Delay in Your Workers Compensation Claim: What You Can Do

If you suffer a workplace accident the consequences are immediate. After a workplace accident, you need medical attention and time off work – in the event of a serious accident, you need emergency care and weeks (or longer) to recover. These ramifications of an injury or illness are costly and there is every reason to worry about the financial consequences of a workplace accident.

In New Jersey, the state government has recognized the swift and cutting impact of a workplace accident and designed the process for a workers compensation claim to follow suit. An employee is entitled to temporary disability benefits when unable to work for seven days. The first workers compensation check should arrive within two weeks of reporting your workplace accident.

What if this isn’t the case for your workers compensation claim? Some employees wait much longer for their workers compensation claim to begin reimbursement of medical costs or payment of lost wages. At the Law Offices of Albert J. Talone, we take a look at what causes these delays and an employee’s options for getting their workers compensation benefits on time.

Delays by the Insurance Company or Employer

The most common cause of delay to a workers compensation claim is the insurance company. Employers in New Jersey are required to carry workers compensation insurance. These insurance policies protect the employer from exceptional costs, in the event of a workplace injury, but also provide assurance to the employee that a workers compensation claim will be paid.

Yet, the involvement of insurance companies in the workers compensation process can have problems. The insurance company is incentivized to pay as little as possible and on as few workers compensation claims as possible. The less paid by the insurance company, the more in revenue. Delays and procedural obstructions can wear on an employee, particularly someone already experiencing pain or disability. There are several instances of an insurance company delaying the workers compensation claim to push for a lower settlement from the employee.

Employers can also be a cause of the delay. Sometimes employer delays are at the direction of the insurance company or to try and limit the negative impact on the business or its reputation. However, the most likely reason for employer delays of a workers compensation claim is poor training around the process and procedure of a workplace accident. Managers and even owners aren’t aware of reporting requirement or don’t understand the importance of informing the insurance company.

Delays for Investigation and Legitimate Reason

Not all delays in a workers compensation claim are malicious or unlawful. There are plenty of situations when procedure or investigations hinder the expediency of the claim. For example, gathering and reviewing medical reports can take much longer than two weeks. Incidents involving machine malfunction and equipment failure or serious neglect in training can also lead to a further investigation that may impact a workers compensation claim.

How to Handle a Delayed Workers Compensation Claim

Unreasonable delays in your workers compensation claim are illegal. An insurance company or employer that unreasonably hinders, prevents, or delays a claim can be held accountable for 25% above the amount of the workers compensation claim. In New Jersey, a delay lasting longer than 30 days could be unreasonable.

Knowing that there are consequences to a delayed claim, your first step is engaging a knowledgeable workers compensation lawyer to review your claim and assess the problem. Before you can take any further action or pursue a case against the insurance company or your employer, you need to know who, what, when, where and why of the delay – a lawyer can uncover these answers.

Plus, when your first step is hiring an experienced New Jersey lawyer, you are more prepared to take action against a bad actor, should the delay be unreasonable or purposeful.

To talk with a New Jersey workers compensation lawyer, contact our team at the Law Offices of Albert J. Talone. You can reach us by calling (856) 234-4023.