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There’s A Dispute With My Workers’ Compensation Claim…Now What?

Dispute With My Workers’ Compensation Claim | Attorney Jeffrey M. Bloom

When there is a dispute over workers’ compensation insurance entitlement between the employer and / or the insurance carrier, the injured worker can do one of two things. First, they can choose to file an Application for an Informal Hearing. Or second, they may want to file a Claim Petition. The case will then be assigned to a judge in the district of the county where the employee worked. Should the injured worker live out-of-state, and then it would be filed where the employer is located.

Reasons For Workers’ Compensation Disputes

The reasons why a dispute may exist can be due to a number of reasons. It could be a compensability problem, which is a dispute over whether the injury was actually work related, the type of medical treatment that was given or the payment of temporary disability benefits. A claim petition may seek permanent disability benefits, or in the case of a death, which was, job related, dependency benefits.

It is possible to file a claim petition on your own, however, it is advisable to be represented by an experienced Workers’ Compensation Attorney. The insurance carrier, more often than not, has an attorney assigned to the case. If it involves a self-insured corporation, it is a requirement to obtain legal representation to defend their interests.

Informal versus Formal Workers’ Compensation Claims

An informal workers’ compensation claim is available if both parties are in agreement for this type of resolution. This is available as a means of resolving issues without resorting to a more involved and lengthy litigation process. Of course, the suggestions by the judge are not binding, and the employee has the right to file a formal claim petition within the statutory time period.

The filing of an application for an informal hearing does not halt the two-year statute of limitations from running.

A formal claim can be filed with the division within the statutory period and the first hearing before the judge is usually held within 6 months of the date of filing.

The great majority of cases are generally settled by mutual agreement. If, however, they are not, trial will commence.  At the conclusion of the trial, the judge will render a decision based on the evidence. The judges’ decision is binding, however, appealable.

Motions for Workers’ Compensation Medical and/or Temporary Benefits

In cases of the injured worker requiring prompt treatment and temporary benefits, the law does provide immediate recourse. In such a case, the worker would file a “Motion for Medical and Temporary Benefits.” With this, an initial hearing date before a Judge of Compensation would take place within a 30-day period.

It would be important to note that all New Jersey employers not covered by Federal programs have workers’ compensation coverage, or be approved for self-insurance.

Legal representation is not required, however, such legal proceedings have the potential of becoming quite involved and beyond the expertise of most individuals. Additionally, you are working under a time limit, with the statute of limitations, making it more complicated.

Contact Workers’ Compensation Attorney Jeffrey M. Bloom

Should you be facing a legal battle over your workers’ compensation and need a competent and dedicated Workers’ Compensation Attorney, contact The Law Offices of Jeffrey M. Bloom for an appointment to assist you. We welcome clients from West New York and greater New Jersey – call (855) 208-3650.

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