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Worker's Compensation |
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Puff & Cockerill LLC has been helping people for many years to enforce their rights to benefits when they are injured on the job. Often the assistance of an attorney in the claims process can make sure that you get the maximum benefits to which you are entitled. In New Jersey, a person can obtain workers' compensation benefits as long as he or she is not an independent contractor, casual employee, sole proprietor, partner in a partnership, railroad employee, member of a crew of a ship, or a federal employee (federal employees process their claims through a separate procedure not handled by our office). Once they qualify as an employee under the Act, all that person has to do is show that the accident or injury arose out of and in the course of that person's employment. If that is the case, the employee is entitled to three main types of benefits, as discussed below. Contact us If you need further information. Medical Treatment. The employer's workers' compensation insurance carrier is responsible to pay for all curative medical treatment for the injury. This is the treatment that, by objectively measurable standards, improves the condition of the employee, bringing him or her back closer to their condition prior to the accident. This is as compared to palliative treatment, which makes the employee feel better subjectively, rather than improving his or her condition. In return for this obligation to pay for all medical treatment, the insurance company has the right to control the treatment and send the employee to whichever health care provider they want. Thus, the employee, although entitled to have all curative treatment paid for, does not have the right to use his or her own family physician (unless the insurance carrier approves said physician). Temporary Disability Benefits. Many times an employee is unable to work during the period of time that curative treatment is being rendered. If that is the case, the treating physician issues a Certificate of Disability, and the insurance company is then obligated to pay the employee 70% of the employee's gross weekly wages up to a cap of $496.00 (for disabilities which result in injuries sustained in 1997). This right to temporary disability benefits accrues once the employee has been out of work for at least seven days as a result of treatment for the sustained injury. Sometimes a physician will send an employee back for "light duty" during the course of treatment. This means that the doctor feels that the employee can go back to work, as long as certain restrictions are observed in what that employee does in the workplace. For example, someone who has sustained a back injury may be limited in the amount of weight he or she can lift. The employer is obligated to provide light duty to the employee if it is available. This provision is in the law to allow employees to earn 100% of their gross weekly wages during the period of treatment, if possible, rather than 70% subject to a cap. If the employer has no light duty for the employee, the employee can then go back on full disability and receive temporary disability benefits until released to go back to work without restrictions by the physician or until curative treatment ends. Permanent Disability Benefits. It may be, upon completion of curative treatment, that the employee is still restricted to what he or she can do in his or her professional and/or personal life. If so, the injury has created a permanent disability that cannot be corrected through curative treatment. Upon release from treatment, the employer's insurance company has up to six months (26 weeks) to have the employee examined by a separate physician to determine whether there are any objective medical indicators that would show permanency to the injury. The employee is also entitled to have his or her own examining physician determine the degree of permanency. The degree of permanent disability is expressed as a percentage of total. In other words, an employee does not have to be totally and completely disabled by an injury; he can be partially disabled. Once the employee and the employer's insurance company agree upon a percentage of total disability (or once a judge in workers' compensation court has ruled as to the percentage of permanent disability), a total dollar figure for such permanency corresponding to that percentage and the part of the body injured can then paid out over a pre-determined number of weeks starting from the date of release from treatment. This figure is fixed based on the percentage of disability and the body part affected regardless of any individual pain and suffering experienced by the employee as a result of the accident. The Workers' Compensation Bar. The advantage of workers' compensation law is that it allows an employee to obtain the above discussed benefits solely by showing that he or she was injured on the job and without having to show the negligence of the employer. The down side to this is that an employee cannot sue his employer in state court for negligence; a claim in workers' compensation court is the sole remedy. The only exception to this is where an employer intentionally harms an employee or requires an employee to do something (or not do something) which the employer knows will result in the employee being harmed. This is a very difficult burden to meet for an employee, and, therefore, very few cases succeed in lifting the workers' compensation bar in negligence actions against employers. If you believe that you might have a case that would not be barred, you should contact our office immediately. Many people face problems in the workplace with the disability they have as a result of a job-related injury. The Federal law, Americans with Disabilities Act (ADA) could help you. For more information on this law, we suggest the following sites:
If you are interested in more information about worker's compensation law, try these sites:
Here are some other related sites for more information:
The information given in this article is a general statement of New Jersey Workers' Compensation Law and it is not intended to be a substitute for a detailed discussion of your case with a workers' compensation attorney. Please feel free to contact us to discuss your case. Please read our site wide legal disclosure. |
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