If you have been hurt or suffered an illness on the job in New Jersey, you have the right to seek workers’ compensation benefits to pay for your medical bills and replace a portion of your lost income. You may also be eligible to pursue a third-party liability claim against a non-employer, non-co-worker who caused your harm.
To help you understand your rights and options, the lawyers of Davis, Saperstein & Salomon, P.C., present the following answers to frequently asked questions about workers’ compensation claims in New Jersey.
In order to discuss the unique facts in your case, contact us today. We will provide a free consultation at our office, the hospital or your home. We can also meet by phone, Skype, FaceTime or GoToMeeting – whichever is most convenient for you.
Most people who are employed in New Jersey are covered by workers’ compensation insurance, which pays benefits for job-related injuries, illnesses or death. But obtaining workers’ compensation can be a complicated process.
An employee or a deceased worker’s dependents are eligible for workers’ compensation benefits for an employment-related injury or a worker’s death – regardless of who is at fault.
If you are injured on the job, you should inform your employer, supervisor or human resources office as soon as possible. If medical treatment is necessary, your employer may select the treating doctor.
Your employer’s workers’ compensation insurance carrier will investigate the claim and make a decision about your eligibility for workers’ compensation benefits.
If your claim is denied or if you disagree with the amount of the benefit provided, you have a right to file a claim with the New Jersey Division of Workers’ Compensation and request a hearing. This is the first of several levels of appeal that are available to you.
Appealing the decision in a disputed workers’ compensation claim requires compiling evidence and refuting claims made by your employer against you or your claim. This is the work an experienced New Jersey workers’ compensation attorney can do for you.
All New Jersey employers are required to carry an insurance policy that provides workers’ compensation benefits or to have an approved self-insurance plan.
Your employer should prominently display proof of workers’ compensation insurance coverage somewhere in the workplace. It is often displayed in the human resources office. You can also obtain information by contacting the Compensation Rating & Inspection Bureau in Newark.
If your employer doesn’t have workers’ compensation insurance, you can file a formal claim petition seeking medical expense and temporary disability benefits from the Uninsured Employers Fund. The UEF would pursue a hearing in which a judge would penalize your employer for non-compliance and enter an order for compensation to you.
Upon application by your workers’ compensation attorney, the UEF is to pay the temporary disability benefits and medical expenses included in the judge’s order.
New Jersey workers’ compensation benefits include repayment of medical expenses, payments to cover a portion of lost wages or salary or a death benefit to immediate family members of a worker who dies from a job-related accident, injury or illness.
Workers’ compensation is a no-fault insurance program. An injured worker is entitled to benefits regardless of who was at fault.
Medical benefits are to pay for all care related to the worker’s occupational injury or illness, including doctor’s visits, hospital stays, surgery and its associated costs, prescriptions, rehabilitation therapy and assistive devices.
Payments for lost wages are either temporary disability benefits, permanent partial disability benefits or permanent total disability benefits. These benefits can replace a portion of your lost wages.
A death benefit includes funeral expenses and wage-loss payments to the surviving spouse and natural children (or other proven dependents) that were a part of a deceased worker’s household at the time of death.
An employer should notify its workers’ compensation insurance carrier immediately when informed that an employee has been injured in an accident. If the employer refuses to take that step, the worker should seek the services of a New Jersey workers’ compensation attorney right away.
An injured worker can file either an application for an informal hearing or a formal claim petition with the Division of Workers’ Compensation.
Either way, if you file a claim, you would be best served to hire an experienced lawyer to represent you. After all, if your employer has refused to report your injury, it is likely they will dispute your claim.
My employer claims I am not entitled to workers’ compensation insurance. Is there anything I can do about this?
Disputes about workers’ compensation claims are not uncommon. Your employer has incentive to dispute your claim for benefits.
Employers pay for workers’ compensation claims through insurance policies. Payouts result in higher premiums. So, a smaller payout is less expensive for your employer in the long run.
Sometimes, an employer will deny an employee’s injury or illness was work-related. Disputes may also arise about the type of medical care the employee should receive. The employer may argue for the employee to return to work faster so disability benefits will end.
When there is a dispute about entitlement to workers’ compensation benefits, the New Jersey’s Division of Workers’ Compensation provides an impartial forum to mediate and, if necessary, make a judicial decision about the worker’s eligibility for benefits.
Your employer’s insurance company will most likely provide a lawyer to argue against your claim and defend your employer’s (and the insurer’s) financial interests. You should hire an experienced NJ workers’ compensation lawyer to protect your interests.
If you miss a week of work because of your job-related injury, you should be able to obtain temporary disability benefits through workers’ compensation insurance. You may qualify for other benefits regardless of work time lost.
In New Jersey, an injured worker must be unable to work for seven days (including weekends and holidays) before being eligible for temporary disability benefits. The benefits are then retroactive to the date of the injury. The days of missed work do not have to be consecutive.
It typically takes two weeks to begin to receive temporary disability benefits. Your employer may delay your claim for an unreasonably long time (more than 30 days). If so, the employer may need to pay an additional 25 percent of the amount it owes to you.
There is no minimum out-of-work time necessary to receive medical benefits. You should be able to make a claim and receive these payments regardless of how long you were out of work for your injury.
Unfortunately, there is little you can do about seeing your employer’s or insurance carrier’s chosen doctor. But, you are not totally stuck with that doctor.
Under New Jersey law, the employer has the legal authority to choose the health care providers for an injured worker who is making a workers’ compensation claim. You must see this provider as directed and follow their instructions, or you could jeopardize your claim.
You can still see another doctor of your own choice. This may be of comfort to you if you have a family doctor or someone you normally see. Getting a second opinion is also an option if the physician your employer sends you to provides a diagnosis that you disagree with.
For example, the insurer’s doctor may release you to return to work before you or your doctor think you are ready.
With a second doctor’s opinion, you could dispute a release to return to work, which would end your temporary disability payments for lost salary or wages.
If the employer refuses to provide medical services necessary to treat your injury or disease, you could seek a court order forcing the employer to pay for benefits. These cases are given priority because of the urgency of receiving medical attention. They are scheduled for a hearing within 30 days of the filing of a motion.
A workers’ compensation claim petition must be filed within two years of the date of injury or the last payment of compensation, whichever is later. Missing a deadline could terminate your claim and opportunity to obtain benefits.
In cases of work-related disease or occupational illness, such as mesothelioma or lead poisoning, the claim petition must be filed within two years of when the worker became aware of the condition and its link to employment.
Workers’ compensation cases are usually assigned to the district office based in the county of residence of the injured worker. If the worker lives out of state, the case is assigned to the county of employment.
New Jersey’s District Offices are:
- Hackensack – Bergen County
- Paterson – Passaic County
- Newark – Essex County
- Jersey City – Hudson County
- Elizabeth – Union County
- New Brunswick – Middlesex County
- Arlington – Sussex, Morris and part of Warren County
- Atlantic City – Atlantic and Cape May County
- Bridgeton – Cumberland and Salem County
- Camden – Camden and Gloucester County
- Freehold – Monmouth County
- Lebanon – Somerset, Hunterdon and part of Warren County
- Mount Holly – Burlington County
- Toms River – Ocean County
- Trenton – Mercer County
Hiring an experienced and knowledgeable New Jersey workers’ compensation attorney as soon as possible after a workplace injury can help ensure that all required forms are filed and that you meet all deadlines of the claims process.
Can an employer terminate an injured worker while he or she is out of work and receiving workers’ compensation?
Termination of employment is not legal. Employees in New Jersey have rights against retaliation for seeking workers’ compensation benefits.
If you believe you were terminated in retaliation for claiming workers’ compensation benefits or because of your disability, you may file a complaint against your former employer with the NJ Division of Workers’ Compensation.
If you prevail, the law provides for restoration of your job and payment of lost wages. But you must be ready and able to perform the duties of your job again.
You may also have a legal claim under the Americans with Disabilities Act (ADA) or a CEPA (Conscientious Employee Protection Act or “whistleblower”) claim.
A New Jersey personal injury lawyer who is knowledgeable about workers’ compensation claims can assist you if you are actually the target of retaliation because of your workers’ compensation claim.
I’m receiving workers’ compensation payments for a jobsite injury. Can I file a lawsuit against my employer to recover additional compensation?
By accepting workers’ compensation benefits, you have agreed to not sue your employer for causing your injury. But, if your employer’s egregious conduct caused your injury, you might have a claim. There may also be others who can be held liable for your injuries.
New Jersey law says that employers who pay injured workers’ medical bills and compensation for lost wages will not be subjected to legal claims for additional recovery.
But if an employer acts with an intent to injure or a substantial certainty of injury, like removing safety guards from dangerous machinery or ordering an employee to do something more dangerous than their normal job duties, then an employee may be able to bring a direct claim for money damages against their employer.
An injured worker can also bring a civil lawsuit against a third party that contributed to their work-related accident.
For example, a subcontractor on your job site would not be protected if they caused your injury because they are not your employer. Or if a flaw in a piece of equipment or machinery caused the accident that injured you, the manufacturer might be liable in a third-party dangerous and defective products claim.