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For the majority of the population, the idea that you may be surveilled at any point in your life sounds ludicrous. That’s the kind of thing that typically happens to spies and movie heroes, not to everyday people.

Yet if you’re involved in a workers compensation case, surveillance is a likely outcome. It’s important to understand this, and to account for it. 

When is surveillance likely to start?

It could start at any point during your case, but the time when it most often happens is when you’ve reached maximum medical improvement and have been given a set of permanent restrictions by your doctor. This is especially true if you haven’t been able to go back on the job because they don’t have light duty available for you.

In many workers compensation cases this is the point where the case is about to be settled, and it becomes the point where the insurance companies want to do whatever they can to pull the plug on paying you anything at all. They are going to want to find reasons to gut the case. Often, documenting the worker’s own behavior is the best way to do this. If they can catch you doing something that is prohibited by your doctor’s list of restrictions then their position becomes very powerful. 

What should you do if you know you’re being surveilled? Can anything be done about it?

The only thing you should worry about doing is complying with the restrictions given to you by …

At some point, many people who end up with an NJ Workers Compensation claim will end up having to make a decision about whether or not to settle that claim. 

When you settle, a number of things can happen. Sometimes the insurance company will send money directly to your medical providers while sending your lost wages directly to you in a lump sum. Sometimes all the money will come to you in a lump sum and you will be responsible for reimbursing your medical provider. Sometimes you’ll end up with a structured payment plan.

Either way, you’re agreeing to a specific amount, and once that amount is paid, that’s it. The workers compensation insurance company no longer owes you any money. Yet receiving a settlement can often be a better option than constantly fighting to keep the workers compensation benefits flowing, or fighting to get the company to agree to treatments you should have.

Here’s what you need to know.

Both your attorney and your insurance company will be assessing “exposure.”

The main thing the insurance company wants to know, prior to offering a settle, is how much they will end up having to pay if they refuse to settle. If it makes sense for them to do so then they will then try to settle the claim for something under that number.

That means they’re going to try to estimate all of your projected medical expenses, along with the number of weeks they’re going to have to pay …

One reason that people get hurt on the jobs is because employers fail to follow appropriate health and safety standards. Some employers will do anything to keep violations from getting reported, including intimidating employees or claiming they can’t get workers compensation benefits if they report the violation.

Yet the law is very clear. Employers may not retaliate against you for reporting an OSHA violation, nor may they deny your workers compensation claim. This doesn’t mean that they won’t try, but it’s not legal and it could open them up to sanctions by the court. 

Of course, if you are going to find yourself in the position of having to report an OSHA violation on top of everything else you might want to retain an attorney so you can protect yourself as you do so. 

Filing an OSHA violation won’t render you ineligible for benefits either. There is no link between whether you can get benefits and whether you file a complaint. If you were injured on the job and you yourself weren’t violating any laws or company policies then you should be able to make your workers compensation claim. 

In fact, if you are seriously injured and your employer was violating the law then you may even be able to pursue additional compensation. Speak to your attorney about whether this may be true in your case. 

Note that employers themselves are supposed to be reporting injuries. These are used to help investigate occupational health and safety claims. If …

Employer-sponsored events are a pervasive part of corporate culture. Employers either ask or strongly encourage their employees to participate in various events.

Such was the case in a recent New Jersey case recently decided by the State Supreme Court.

Here are are the facts of the case:

“On September 23., 2017 [Jersey Friendship House] hosted a ‘Family Fun Day’ event for clients and families, and asked employees if they would volunteer. Mrs. Goulding offered to cook, and while she was preparing to grill she stepped into a small pothole on the grounds and fell, injuring her right foot and ankle. She applied for workers compensation, which was denied by a workers comp judge.” –Business Insurance.

The judge in the case used the standard that volunteering for the company did not produce a “benefit to the employer” beyond boosting employee health and morale. The Supreme Court disagreed. 

Thus, yes, in some cases you can be covered by worker’s compensation while volunteering at an employer-run event. However, you should be aware of a few key facts which can impact whether you would be covered or not.

Were family and friends invited to the event?

One of the major deciding factors for the judge in this case was the fact that family and friends were not invited to the event. Instead, it was mostly the regular clients of the employer, which meant it provided a benefit to the employer in the form of community goodwill and PR.

The purpose of the …

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 a clear conflict of interest and most have every incentive to side with the defense wherever possible. Nevertheless, you’re still going to want to go. You want to show that you’re complying with the insurance company’s investigation of your injuries. 

You have the right to a second opinion. 

You should think about getting a second opinion even if you trusted the IME doctor. In many cases you won’t: it’s not that uncommon for these doctors to spend less than 5 minutes with patients before finding in favor of the insurance company.

The insurance company will not necessarily pay for …

Plenty 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, many people with mental illness suffer chronically.

Usually, this will mean identifying a specific triggering workplace event. This could be an incident in which you were harassed, where someone assaulted you, or some other unusual event.

If you are in a known high-stress profession, however, or are forced to work unusually long hours, then a case may still be made for your work environment as the cause of the distress. This is

 that every workplace faces. 

As you might imagine, these claims are challenging. Even when injuries are physical there are often difficulties with drawing a clear line between the …

In 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 return for asking employers to pay for workers compensation insurance. (If yours isn’t, you can report them by using this form).

Difference #2 – Lost Wages

In a personal injury case you can be compensated for 100% of your lost wages, whatever those wages happen to be, if you can’t work while you’re recovering from your injuries. 

In a New Jersey workers compensation case, there are caps on the amount of money you can receive each week, regardless of how much you made, though the amount you made will also determine how much you get. The most money …

On 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 instructions to the letter. Why is workers compensation continuing to be such a beast? 

Your employer faces rate hikes.

Your employer is worried about their budget just like you are likely to be worried about yours, and every claim can raise premiums. 

Here’s a nice example from a construction magazine.

“In this example, the claim-free experience mod is 66 percent, which means the premium for the workers’ compensation policy is $105,600. However, this single claim, where the fracture with direct costs is $50,000, will drive the mod up 15 points. When this claim hits the mod (experience modifications …

On 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 members of the public and are essential to the public’s health, safety, and welfare, including transportation services, hotel and other residential services, financial services, and the production, preparation, storage, sale, and distribution of essential goods like food, beverages, medicine, fuel, and supplies
• Is any other employee deemed essential by the public authority declaring a state of emergency.

Note that the presumption is rebuttable. That means your employer may still have a defense if you contract or contracted Covid-19 on the job. They will have to show “by a preponderance of evidence” that you were at no point exposed to the …

No. 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 Internal Revenue Service. It also accounts for other forms of income that may be taxable, such as W2 income earned earlier in the year, retirement benefits, or capital gains.

In addition, if your payments are delayed, for example, in cases where you receive a lump sum settlement because you and your lawyer had to fight for your benefits, then any interest earned on that sum can be taxable as well. 

Can other parties put liens on workers compensation benefits?

Yes. If you owe child support, for example, and that amount is in arrears, then the child support enforcement office …