You don’t have a choice about attending an IME—if you want your benefits, you’ll have to go. Unfortunately, IMEs are a highly stressful situation. How can you maximize your chances of getting an honest, fair evaluation that helps your workers’ compensation case? Understand the Function of an IME Independent medical examinations aren’t meant to treat you. Instead, they’re meant to determine the extent and nature of your permanent disability and the effect your injuries have had on your life. In short, it’s an insurance company’s attempt to set the value of your case and your potential settlement. Of course, they choose the doctor, and they are hoping the doctor is going to rule primarily in their favor. Often, they do. One judge said that IME doctor reports are so predictable that “it’s almost a waste of time to read the report because you know what it’s going to say.” Whenever
Read MoreYour employer has 21 days to file a claim after you sustain an injury at work. You should always mark the date that you reported the injury. Remember, you should inform your employer you’ve been injured on the job within 14 days of the injury. In reality, we recommend reporting the injury immediately unless there is some good reason why you can’t. For example, if you end up unconscious and spend three days in the hospital before you wake up, then it wouldn’t be reasonable to expect an immediate report…but you’d want to make the written report as soon as you are medically capable of doing so. Usually, the New Jersey Division of Worker’s Compensation will notify you directly when the claim is accepted, and you’ll receive notice long before it’s really necessary to start checking the status of your claim. If you feel like your workers’ compensation claim is
Read MoreNew Jersey gives employers the right to choose the doctor who handles most of their treatment and care after an accident rather than employees. Many employees believe that an apparent conflict of interest exists, and for the most part, they’re right. Doctors know where their bread is buttered and certainly, look for any excuse to help employers deny workers compensation claims. None of this means you are helpless. There are steps you can take to help your case and to obtain better care from day one. Report Every Ache and Pain Bring a list to the doctor in writing, and make sure that everything makes it into the medical record. Don’t ignore anything. Even small pains can be an indicator of bigger problems later. You only get one chance to make this initial report. Remember, the doctor treating you is treating you like a legal case, not like a patient.
Read MoreWith New Jersey facing an early summer this year and temperatures projected to be higher than ever, it’s a good time to discuss heat injuries and workers’ compensation. While heat injuries aren’t always weather-related, 50% to 70% of them are. A large percentage of heat injuries in the United States are even fatal. Hopefully, you will be able to protect yourself from heat while on the job, and your employer will provide some PPE and policies to help you do so. Nevertheless, it’s good to know that heat injuries are covered if you need them to be. Types of Heat Injury While heat stroke is the most common and most serious heat-related illness, there are others. Heat may also cause secondary injuries. Sweaty hands, dizziness, and fogged glasses can cause slips, trips, and falls, for example. Heat Injuries Are Compensable Heat injuries are like any other injuries in New Jersey.
Read MoreYou already know that New Jersey workers’ compensation should be paying for your medical expenses after an accident. You also know that, in reality, insurance companies often deny or delay claims or attempt to wriggle out of paying for treatments your doctor recommends. That’s why it’s important to understand what the law actually says. In this case, the employer must provide all medical treatment necessary to “cure and relieve” the effects of the work injury. They must pay 100% of the medical bills. You should not owe any co-pay. This should include: However, there are caveats. The insurance company can recommend cheaper treatments. The treatment your doctor recommends isn’t always going to be the treatment your workers’ compensation company wants to give you. For example, if you need a prosthetic, they may suggest a cheaper “claw-style” prosthetic over a working hand. They may also try to deny you treatments that
Read MoreWhen you settle your New Jersey workers’ compensation claim with a Section 20 settlement, you receive a lump sum, and you stop receiving regular benefits like lost wage payments and medical payments. Thus, any settlement decision should be considered carefully, especially if you’ve been relying on those payments to pay your expenses as you recover. Here are a few signs that settlement might be advantageous. When You Reach Maximum Medical Improvement (MMI) Most people should wait until they reach MMI. Settling any earlier than MMI is risky because there’s always the chance you’ll need additional treatments or surgeries. Once you’ve settled, the insurance company stops paying your medical bills, which means you’ll have to pay them out of pocket. The costs of any medical treatment in America today could mean wiping out your entire settlement amount on a single surgery. One alternative path would be to go for a Section
Read MoreYou might go through multiple hearings during a New Jersey Workers’ Compensation case. The first hearing generally comes after you make a formal claim to dispute a denied workers’ compensation claim. Here’s everything you need to know about these hearings. Who runs the hearing, and who attends? The hearing will be run by a judge of compensation in the county where you live or the county where the employer is located. You and your lawyer will attend, as will the insurance company’s lawyer. Witnesses will also attend. This could include your supervisor, co-workers, expert witnesses, or other relevant parties. Will the judge help me get aid right away? Your attorney can ask the judge to grant you immediate aid with a Motion for Medical and Temporary Benefits. This motion asks that the employer and the insurance company provide you with immediate benefits while the dispute takes place. Is the hearing
Read MoreRepetitive stress injuries. Lung diseases caused by exposure to toxic fumes. Cancer caused by repeated exposure to carcinogens within the workplace. Deafness caused by repeated exposure to loud workplace environments. There are a myriad of ways that our workplaces can erode our health and make us sick. When that happens, you have grounds for an occupational injury claim under N.J.S.A 34: 15-31. The law defines a compensable occupational disease as: “All diseases arising out of and in the course of employment, which are due in a material degree to causes and conditions which are or were characteristic of or peculiar to a particular trade, occupation, process, or place of employment.” It goes on to specify that deterioration of tissues, organs, or body parts due to the natural aging process are not compensable. As you might expect, arguments over whether a given ailment is the result of aging or arising out
Read MoreAs of February 6, 2023, temporary workers are protected by the Temporary Workers’ Bill of Rights. The Bill of Rights makes temporary agencies responsible for protecting their workers. This Bill strengthens a temp worker’s ability to claim workers’ compensation. New hires should be provided with information on the temporary firm’s workers’ compensation carrier. It also specifies the responsibility that both the temp agency and the assignment employer have to provide workers with workers’ compensation insurance. What to Do If You are Injured on an Assignment in New Jersey If you are hurt at work, you should inform both your assignment site supervisor and your temporary service. Both companies have equal responsibility for providing you with workers’ compensation insurance. You should seek medical care and file for workers’ compensation as normal. When determining your wages for the purposes of providing temporary disability benefits, you’d calculate your average weekly wage by adding
Read MoreYou work in the insulation industry, and you come down with a case of mesothelioma, an asbestos-caused cancer closely linked with the insulation and construction injury. While an employer might be very eager to assert that your cancer diagnosis could have arisen from any number of sources, New Jersey employers don’t have it that easy. Presumption laws cover many occupational diseases. What is presumption? Presumption shifts the burden of proof from you, the employee, to the employer. If they want to avoid paying workers’ compensation, they will have to prove that their work environment didn’t cause cancer. Presumption laws have existed since 1921. They were established in WWI, allowing veterans a clearer path to proving their tuberculosis and certain psychiatric disorders were related to their service. New Jersey Presumption Laws In New Jersey, the Canzanella Twenty-First Century First Responders Protection Act protects the right of employees to receive workers’ compensation
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