Workers' Compensation: Employees

New Jersey has a workers’ compensation system that covers employees’ medical costs – including physician care, surgery, prescribed medications, and rehabilitation through approved providers – and lost wages as a result of workplace injuries or illnesses. Compensation for lost wages is also referred to as temporary or permanent disability benefits. 

Temporary disability benefits are the most commonly received and are calculated at 70% of your average weekly pay. Permanent disability benefits are an additional compensation based on permanent injury or loss of function. Whether or not temporary or permanent disability will be granted depends on the strength of your case and the final decision of the court. 

The first thing to do is speak with your employer and notify them of your situation. Notifications don’t need to be in writing, but it’s always worth documenting any communication about a claim. 

Your employer would give you forms to document the event so they can file a claim with their insurance carrier. If your employer refuses to file a claim for you, you should contact an attorney immediately to file a case on your behalf.

Working with a lawyer can be extremely helpful in these types of cases, as denials can be common and the rules surrounding appeals are often complex. 

New Jersey is a no-fault state for workers’ compensation claims. That means that, when it comes to filing a claim, it doesn’t matter who or what caused the injury – you are still entitled to benefits.

Although attorneys may seem like an expense that you can’t afford when you’re strapped for cash, it’s highly advisable to retain legal counsel when you’re dealing with a workers’ compensation claim. Workers’ compensation claims are complex and insurance denials are common. Between the paperwork, legal and insurance regulations, and your own pain and suffering, you want to have an experienced attorney in your corner. 

Additionally, you may be entitled to a monetary settlement via a formal claim with the New Jersey Workers’ Compensation Courts, but this can only be filed by an attorney licensed in the state. Not filing the formal claim will impact your ability to claim compensation and may even affect your right to medical care.

At Mindas and Morris, we don’t require any upfront payment and we don’t collect any fees until your case is settled.

No, in New Jersey your employer can’t fire you because of a workers’ compensation claim or because you’re on work restriction as determined by an authorized treating physician. Your employer is legally required to accommodate those restrictions for the duration of your claim until you are released to normal work duty.

However, you aren’t protected from termination solely on the basis of being on workers’ compensation. If there were other demonstrable grounds for firing you, your employer could do so regardless of your claim. 

No. Under the Workers’ Compensation law, the insurance carrier has the right to “control” treatment. That essentially means they get to choose the treating doctors and you cannot select any doctor you would like. The trade off to this is that the insurance carrier pays 100% of the medical bills. You are not responsible for any co-pays or deductibles.

Yes and no. The answer to this question depends on your individual situation.

Yes, you can in regards to medical treatment. It’s important to know you’re entitled to medical treatment whether you’re working or not. 

However, that doesn’t mean you’re entitiled to workers’ compensation disability payments. Three are three main situations involved in this scenario: 

1) If a doctor, approved the insurance carrier, determines you are unable to work due to your injuries and keeps you out of work for 7 days or more. In that situation, you are entitled to workers’ compensation disability payments. The payments are equivalent to 70% of your gross weekly wage. If you are receiving disability payments, you cannot work. 

2) If a doctor, approved by the insurance carrier, determines you are able to returnt o work full duty. In that situation, you will not receive any disability payments. 

3) If a doctor, approved by the insurance carrier, determines you are able to return to work but only on light duty. In that situation, if your empoyer can accomodate your light duty restrictions, you will not receive any disability payments. If your employer cannot accomodate your light duty restrictions and you are out of work for 7 days or more, you will receive disability payments. 

In New Jersey, all employers must have workers’ compensation insurance for their employees. If you find that your employer doesn’t have insurance, the State of New Jersey established the Uninsured Employees Fund (UEF) to provide benefits to those employees. 

There are lots of reasons why employers deny workers’ compensation claims. An experienced lawyer can help you determine the cause of the denial and what steps to take next to get your benefits.