Injury must occur while working • An injury must arise out of and in the course of employment to be a workers’ compensation case in New Jersey. This means you must have been injured while on the premises, or if off premises, in the direct performance of your duties on a trip for work. There are exceptions, but they are few. Seek counsel if you have questions!
• Purely personal conditions or injures may NOT be compensable. If you set fire to your hair with a cigarette, sitting at your desk, the Supreme Court of New Jersey has termed that a purely personal risk and injury, not ordinarily subject to workers’ compensation. Report your accident at once • If you are injured in the course of your employment, report it immediately. Don’t wait to see if it clears up on its own. Make a report to your employer, to a person responsible for taking that report. Don’t just mention it to a foreman or secretary. Find out who takes injury reports, and make a formal report. Be specific.
• Your injury must be reported to your employer within ninety days, or it can be barred. You must file a formal claim petition with the State within two years of your last payment of compensation for your claim (medical, temporary disability or permanency) or your rights will be barred. Workers Compensation carrier information • Your job has a legal duty to prominently post the identity of the workers’ compensation insurance carrier on the premises. Take note. If your employer will not report your injury, report it yourself. You are protected from retaliation by Statute (34:15-39.1) and anyone who testifies for you, in support of your claim, is also protected by that law. Medical Treatment • Seek medical treatment at an emergency room if your employer will not direct you to a company physician. Take great care to inform the ER staff that you were injured at work, and precisely how you were injured. Records cannot be corrected once an error or omission occurs.
• Your company has the right to direct your medical treatment, but that is secondary to their duty to provide you with treatment. The company doctor is YOUR doctor, and must treat you like any other patient.
• The company may send a nurse to your medical appointments. Demand that the nurse stay outside, and demand that you be part of any discussions with the doctor. The doctor is YOUR doctor, and has a physician patient relationship with you. It is NOT appropriate for your doctor to talk to other people about your case, without informing you.
• Do not fill out long forms, questionnaires, or releases for your entire life of medical treatment simply because you are told to do so. Filing a workers’ compensation claim does not waive all of your privacy rights. Consult a lawyer before giving up your privacy!
• You do not have a right to a second opinion under New Jersey law. A lawyer, however, can usually negotiate for a second opinion, or send you for a second opinion and file a Motion to force the insurance company to treat you more adequately. Temporary disability benefits • You are owed 70% of your wages as temporary disability while you are certified as unable to return to work by your authorized physician, and under curative treatment. There is an annual maximum. There is a legal minimum, adjusted annually. Insurance companies often miscalculate this rate. Only your lawyer can help you get the correct rate.
• Your employer must offer you light duty if you are returned to light duty by your doctor while under treatment. If they do not, or offer you light duty inappropriate to your condition, they must pay you to stay out. Monetary compensation at the end of your case • You have the right to money for your injuries if they are permanent and cause anything more than an absolutely minimal disability. Scars, hearing loss, vision loss, breathing problems, and many other occupational diseases are covered by workers’ compensation. A specialist in workers’ compensation can advise you as to how to recover money for your injuries.
• Counsel fees in workers’ compensation cases are set by the Judge, and ordinarily, your employer ends up paying most of the fee. Medicare, Medicaid, Social Security Disability, private health insurance • Workers’ compensation is complicated: It involves Medicare, Medicaid, and potential problems with your health insurance, if bills are misdirected. Only someone who really knows the system can prevent interruption of your other benefits, or liens on your case. Final words • Get help early. Don’t wait until you fall behind on your bills because of late payments. Don’t wait for unpaid bills to harm your credit rating. And above all, do not let two years pass before filing the paperwork that keeps your case alive.