An employee is entitled to three basic entitlements under New Jersey Workers’ Compensation law. They are entitled to medical treatment, temporary disability benefits, and if a permanent injury is sustained, a permanency award.
The insurance company is not required to advise you about your right to pursue a permanency award and they often do not. However, this is an additional benefit and additional money that you are entitled to after you have sustained a work accident that causes permanent residuals.
In terms of exercising those rights, the way you go about doing that is filing a claim petition with the NJ Division of Workers’ Compensation, so the court can have jurisdiction to hear your matter.
Without the filing of a claim petition, the matter is essentially between you and your employer or their insurance company. Frequently, if there is inadequate medical treatment being provided by the insurance company, you have the right to challenge the treatment that has been provided by filing a motion for medical treatment with the workers’ compensation courts.
This would get your matter in front of a judge. The same goes if they are not paying you temporary disability benefits. You have the right to go before a judge to seek any benefits that are not being provided.
You are not entitled to a jury in a workers’ compensation claim. It is solely an administrative proceeding where the judge is the finder of fact and makes all legal conclusions in your case.
If you have received all medical treatment and temporary disability benefits and have suffered some permanent residuals, which is a fluid concept, you would then have the right to pursue what we call a permanency award and that is additional monetary benefits you are entitled to under New Jersey Workers’ Compensation law.
Will I Be Able To Choose My Own Doctor For My Work-Related Injury?
Unfortunately, you are not able to choose your own doctor in New Jersey for work-related injuries. The insurance company or your employer has the right to designate which doctor will provide treatment for you.
The doctor needs to be qualified to provide that treatment, but you cannot go out on your own and expect the insurance company to pay for a treatment that they have not authorized. If you go and get that unauthorized treatment, you could be stuck for the medical bills.
If you use your private health insurance and your private health insurance later determines that it is a work-related condition, they could charge back any money they paid or deny payment of anything that is related to workers’ compensation under their policy.
It is important that any injured worker goes to a doctor who is designated by the insurance company. If you’re not satisfied with the treatment that is being provided, the treatment is inadequate, or the claim has been denied, that is a different situation because you may be able to file a motion with the court to get the judge to order the insurance company to send you to a different doctor for additional treatment.
You would normally do this through your attorney, who would get the necessary medical evidence or opinion evidence from a treating physician or an examining physician, who would write a report in furtherance of your application with the court to change medical providers.
In certain circumstances where the insurance company has denied the claim and there has been a demand for treatment, you may be able to go out and get the treatment on your own and have a judge decide later in your case whether your treatment was for a work-related injury.
In any case, you always have to demand medical treatment from your employer or workers’ compensation carrier in order to approach it correctly.
How Do I Get Paid When I Am Treating For My Work Injury And My Doctor Instructs Me To Stay Off Work?
You are entitled to temporary total disability benefits from the workers’ compensation insurance company if you have been out of work for seven days. The amount you are entitled to is based upon your earnings before the injury.
It is 70% of your gross weekly wage, but that is subject to a statutory cap set by law. If someone is a high-income earner and they get hurt, they would only be entitled to that maximum amount provided by law.
It must be a doctor designated by the insurance company who deems you unable to work and the doctor has to provide a work script that you are unable to work because of your injuries.
When those conditions have been met, you would be entitled to those weekly benefits until you are discharged from the care of the doctor or the doctor returns you to work, either light duty or full duty.
If you are returned to work in the light-duty capacity by the doctor, you have an obligation to report the return-to-work restrictions to your employer. If your employer can accommodate the work restrictions, you must return to work. I
f the employer cannot accommodate the work restrictions, you are entitled to continuing temporary disability benefits until a doctor has discharged you from care. When you are discharged from care, your temporary disability benefits will stop.
Can I Sue My Employer If My Work Injuries Were Caused By My Employer’s Negligence?
When you file a workers’ compensation claim, you are not suing your employer. When the law was designed, it was in exchange for the injured worker giving up the right to sue their employer.
Even if a co-worker causes your injury or your employer is negligent and there is a hazardous condition due to that negligence, you are limited only to workers’ compensation benefits.
The only exception to that is if your employer intentionally caused you injury, which is a very difficult legal standard to meet.
What If My Work Injury Was Caused By A Co-Worker Or Someone Other Than My Employer?
If your injury was caused by a third party, you may not be limited to workers’ compensation benefits. You may also have a third-party case against someone other than your employer or co-workers.
For instance, if you are working as a delivery driver and get into a car accident caused by another driver, you have a workers’ compensation claim as well as a potential lawsuit against the driver of the vehicle.
We are always looking to see if there is a potential for a third-party lawsuit in all workers’ compensation claims. Frequently, on construction sites, there are multiple subcontractors present.
A carpenter may inadvertently be injured by someone working as an iron worker and if the iron worker is negligent, the carpenter may have a potential lawsuit against the iron worker’s employer, in addition to New Jersey workers’ compensation benefits.
For more information on Employee’s Rights In The State Of New Jersey, an initial consultation is your next best step. Get the information and legal answers you are seeking by calling (908) 200-2297 today.