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An injured worker is obligated to immediately report their injury to their employer. The employer is then obligated to file a “First Report” with the insurance company. The employer is also then required to provide medical treatment for the employee. The employer, through their insurance company, pays 100% of the medical treatment. The employee, however, must go to the doctor or other health care provider chosen by the employer. If the employee chooses to go to his own doctor, he will be obligated to pay for that medical treatment.
Workers’ Compensation is handled by an Administrative Judge. Claims are filed with the Department of Labor and are assigned a Claim Petition (CP) Number. The claims are then assigned to a Judge in the county where the employee resides.
An injured worker does not have to prove anyone was at fault to obtain workers’ compensation insurance benefits. He or she must show that the injury or illness was related to job duties.
Workers’ Compensation covers all injuries that arise out of or in the course of the worker’s employment. These can include specific accidents caused by lifting, motor vehicle accidents or fall down on the job. They may include exposure to chemicals, toxic fumes or other hazardous or dangerous substances.
Injuries may occur traumatically or be the result of continued and overuse of a body part over time. Injuries can be as minor as having a splinter from working in a lumber yard or as severe as an amputation of an arm or leg. Injuries can also be emotional as well as physical.
If an employer refuses to provide medical treatment, the injured worker has the option to file a Motion for Medical and Temporary Disability Benefits with the Court. That motion, accompanied by a Certification of the injured worker and medical report from an expert, will be evaluated by a Judge. The Respondent, or employer, will also be able to provide evidence, including medical expert evidence, as to whether the injury arose out of and in the course of employment and whether or not there is a need for treatment. If the parties cannot resolve the issues, a Judge of compensation will hear testimony from both the injured worker, possibly co-workers and the medical experts before determining whether or not a claim exists and treatment is necessary.
The cost of the medical experts and treatment that the employee may receive without consent, due to the need for treatment that has been denied by the employer, shall be paid by the employer if the claim is successful. All attorneys’ fees that would be due as a result of a successful motion will also be paid by the employer. If the claim proves unsuccessful, there will be no attorney’s fees and the employee is responsible for paying the medical costs incurred.
While you’re entitled to receive workers’ compensation benefits after being injured on the job, the filing process is very complicated and you must deal with a lot of paperwork and red tape before you actually receive your benefits. In an effort to reduce the amount of money paid to injured workers, insurance companies will often try to unfairly deny your claim. You’ll need an experienced New Jersey workers’ compensation lawyer on your side to make sure you receive the benefits to which you’re entitled.
To learn more about the circumstances of filing a workers’ compensation claim, contact a family law attorney at the Law Offices of Jeffrey M. Bloom in West New York. We have been helping people devise solutions to sensitive and difficult legal problems since 1988, serving north Jersey communities such as Ridgewood, Englewood and Fort Lee. Call (855) 208-3650.