’t always easy to get, and even when they happen, decisions can take weeks—or months.
It used to be simpler to request a hearing. Now, the rules are tighter. Your issue has to fit into a narrow list of categories, and you’ve got to check all the right boxes just to get it scheduled.
And even if you get your day in court? There’s still a chance the judge won’t decide right away. “Reserved decisions” mean more waiting. If someone appeals after that, expect even more delays.
Sometimes, you won’t even know what’s causing the holdup—could be staffing issues, system backlog, or just the usual comp slow-down.
Getting to the settlement stage should mean you’re almost done—but it doesn’t always play out that way.
A common issue? The insurance company stops responding. Or they toss out a low offer and refuse to budge, even if your condition’s gotten worse or the case has clearly changed.
Sometimes they’ll say they already looked at the case months ago and won’t re-evaluate, even with new injuries on the table.
Sometimes the holdup isn’t the insurance company—it’s your own legal team. Maybe you’re not getting updates, your calls aren’t being returned, or you and your lawyer just aren’t clicking. And yeah, that can seriously slow things down.
Even great lawyers get busy, but if you’re constantly left in the dark, it’s time to speak up. Ask for a meeting. And if it feels like the fit just isn’t there, that’s okay too. Sometimes you just need someone who gets you.
If your case feels stuck, confusing, or just totally overwhelming—you’re not alone. And you don’t have to try to sort it all out on your own. Give me, Rex Zachofsky, a call. You can reach me at 212-406-8989. Hope to hear from you soon.
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