Getting injured on the job can be a devastating event, especially when injured workers are unable to return to work. Fortunately for those who work in New Jersey, employers must carry Workers’ Compensation insurance that provides benefits to employees injured on the job.
Workers’ Compensation is a no-fault system. This means you can generally collect benefits, regardless of who was at fault for the injury. However, employee misconduct, such as being intoxicated at work, horseplay, or not using safety equipment provided to you by your employer, will negate coverage.
Even though this coverage is mandatory, injured workers can still encounter difficulty and even denial when claiming their benefits. The New Jersey Workers’ Compensation lawyers at the Law Office of Mark S. Nathan have a long history of successful claims for our clients. Our experienced team of New Jersey Workers’ Compensation lawyers is committed to fighting for our client’s benefits, ensuring that their medical bills are covered, and their wages are compensated fairly.
Workers’ Compensation Benefits
If you are injured at work, or contract an illness directly related to your job, Workers’ Compensation benefits can provide partial wages and medical coverage while you are unable to work. New Jersey Workers’ Compensation insurance provides wage benefits of 70 percent of a worker’s salary. The formula to determine this benefit is based on your earnings for the 52 weeks preceding the injury date.
Your Workers’ Compensation benefits will include compensation for doctors’ appointments, hospitalizations, prescription medications, and any necessary physical or cognitive therapies related to your injury or illness.
Benefits continue throughout the recovery period, so long as you are under a medical doctor’s care. Benefits are terminated when an employee is deemed medically able to return to work.
In some cases, an employee may be able to return to work, but in a limited capacity. When this happens, benefit amounts may be adjusted to compensate for the reduction in work hours.
While medical expenses are covered under Workers’ Compensation insurance, they do not provide extra compensation for additional pain or suffering. However, if the injury resulted from the negligence of an individual, business, or entity other than your employer or co-workers, you may be able to also file a third-party personal injury claim to recover damages from the negligent party for pain and suffering.
Claiming Workers’ Compensation Benefits
The first step in any work-related injury is to report the incident to your supervisor, or to the appropriate person in your employer’s human relations/resources department. There is a 14-day limit for reporting the injury, but it is best not to wait any longer than is medically necessary. In some instances, if you can provide a reasonable explanation for delaying, you have 90-days to report.
Emergent or urgent medical care is covered and does not require preauthorization by your employer or insurance company. Any non-urgent medical care should be approved by your employer. Under New Jersey law, your employer has the right to choose your physician. To ensure that your medical bills are covered, you must be seen by the medical professional your employer dictates.
Your employer will notify its Workers’ Compensation insurance company, who will then file an injury claim with the New Jersey Department of Labor and Workforce Development (DLWD). After careful review by the Workers’ Compensation insurance carrier, a determination will be made to accept or decline your claim.
Denial of Workers’ Compensation Benefits
If you are initially denied Workers’ Compensation benefits, there is no need for panic. Appeals can be filed with the DLWD. There are strict laws and deadlines that must be met, and a reliable Workers’ Compensation lawyer can ensure that you have the best chance to win your appeal.
There are many reasons why Workers’ Compensation benefits are initially denied. If the work-related injury was not reported within the mandated time frame, or if the claim was not filed within the 30 to 90-day time frame, benefits can be forfeited.
Benefits can also be denied if your employer believes your injury is not related to your job. Perhaps you broke your arm in a fall at work, but postponed medical treatment because you believed it was not broken. Your employer may claim that you broke your arm during an extracurricular activity outside of work, and thus deny your claim for benefits.
Your Workers’ Compensation benefits can also be denied if you have a non-compensable injury. This type of injury could be for a stress-related illness, such as depression or anxiety. These conditions are hard to justify as work-related injuries, because there are so many factors that contribute to these conditions, including divorce, family problems, or caring for a disabled relative.
Wage benefits will be denied for claims where no medical treatment was required. All injuries need to be substantiated by a medical professional. Denial can also happen when there is insufficient evidence to support that the injury was work-related or requires time off from work to heal.
A New Jersey Workers’ Compensation lawyer can help you gather the evidence you need to support your claim.
New Jersey Workers’ Compensation Lawyers at the Law Office of Mark S. Nathan Help Injured Workers Claim Compensation
If you have suffered a work-related injury, or have been diagnosed with a medical condition directly related to your job, you may be entitled to compensation. Call the New Jersey Workers’ Compensation lawyers at the Law Office of Mark S. Nathan at 856-232-5559 or contact us online to schedule a consultation today. Our offices are conveniently located in Blackwood, New Jersey and serve clients throughout the state.