An injury at work can greatly impact your livelihood and the financial stability of your family. Fortunately, workers’ compensation laws may allow you to receive certain benefits to help cover the costs of medical care, disability benefits, lost wages and even death benefits.
Whether you or a loved one has suffered a work-related injury or illness, the New Jersey workers’ compensation lawyers at Kemeny, Ramp & Renaud, LLC are prepared to assist you through the process.
Who is Covered by Workers’ Compensation?
Workers’ compensation is a no-fault insurance program that provides benefits for medical care, lost wages and permanent disability for workers who suffer job-related injuries or illnesses. Death benefits are also available in situations where a worker is killed on the job.
Under this program, compensation benefits are available regardless of who caused or contributed to the accident. However, this also means that workers forfeit their right to file a personal injury lawsuit against their employer for pain and suffering or other damages unless the case involves intentional acts.
The Division of Workers’ Compensation is responsible for administering the New Jersey Workers’ Compensation Act (N.J.S.A. 34:15-1 et seq.). This legislature enforces the law that requires employers to purchase workers’ compensation insurance and ensures workers receive fair and timely benefits.
Employers are required to post information about their workers’ compensation insurance in a visible location. They must also establish clear procedures for employees and managers for handling workplace injuries and workers’ compensation benefits.
Benefits Available for Work Injury Victims
Obtaining medical care for a job-related injury or illness can be costly and cause unwanted stress. Reasonable medical expenses for necessary services are covered under workers’ compensation, such as:
• Hospital care, including in-patient stays
• Doctor visits
• Prescription medications
• Physical therapy
• Medical equipment
The employer or its insurance company has the right to designate medical providers for work-related injuries. If you are treated by another doctor without permission, your medical bills may not be covered.
Temporary Total Disability Benefits
Injured workers who are disabled and unable to work for more than seven days may be able to receive temporary total disability benefits to replace lost wages. These benefits help pay for 70 percent of the worker’s average rate of pay up to a maximum amount as established by the Commissioner of Labor and Workforce Development.
Temporary total disability benefits are also provided until a doctor releases you to return to work, you reach maximum medical improvement, meaning that no additional treatment will aid your injury or illness, or you reach the maximum amount of time for these benefits at 400 weeks.
Permanent Partial Benefit
If a job-related injury or illness causes permanent injury, a worker may be able to receive benefits based on his or her functional loss. New Jersey has a schedule of disabilities that list the maximum benefits for impairments for certain body parts. A scheduled injury could include eyes, hands, arms, legs and feet while a nonscheduled injury could involve other body parts or organs (heart and lungs). These benefits begin after temporary benefits end and are paid on a weekly basis.
Permanent Total Benefits
Workers who are permanently disabled by a workplace injury or illness and cannot return to work may be eligible for permanent total benefits, which pay 70 percent of the worker’s average rate of pay up to the maximum allowable benefit. These benefits are available for 450 weeks but may be extended if the individual remains totally disabled. To extend your benefits, you would have to be evaluated and prove that you had were still unable to work.
When an injury or illness results in a fatality, death benefits can be paid to the surviving spouse, children or other eligible dependents up to a certain limit. Up to $3,500 in funeral and burial costs must be paid by the worker’s employer. For one dependent, these benefits are generally 50 percent of the deceased worker’s wages. The compensation rate increases by five percent for every additional dependent up to 70 percent of the deceased worker’s wages for a maximum of 450 weeks from the date of death.
Injuries Suffered While Working Offsite
New Jersey provides workers’ compensation benefits to workers who sustain injuries as a result of an accident arising out of and in the course of employment. This means that you must be at work and performing your assigned job duties, not driving to or from your workplace.
However, there are exceptions for when a worker may be eligible for benefits if an accident occurred away from the workplace, such as if a job or assignment required travel. This could include commuting for a business meeting or riding in a vehicle contracted, leased or owned by the employer as a condition of your employment.
If you have encountered difficulties in recovering the full benefits you need, it is in your best interest to contact a reputable attorney. Our New Jersey workers’ compensation lawyers are experienced in helping injured workers and their families recover what is rightfully owed to them.
Seeking Additional Compensation
In some situations, it may be possible to seek additional compensation by filing a personal injury lawsuit against a third party that was at least partially responsible for your accident and injuries.
Workers’ compensation laws prevent injured employees from filing a lawsuit against their employer, but you can make a claim against any other parties that may have contributed to your injuries. This could include anyone who is not your employer or coworker, such as:
• Suppliers of dangerous products
• Vendors responsible for installing or maintaining equipment
• Manufacturers of defective materials
• Other drivers in a vehicle accident
Reporting a Work-Related Injury in New Jersey
It is important to notify your employer of a work-related injury or illness as soon as possible. Notifications can be done in writing or verbally. Failure to give notice may result in you losing your rights to workers’ compensation benefits.
Once your employer receives notice of your injury, he or she is responsible for notifying his or her workers’ compensation insurer. The insurance provider will then begin its investigation into your claim to determine whether you will be awarded benefits.
If your employer disputes your injury or does not report it, you have the option to contact the workers’ compensation insurance provider directly or you could file a claim. Workers’ compensation claims in New Jersey must generally be filed within two years from the date of injury.
Can I Be Treated by My Regular Doctor?
In most situations, you are only allowed to see a doctor that your employer provides. Medical bills will be paid for as long as the treatment is approved. Unauthorized treatment could include:
• Visiting your regular or family doctor
• Visiting a specialist without a referral from an authorized doctor
• Visiting any other doctor not recommended by your employer
• Receiving a second opinion without prior approval from your employer
Only certain circumstances would allow you to seek necessary medical care from any doctor you choose and still get reimbursed for the cost, such as when your employer neglects or refuses to provide services that are reasonable and necessary to help relieve you from an injury or treat an illness.
Appealing Denied Workers’ Compensation Claims
Although filing a claim for New Jersey workers’ compensation seems like a straightforward process, it does not always proceed as it should. Your employer or its insurer may attempt to claim that your injuries did not happen while at work or that they are not as serious as you claim. When this happens, you have the right to appeal a denied workers’ compensation claim.
The Division of Workers’ Compensation has two avenues for an appeal: a formal and informal hearing. An informal hearing is a more expedited process. An Application for an Informal Hearing must be submitted. The case would be assigned to a judge and a hearing date set within weeks. The judge would assess all of the evidence before making a recommendation. If a dispute is not resolved, you may request a formal hearing.
For a formal hearing, a Claim Petition form must be filed within two years from the date of your injury or the date you last received compensation from the insurance provider, whichever comes later. The case would be assigned to a judge and a hearing date set within six months. The hearing would be similar to a trial, with both sides presenting evidence and having witnesses testify. The judge would then issue a written decision.
If the decision is not favorable, you may appeal to the state courts of New Jersey in the Appellate Division of the Superior Court. Our lawyers are ready to help you with the appeals process should your claim have merit.
Types of Workplace Accidents and Injuries
Some of the most common claims for workers’ compensation include injuries such as:
• Injuries from repetitive movements
• Warehouse, manufacturing and industrial accidents
• Sprain and strain injuries
• Broken bones
• Spine or back injuries
• Traumatic brain injuries
• Exposure to toxic chemicals
Some workers may have an increased risk for developing an occupational disease, such as carpal tunnel syndrome or heart disease. In other industries, there is also a higher risk of developing certain conditions, such as cancer or mesothelioma, when exposed to hazardous substances over a long period of time.
At Kemeny, Ramp & Renaud, LLC, we are committed to protecting injured workers’ rights and complete compensation if they have been injured while at work. Contact Kemeny, Ramp & Renaud, LLC to learn more about the legal services offered by our workers compensation attorneys.