Skip to main content
Samuel Michael Gaylord
Avvo
Pro

Samuel Gaylord’s Answers

44 total


  • Workers compensation for a two-level fusion.

    I got hurt at work on November 2014. I had a two level fusion done in April 2015 after going through every step possible before surgery. I just want to know why I would need a lawyer, what a layer would do for me, and some other advice.

    Samuel’s Answer

    As you have been injured at work you are automatically entitled to three main benefits. You are entitled to medical care which is paid for by the insurance carrier. If you were to receive a bill in the mail from authorized treatment you would give that to your lawyer and they would make sure the bill gets paid. Workers compensation provides automatic medical coverage at no expense to you. Second i presume you are out of work. If this is the case and if you work for a private company then the carrier will be paying you 70% of your gross weekly wage. An attorney would be able to confirm that you are being paid at the correct rate. You will receive this benefit until such time as the doctor indicates that you are released to return to work. The doctor can say light duty but if your job indicates there is no light duty then you would still receive your temporary disability benefit. An attorney would be able to make sure you receive the appropriate benefits. If you work for a public entity your benefits may be different due to specific Union Rules or collective bargaining agreements they may have with your job. The final benefit you are entitled to receive is an award for your injury. This is labeled as permanent partial disability. This would entitle you to receive money and more importantly future medical care. This final benefit and the future medical protection is the TRUE benefit to the workers compensation system and the real reason you want to acquire an attorney.
    Other advice - If you have been out of work since November i would also recommend you start the application process for Social Security benefits. SSD indicates that as long as you are out of work for at least one year you are eligible to receive benefits on top of WC benefits. If you are able to return to work then you would be entitled to what is called a closed period of benefits again on top of what WC would have paid you. Also, if you are employed by a public entity or are a policeman, fireman or teacher you may also be eligible for pension benefits if you can not return to your former employment. I would also advise that an attorney handling a workers compensation matter or SSD matter will not receive any fee unless you get paid and therefore there is no cost to consulting with and retaining an attorney. However, i would caution that if you do you find one that specializes in these areas. You wouldn't go to your primary care doctor if you needed cardiac surgery. Same goes with what you find yourself involved with here. These are complicated legal issues that interact with one another and you want to make sure whomever you retain has experience in dealing with all of these areas.

    See question 
  • I fell from the roof of a 2 story house. I work with a gutter cleaning company. I was not given a harness or any other equipment

    I sustained a broken arm/wrist and had surgery with metal rods. I am in the hospital waiting for cats can MRI as well

    Samuel’s Answer

    As a result of your injury occurring while working you are entitled to receive workers compensation benefits. This means you are entitled to receive medical care paid for in full by the Workers Compensation insurance carrier. In addition, you are out of work and should receive 70% of your gross weekly wage tax free as long as the doctors say you cant work and need treatment. Finally you are entitled to receive an award for your injury through workers compensation. The most important thing and the reason to consult an attorney who specializes in workers compensation cases is that when your matter resolves you also are provided future benefits. This means that even after your case settles if your condition were to get worse you would have the right to re-open your matter and the insurance carrier would have to provide to you future medical treatment if the condition got worse and if there were no other reason why the condition got worse. It is this protection that you need to make sure you assert for yourself. Also, to be clear you can not sue you job. There may be other third parties who might be responsible and allow for the pursuit of a negligence lawsuit but there is no doubt you have a workers compensation case. A WC specialist will not charge for a consultation or the work that we perform. The fee is paid at the end and is 20% of the recovery with a portion of that being paid for by the workers compensation carrier.

    See question 
  • I hurt my knee at work,had surgery and p/t. After dr recommends knee replacement, company stops paying me and treatment

    my lawyer filed motion with court. work is saying that the arthritis i have now been diagnosed with is problem. never had arthritis before, my dr (which was dr work referred me to) says injury aggravated the arthritis. this is NJ. will workers...

    Samuel’s Answer

    A New Jersey work accident provides an injured worker three basic benefits. Medical care, temporary disability (which is 70% of your gross weekly wage) and an award for your injury. In order to get benefits one has to show that the work injury arose out of and in the course of your employment. Meaning, you were where you were supposed to be doing what you were supposed to do and the injury occurred due to something that was related to the employment. The issue that your attorney is confronting is of medical causation. It doesnt matter in New Jersey (for purposes of getting medical care) if you had a prior problem IF you can show that the work accident "aggravated, accelerated, or exacerbated the pre-existing problem." That language is right in the New Jersey workers compensation statute. So, being diagnosed with arthritis is irrelevant if the doctors opine that the work accident made it worse. IF that is the case then the comp carrier will have to provide medical care. Hopefully this is helpful.

    See question 
  • Can you work while collecting worker's comp in nj?

    I've been hurt on the job three times at the same job, one of the times I was told it wasn't a workers comp claim, even though I got hurt on the job. I'm no longer receiving worker's comp, but I'm in consistent pain with both knees.

    Samuel’s Answer

    The short answer to this question is NO. You can not work and collect workers compensation temporary disability benefits at the same time. You can work and have a workers compensation case and can be working and collect an award for the injury. From what you describe, you should be consulting a certified workers compensation law attorney. There are other benefits you may be entitled to as well depending on who your employer is and whether you can return to work at all.

    If you would like additional information please do not hesitate to contact us.

    See question 
  • I had open heart surgery. I was on temp. disability. It is now running out.

    I was told I can return to work, but light duty only. My company does not offer any light duty work. Can I collect unemployment till I find a new job?

    Samuel’s Answer

    If your company does not offer light duty then the workers compensation carrier will continue to pay you temporary disability benefits until such time as you are able to return to full duty. In addition, you should absolutely consult with a certified workers compensation attorney because you are also eligible for additional benefits by way of an award and if you have dependents (wife, children under 18) and god forbid something happened to you as a result of your injury they may be able to pursue dependency benefits through workers compensation. Further, if you have been out of work for a year you may also be entitled to apply for and receive social security disability benefits.

    See question 
  • Can workmans comp garnish your workmans comp check

    My husband was hit by a drunk driver while working on parkway. The driver has no insurance. my husband is receiving money from our car insurance. Workmans comp is getting 1/3 towards the lien they have on my husband. Now they are taking 2/3 of hi...

    Samuel’s Answer

    When there is a personal injury claim which comes from a work accident the law simply is saying that you cant double recover from two places for the same injury. From the way in which you worded your question, i would presume your husband is still receiving what would be called temporary disability or workers compensation benefits from the workers compensation carrier and to answer your question the carrier is entitled to be reimbursed and so the checks would be reduced 2/3. However, your husband may be entitled to receive an award through workers compensation, and if he were working on the parkway he may also be entitled to a disability pension and if he has been out of work for at least 6 months and looks like he will not return to work within one year he is also eligible to apply for Social security Disability benefits. I would strongly suggest consulting with an attorney who specializes in workers compensation and the other disability programs to get additional answers.

    See question 
  • Can I get my workers comp claim reopen and my no restriction status changed? What is the procedure? How long will it take?

    This was recent workers comp claim for a back injury. I received 12 weeks TTD. My status is now MMI no restrictions. The workers comp doctor seemed very bias and would not listen to me , He also misrepresented workers comp benefits and took advan...

    Samuel’s Answer

    It is good that you are being seen for a second opinion. However, the question i would have is the second opinion being paid for by workers compensation or are you having to go out on your own and use your own insurance. The carriers are given the right to control medical care in New Jersey and thus the doctors that injured workers are sent to are being paid by the workers compensation carriers. If you require additional medical care the carrier will have to pay for it and if the doctor takes you out of work OR says light duty and your job does not have light duty then you would receive temporary disability benefits (70% of your gross weekly wage) until the doctor again indicates that you are MMI'd. I would strongly suggest you contact a lawyer who specializes in workers compensation as soon as possible. Good Luck.

    See question 
  • Workers comp

    hi I'm having a workers comp cases once January 21 2013 Received checks from workers comp until February of last year Had unemployment benefit for six months and ended on December of last year ... On October 2014 had surgery for my lower bac...

    Samuel’s Answer

    If your surgery in Oct 2014 was work related and you were out of work again you should have been receiving workers compensation benefits. You may not be eligible to receive State TDB because when you collected unemployment you may have used up all of your benefits through that system. The best thing to do for those benefits would be to contact State TDB 609-984-4401. I would certainly get a hold of my lawyer and tell him/her what is going on and ask why you are not receiving temporary disability benefits if the authorized WC doctor has you out of work and you had authorized surgery in October. Good Luck.

    See question 
  • I need some information on collecting workers comp and SSD disability benefits at the same time

    I was injured in a work related accident on 11/2009. I have been out of work since then. I have been collecting workers comp benefits since 2009. I have had numerous back surgeries (2) , and right arm ulnar nerve damage surgery (3).I am still i...

    Samuel’s Answer

    When you are injured at work the workers compensation insurance carrier will provide three basic benefits. You are entitled to medical treatment, however the carrier gets to choose the medical doctors you will treat with, temporary disability benefits, which is 70% of your gross weekly wage but is tax free, and you are entitled to an award for your injuries. New Jersey is what as known as a reverse offset state. What this means is that while you are receiving temporary disability benefits your social security disability benefit would be reduced if the combination of both benefits exceeds 80% of your average cumulative earning as determined by Social Security. If Social security has told you there is not offset what that means is that they have done the calculation and determined that your SSD benefits do not have to be reduced. Once you are done receiving medical care and temporary disability and the WC doctors have determined that you have reached you MMI (maximum medical improvement) the workers compensation temporary disability benefit will end and if you are represented for your workers compensation matter your attorney will move to resolve your case. If your WC case settles for less than total disability what would occur is that you would receive your award and if there were a calculated offset SSD would be reduced. IF your matter would result in your receiving an award for total disability than if there is an offset your workers compensation award is reduced and your SSD benefit remains untouched. Again, if SSD has told you there is no offset thats fine but certainly i would advise your attorney that you are receiving SSD benefits not only because of the potential offset issues but because Medicare, once you are approved for it, will also need to be contacted as a result of your workers compensation case. I would certainly speak to your attorney regarding these issues.

    See question 
  • Do I have to go to work for the place where I got injured,in order for them to pay the WC bills, and can I move out of state ?

    I got hurt on the job in NJ. I need to move out of state ASAP! Can I continue my care in the other state or Will it no longer be a claim? Would W.C. pay for the care I have already had done in NJ if I do not return back to the same work place, a...

    Samuel’s Answer

    As a result of having been injured in New Jersey you are entitled to receive three specific benefits. You are entitled to receive medical care paid for by the insurance carrier, if you are out of work you are entitled to receive temporary disability benefits which amounts to 70% of your gross weekly wage until such time as you can return to work and you are entitled to receive an award for your injury. If you need to move to a different state and still need medical care the carrier is still responsible to provide that treatment to you and these benefits are provided whether you remain employed with the same employer where you were injured or not. The employment does not affect your entitlement to the three benefits. The only time you would be needed to return would be to be evaluated by experts in an attempt to resolve the claim and the exams can be coordinated so that you would only have to return one time. The rest can be done by mail. I would strongly suggest hiring an attorney who specializes in workers compensation and file a claim on your behalf prior to leaving so that the attorney can communicate with the carrier on your behalf prior to your departure. If you require any additional information please don't hesitate to visit our website.

    See question