An IME, or Independent Medical Examination, is what happens when the workers compensation insurance company demands that you go to a doctor of their choice so that your injuries may be evaluated. Naturally many workers are nervous about this process because the doctor doesn’t seem entirely objective. What happens if the doctor lies about the extent of your injuries, claims they were the result of a preexisting condition, or otherwise spins a story that benefits the insurance company at your expense? And who is paying for this anyway? Here’s everything you need to know about IMEs in New Jersey. The insurance company must pay for the IME. If the insurance company wants you to get an independent medical examination they must pay for it. In most cases they must choose a doctor that’s a reasonable distance from your home or workplace. These arrangements are very lucrative for doctors. There is
Read MoreThere are times when a New Jersey employer is permitted to deny your workers compensation claims. For example, they are not required to pay your claim when your injury is self-inflicted, or the result of horseplay or willful misconduct. Some employers claim you’ve engaged in behavior that can result in a denial, and do so in bad faith. It’s important to know when they can, when they can’t, and what you can do about it if your claim is denied. Valid Justifications for Denial A New Jersey employer may deny your claim when any of the following are true: The injury is not job-related. You engaged in willful misconduct. You engaged in assault or horseplay. You were under the influence. You did not follow the proper procedures for filing your claim. You missed claims deadlines. If you are certain you have a legitimate, job-related injury and are equally certain you
Read MorePlenty of jobs come with lots of stress, which can lead to mental health issues like anxiety and depression. Sometimes these conditions can be debilitating, making it impossible to work normally. Which makes it natural to ask whether you can get compensation for the damage your job has done to your mind, especially if you need extensive psychiatric interventions to function. Fortunately, the answer is “yes.” What does it take for Workers Comp to cover a mental health issue? As you might imagine, minor mental health issues won’t get coverage. Instead, you will have to demonstrate that your mental health issue is sufficient to make it impossible for you to do your job. You’ll also need to prove the issue happened at work. This can be difficult, as there are many issues which could trigger a mental illness, and many of them can take place outside of work. In addition,
Read MoreOne of the most common problems people face in a worker’s comp case is the tendency for employers to utterly violate or ignore the doctor’s light duty orders. They often figure that once they have you back at work that you’re at their mercy and they can make you do anything they want. They may even be trying to pressure you into quitting your job so that they can stop paying the workers comp claim. When this happens it’s important to fight back, and it’s important to do it in the right way. Otherwise you could either exacerbate your injury or lose your job. What are light duty restrictions? You may be able to return to work before you have reached maximum medical improvement. Many employees prefer to do this when their disability award is much lower than the money they’d make at work. In many cases you have to
Read MoreIn many ways, a New Jersey workers compensation claim looks and feels just like a personal injury claim. In other ways they are completely different. In fact, the workers compensation system exists, in part, to protect employers from the kinds of liability that are invoked in a personal injury suit. Employers admit no fault, but take responsibility for the fact that employees do get hurt on the job. Here are some of the other key differences. Difference #1 – No Pain & Suffering Personal injury suits come with pain and suffering damages. In New Jersey, these damages are not capped and can be any amount based solely on the extent to which the victim’s life has changed as a result of the injuries. As you can imagine these pain and suffering awards can get quite large, and so workers compensation law was written to allow employers to avoid them in
Read MoreOn its surface, workers compensation is a reasonably straightforward system. If you get hurt on the job, insurance exists to make sure your medical bills get paid. If you can’t work while you’re hurt, that same insurance pays you to stay home and recover. Sometimes, the system works as its meant to work. This is especially true when injuries are minor or the disability is temporary. It’s not worth your employer’s time to fight these claims in most cases, more is it worth the insurance company’s time. The accommodations you’ll need tend to be cheap and minor in these cases, and everyone is willing to play along as a result. When injuries are more extensive and expensive, the equation changes. Let’s assume you’ve done everything right during this process. You reported the injury to your employer, went straight to the correct doctor, filed your claim, and have followed your physician’s
Read MoreOn September 14th Governor Phil Murphy signed S2380 into law. This means that every essential worker who has to go into a physical location to do their job now benefits from a rebuttable presumption of worker’s compensation coverage for Covid-19 cases. The law took effect on the day of signing, and is offering retroactive coverage to March 9, 2020. This means if you got sick while on the job after that date you can now begin your worker’s compensation claim. Note that the law does outline exactly who qualifies as an “essential employee.” The rebuttable presumption does not apply to everyone who might step into an office and get sick. According to S380 an essential worker is: A public safety worker or first responder, including fire, police, or other emergency responders. Provides medical or health care services, including emergency transportation and social services. Performs services which involve physical proximity to
Read MoreNo. In most cases neither the state of New Jersey nor the IRS will tax your workers compensation benefits. They are not considered gross income under either state or federal law. There is a Social Security and Supplemental Security Offset that has to be considered if you receive either form of government aid in addition to your workers compensation. In some cases you may have to pay tax on those benefits in those cases. The specific amount will depend on whether you’re receiving permanent or partial benefits. In fact, if you’re receiving temporary benefits then the amount you’re paid is equal to the amount you would have typically received after taxes. Do I still have to file a tax return? Yes, you will want to file a tax return. This will not create a situation where benefits that aren’t taxable become taxable. It merely reports your individual situation to the
Read MoreEvery business that has employees, even one, must take out a workers compensation policy. If you’re a small business owner like a sole proprietor, partner, or LLC member then you would generally add yourself to the policy at that time. You don’t have to, of course. It’s an optional thing, and it’s not done automatically. Yet you probably should. After all, you’re just as likely to get hurt on the job as your employees are. In some cases, you may even be a “key” employee, as in your business cannot easily survive without you. While workers compensation won’t help with that (that’s what key employee insurance is for) your duties do help to demonstrate that as a small business owners you may well be taking actions, every single day, that could mean you get hurt. Even office workers and telecommuters can get hurt on the job, after all. When you
Read MoreMany people in New Jersey work multiple jobs, or work part time in the gig economy while working full-time at more traditional pursuits. Yet many don’t know that having multiple jobs can complicate workers compensation. The first thing you have to know is that if you get injured on the job you only get workers compensation for the job you were injured at. This means if you get injured on your part-time job you’ll only get replacement wages for the part-time job, while being forced to quit work at your full-time job. Life can get even more complicated if your problem is a repetitive stress injury. In that case you might have sustained the injury on both jobs but would have to prove it, with each employer trying to shift the responsibility to the other employer. Your full-time job will also be under no obligation to hold your job or
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