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Work Related Injuries: Know Your Rights and Your Options
If you have sustained a work related injury, you are entitled to certain rights and benefits under New Jersey workers compensation laws. You may also have the right to pursue a claim against a third party, other than your employer, if they were negligent and caused your injuries.
Workers compensation is insurance paid for by your employer, starting with your first day of work, to compensate you when you get injured on the job site or in the course and scope of your employment. Workers compensation benefits include:
Workers compensation law can be complex. Knowing what to do as soon as you are injured protects your rights and maximizes your benefits under New Jersey workers compensation laws. All NJ employers, not covered by Federal programs, must have workers’ compensation coverage or be approved for self-insurance.
An injured employee will receive benefits from the workers compensation insurance company regardless of who was at fault. The insurance company will direct the injured worker to an authorized medical provider for treatment. If time out of work extends beyond 7 days, they will also provide the injured worker temporary disability benefits during the period of rehabilitation.
OBTAIN THE NECESSARY AND APPROPRIATE MEDICAL TREATMENT
All necessary and reasonable medical treatment, prescriptions and hospitalization services related to the work injury are paid by the employer's insurance carrier or directly by the employer if they are self-insured. The employer has the right to designate the authorized treating physician for all work related injuries. Only in the situations where the employer inappropriately refuses to provide medical treatment or if an emergency exists, may the injured worker choose the treating physician.
If the workers compensation insurance carrier determines that you have reached maximum medical improvement it may cut off your medical treatment. You do not have to accept this decision. If the insurance carrier cuts off your medical treatment, you may file a Motion for Medicals and Temporary Benefits and have a Judge in the Workers Compensation Court determine if you need additional medical treatment.
TEMPORARY DISABILITY BENEFITS
If you are temporarily disabled and unable to work from your injury for a period of more than seven days, you will be eligible to receive temporary total benefits at a rate of 70% your average weekly wage, not to exceed 75% of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20% of the SAWW. These benefits are provided during the period when you are unable to work and is under active medical care.
Benefits are usually terminated when the worker is released to return to work in some capacity or if he or she has reached maximum medical improvement (MMI). MMI is a term that is used when additional treatment will no longer improve the medical condition of the injured worker. Again, you do not have to accept this decision. If the insurance carrier cuts off your temporary disability benefits, you may file a Motion for Medicals and Temporary Benefits and have a Judge in the Workers Compensation Court determine if you are entitled to additional temporary disability.
FILING A CLAIM FOR A PARTIAL PERMANENT DISABILITY AWARD
In addition to temporary disability payments, an injured worker is usually entitled to a partial permanent disability settlement at the conclusion of treatment and temporary disability. The injured worker also has the option of filing a Claims Petition in Workers Compensation Court, within the statutory time period. A Claims Petition must be filed within two years of the date of injury or the date of last payment of compensation, whichever is later. Medical treatment authorized by the employer is considered a payment of compensation.
The majority of Claim Petitions are settled by mutual agreement as to the amount of benefits due and extent of disability. The first hearing before a judge of compensation is typically held within six months from the date of filing. Cases are usually assigned to a district office by either the county of residence of the injured worker, or if the worker lives out of state, the county where the employer is located. If the issues cannot be resolved during the pretrial stage, a trial commences with the taking of testimony of the injured worker, medical and lay witnesses. At the conclusion of trial, the judge renders a decision based upon the relevant evidence surrounding the case.
When a job related injury or illness results in a partial permanent disability, benefits are based upon a percentage of certain "scheduled" or "non-scheduled" losses. A "scheduled" loss is one involving arms, hands, fingers, legs, feet, toes, eyes, ears or teeth. A "non-scheduled" loss is one involving any area or system of the body not specifically identified in the schedule, such as the neck, back or shoulder. These benefits are paid weekly and are due after the date temporary disability ends.
Sometimes when a work injury or illness prevents a worker from returning to any type of gainful employment, he or she may be entitled to receive permanent total disability benefits. These weekly benefits are provided initially for a period of 450 weeks. These benefits continue beyond the initial 450 weeks provided that the injured worker is able to show that he or she remains unable to earn wages.
WHAT TO DO IF YOU ARE INJURED
You should notify your employer as soon as possible. The notice may be given to your supervisor, personnel office, or anyone in authority at your place of business. Notice does not have to be in writing. If you need medical treatment, a request should be made to your employer as soon as possible.
You should know that it is against the law for an employer to discharge or discriminate against an employee because the employee claimed or attempted to claim workers' compensation benefits or because the employee testified or is about to testify in a workers' compensation matter.
Workers compensation is insurance paid for by your employer, starting with your first day of work, to compensate you when you get injured on the job site or in the course and scope of your employment. Workers compensation benefits include:
- Temporary Disability Payments
- Permanent Disability Settlements
- Current medical expenses and hospital bills
- Future medical expenses
- Medically necessary treatment
- Physical therapy and orthopaedic treatment
- Prescriptions
- Lost wages
- Lump sum settlement
Workers compensation law can be complex. Knowing what to do as soon as you are injured protects your rights and maximizes your benefits under New Jersey workers compensation laws. All NJ employers, not covered by Federal programs, must have workers’ compensation coverage or be approved for self-insurance.
An injured employee will receive benefits from the workers compensation insurance company regardless of who was at fault. The insurance company will direct the injured worker to an authorized medical provider for treatment. If time out of work extends beyond 7 days, they will also provide the injured worker temporary disability benefits during the period of rehabilitation.
OBTAIN THE NECESSARY AND APPROPRIATE MEDICAL TREATMENT
All necessary and reasonable medical treatment, prescriptions and hospitalization services related to the work injury are paid by the employer's insurance carrier or directly by the employer if they are self-insured. The employer has the right to designate the authorized treating physician for all work related injuries. Only in the situations where the employer inappropriately refuses to provide medical treatment or if an emergency exists, may the injured worker choose the treating physician.
If the workers compensation insurance carrier determines that you have reached maximum medical improvement it may cut off your medical treatment. You do not have to accept this decision. If the insurance carrier cuts off your medical treatment, you may file a Motion for Medicals and Temporary Benefits and have a Judge in the Workers Compensation Court determine if you need additional medical treatment.
TEMPORARY DISABILITY BENEFITS
If you are temporarily disabled and unable to work from your injury for a period of more than seven days, you will be eligible to receive temporary total benefits at a rate of 70% your average weekly wage, not to exceed 75% of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20% of the SAWW. These benefits are provided during the period when you are unable to work and is under active medical care.
Benefits are usually terminated when the worker is released to return to work in some capacity or if he or she has reached maximum medical improvement (MMI). MMI is a term that is used when additional treatment will no longer improve the medical condition of the injured worker. Again, you do not have to accept this decision. If the insurance carrier cuts off your temporary disability benefits, you may file a Motion for Medicals and Temporary Benefits and have a Judge in the Workers Compensation Court determine if you are entitled to additional temporary disability.
FILING A CLAIM FOR A PARTIAL PERMANENT DISABILITY AWARD
In addition to temporary disability payments, an injured worker is usually entitled to a partial permanent disability settlement at the conclusion of treatment and temporary disability. The injured worker also has the option of filing a Claims Petition in Workers Compensation Court, within the statutory time period. A Claims Petition must be filed within two years of the date of injury or the date of last payment of compensation, whichever is later. Medical treatment authorized by the employer is considered a payment of compensation.
The majority of Claim Petitions are settled by mutual agreement as to the amount of benefits due and extent of disability. The first hearing before a judge of compensation is typically held within six months from the date of filing. Cases are usually assigned to a district office by either the county of residence of the injured worker, or if the worker lives out of state, the county where the employer is located. If the issues cannot be resolved during the pretrial stage, a trial commences with the taking of testimony of the injured worker, medical and lay witnesses. At the conclusion of trial, the judge renders a decision based upon the relevant evidence surrounding the case.
When a job related injury or illness results in a partial permanent disability, benefits are based upon a percentage of certain "scheduled" or "non-scheduled" losses. A "scheduled" loss is one involving arms, hands, fingers, legs, feet, toes, eyes, ears or teeth. A "non-scheduled" loss is one involving any area or system of the body not specifically identified in the schedule, such as the neck, back or shoulder. These benefits are paid weekly and are due after the date temporary disability ends.
Sometimes when a work injury or illness prevents a worker from returning to any type of gainful employment, he or she may be entitled to receive permanent total disability benefits. These weekly benefits are provided initially for a period of 450 weeks. These benefits continue beyond the initial 450 weeks provided that the injured worker is able to show that he or she remains unable to earn wages.
WHAT TO DO IF YOU ARE INJURED
You should notify your employer as soon as possible. The notice may be given to your supervisor, personnel office, or anyone in authority at your place of business. Notice does not have to be in writing. If you need medical treatment, a request should be made to your employer as soon as possible.
You should know that it is against the law for an employer to discharge or discriminate against an employee because the employee claimed or attempted to claim workers' compensation benefits or because the employee testified or is about to testify in a workers' compensation matter.