The New Jersey Department of Labor and Workforce Development handles every New Jersey workers compensation claim. Regardless of the severity of your injury, the industry of your employer, or complexity of your claim, your case will eventually pass before the same department.
However, there are certain steps you must take to make a valid claim, and the process isn’t always as straightforward or simple as you may imagine. Our team at the Law Offices of Albert J. Talone takes you through the five steps to filing a New Jersey workers compensation claim, but simultaneously encourage any injured employee to contact our office for assistance with one or all of these steps.
#1: Report Your Injury to a Supervisor
The first action you must take after a workplace injury in New Jersey is to inform your employer. Under New Jersey workers compensation law, an employee is required to provide notice of a workplace injury before filing a claim with the Department of Labor and Workforce Development.
You are expected to provide notice to your employer within 14 days of an injury, but the sooner you report the injury the better. If you fail to report a workplace injury within 90 days of such injury or onset of illness, then you may lose your right to New Jersey workers compensation benefits.
#2: Obtain a Medical Report and Evaluation
In most New Jersey workers compensation claims, the most important aspect is recovering costs for medical treatment. If you required emergency care, a long hospital stay, or specialized treatment, you know the costs of this care can skyrocket. Even medical care for a minor workplace injury adds up quickly. All of these costs, including the fees for physical therapy and ongoing rehabilitation are covered by New Jersey workers compensation.
To receive compensation for medical costs and emergency services related to a workplace injury, you need documentation of the expenses. You’ll want to save all medical bills, hospital forms, and other notations from your doctor or specialist. This includes a medical report that states the cause, the severity, and necessary treatment for recovery from your injury. This last document is crucial if your employer or the workers compensation insurance provider dispute any aspect of your claim.
#3: Confirm Your Employer Informed the Insurance Company
Once you reported a workplace injury to your employer, the company has an obligation to inform its workers compensation insurance provider of the claim and circumstances. The notification from employer to insurance provider is called a report of injury under New Jersey workers compensation law, and the report is further relayed to the New Jersey Department of Labor and Workforce Development.
While your employer should automatically and without further prompting inform the insurance company of your claim, you must confirm this communication took place. If an employer delays or refuses to inform the insurance company of your workplace injury, you may need to file a claim directly.
#4: Your Claim Is Approved
The insurance company will inevitably review the facts and circumstances of your claim. This may include conversations with your employer and supervisor, discussions and questions for you to answer, request medical records and bills, and even a review of the workplace and location of the injury. Then the workers compensation insurance company must either approve or deny your injury claim.
If your claim is approved, then you will receive workers compensation for medical costs from the insurance company and will begin receiving lost wages benefits within a few weeks. It is unlikely you need to take further action unless the diagnosis or assessment of your injury changes.
Be certain that the full extent of your injury and necessary treatment is taken into account if and when you sign a settlement agreement with an insurance company. Many employees lose out on deserved compensation by signing a settlement agreement too early. If you are uncertain about the timing, terms, or amount of a settlement agreement, definitely speak with a workers compensation lawyer.
#5: Your Claim Is Denied
If your claim is denied, you must challenge the insurance company’s decision through the New Jersey workers compensation claim process. There are two paths available to any and all employees that want to challenge a delayed or denied claim.
The first path to challenge a denied New Jersey workers compensation claim is an informal hearing. This process can be faster and cheaper if you are able to reach a compromise and settlement agreement with the insurance company. However, if you can’t come to an agreement, you must proceed through the formal process anyway.
The second option is immediately proceeding through the formal claim process. An administrative judge with the New Jersey Department of Labor and Workforce Development will hear your case, similar to a trial, and issue a decision based on New Jersey workers compensation law.
You can read more about these paths to challenge a delayed or denied claim here.
Assistance with Your Claim
Whether you have one question or 20, the Law Offices of Albert J. Talone can help. We have years of experience with the New Jersey workers compensation system and process. Our team is prepared to outline your path to workers compensation or guide you through the entire process.
To find out more about our New Jersey workers compensation services, contact lawyer Albert Talone directly at 856-234-4023.