If you are injured playing basketball with friends and fracture your arm, you need health insurance to help cover the medical bills from hospital visit or expenses for other care. Depending on your health insurance plan, there are many in New Jersey, you may pay a certain portion of these expenses “out of pocket.”
If you are working as a bartender and fall on the wet floor, fracturing your arm, you are entitled to workers’ compensation to cover the medical expenses. Workers’ compensation is mandated by New Jersey law, but provided through your employer. In New Jersey, nearly all employers are required to have workers’ compensation insurance to cover these incidents. Therefore, a form of insurance also covers these expenses.
While these examples show the basic difference between health insurance and workers’ compensation insurance, the questions and interworking of these two insurance plans are much more in-depth.
If I am Injured at Work, Do I Need Health Insurance?
Currently, the majority of United States citizens are required to have health insurance under the Patient Protection and Affordable Care Act’s individual mandate. To remain compliant with federal law, you probably need health insurance, whether or not you are injured at work.
When it comes specifically to work-related injuries, workers’ compensation will cover these costs. That is why it is essential to document injuries and Of course, there are always contentious cases. An employer or insurance provider may argue that an injury wasn’t actually sustained at work or wasn’t in the …Read More
You slip and fall at work in New Jersey Whether it was a power cord at the office or spilled liquid on the restaurant’s floor, you are likely entitled to workers’ compensation for medical costs resulting from this fall. For instance, if you injured your neck or badly sprained a wrist trying to break the fall.
These injuries could even keep you from work for multiple days, weeks, or more. Then, you would be entitled to disability benefits under workers’ compensation in New Jersey. However, these injuries were not entirely new. You hurt your neck in a softball game four years earlier or broke your wrist rollerblading last summer and it stayed tender and fragile.
Do these old injuries change anything? If you had a pre-existing condition, of any kind, does it affect your right to workers’ compensation under New Jersey law?
Broad Right to Workers’ Compensation in New Jersey
New Jersey workers’ compensation is available to all employees who suffer a job-related injury. This includes employees who acted negligently. It even applies to incidents that involve the recklessness or negligence of a third party. This policy is not only protective of employees who accept risk of injury as part of their job duties, but keeps employers accountable for training, safety standards, and oversight.
The law in New Jersey even covers exacerbation or acceleration of a pre-existing condition. Employers and insurance companies are prohibited from denying workers’ compensation benefits due to a pre-existing condition. Further, how the original injury …Read More
Employers and their insurance providers often see workers’ compensation claims, and the process of making benefit payments, as an ongoing burden. For these parties, it is valuable and preferable if the situation is finalized swiftly and efficiently through a contractual arrangement with you, the injured employee.
Therefore, it is very likely that in the course of reporting your work-related injury and seeking workers’ compensation benefits (even if you haven’t filed a formal claim with the Department of Labor), your employer or an insurance provider has made an offer to settle. When this offer is extended, most likely it will come from the insurance company, you have two options under New Jersey law for settling your case.
Accepting a Lump Sum Settlement
The New Jersey Statutes Annotated (N.J.S.A.) 34:15-20 provides a mechanism for employers, through or with the insurance company, to make a one-time payment to an injured employee. Often, because of the citation for these one-off payments, those familiar with New Jersey workers’ compensation will call this form of settlement a Section 20 settlement.
Approximately 30% of workers’ compensation cases in the State of New Jersey are resolved through the Section 20 mechanism, but employees often enter the contractual agreement for these settlements without fully understanding the pros and cons of doing so. The upside of resolving a workers’ compensation situation through Section 20 is the lump sum becomes immediately available to the employee to use for past, present, and future medical costs. This can be incredibly attractive for …Read More
Few people are drawing a connection between the misuse and substance abuse of opioids that is sweeping the United States and workers’ compensation insurance. However, for employees in New Jersey there is reason to believe that the governmental response to opioid abuse will directly impact the workers’ compensation scheme in the state.
Background Information on Opioid Misuse in New Jersey
Between 2004 and 2015 the number of drug overdoses in New Jersey exponentially grew, and most of the deaths are from an overdose of heroine or morphine. There were only 362 heroine and morphine deaths in 2004, but a scary 961 deaths in 2015. This rise in fatalities from opioids is due in part to fentanyl, an incredibly strong and dangerous opioid, being mixed with street heroine.
What mirrors this epidemic in illegal opioids is the misuse of prescription painkillers in New Jersey. Data shows that for many heroine users, there was a progression of prescription drug addiction to the stronger, illegal drug. It is this progression that New Jersey wants to stop, or at the very least diminish.
To this effect, on February 15, 2017, Governor Chris Christie signed into law new restrictions on the prescription of opioids and certain other drugs in Senate Bill 3. These restrictions are likely to change how workers’ compensation doctors are able to treat patients and what information an employer will receive due to reporting requirements in the law.
New Requirements of Senate Bill 3
There are two major impositions on …Read More
Quite often, expenses and costs are perceived as a barrier to legal representation and recovery. Admittedly, it is true that participation in the modern day legal system can be costly. However, when it comes to workers’ compensation in New Jersey, the law provides mechanisms that try to ensure an injured employee can afford the costs of filing a claim. Therefore, this post will answer two questions: what costs are associated with a workers’ compensation claim and what mechanisms help alleviate these costs?
Compensation for Your Lawyer
New Jersey limits the amount and process for payment of a workers’ compensation lawyer. This provides safeguards for an injured employee and also ensures the path to recovering workers’ compensation benefits is available to all workers. First, workers’ compensation lawyers in New Jersey are paid on a contingency basis. This means you do not pay your lawyer until a settlement is obtained from the insurance company.
Second, the legal fees are based upon the amount of settlement you receive, as a percentage. Under the law, a workers’ compensation lawyer cannot receive more than 20% of a settlement. Of this amount, the employer is expected to cover 60% and the injured employee 40%. Therefore, if you receive $10,000 as settlement, your lawyer can collect up to $2,000, of which you will pay $800.
Keep in mind, that in order for your lawyer to be paid, you must be awarded a settlement of your workers’ compensation claim by the New Jersey Division of Workers’ Compensation, …Read More
While certain jobs and job-related activities have inherent risks, a number of workplace injuries happen when employees do not or cannot follow workplace safety policies and procedures. Often, these accidents happen when there is improper training of an employee for his or her role or when mental factors prevent an employee from operating at 100% while on the job.
It is incredibly common for an employee to say, “I just wasn’t thinking straight,” or “I was stressed and trying to rush,” after an accident occurs. When a workplace injury happens for these reasons, many employees and employers want to know how the employee’s mental state or mental fatigue may affect a workers’ compensation claim.
Underlying Cause of a Workplace Injury
Lawyers and workers’ compensation insurance companies frequently discuss the most common types of injuries that occur at work. In New Jersey, similar to the rest of the country, employees are injured by overexertion, a slip, trip, or fall, or being struck by an object or piece of equipment. It is important for a workers’ compensation claim to know exactly how an employee was injured. Yet, the underlying cause for an accident or injury can be overlooked.
Mental fatigue, stress, sleepiness, and anxiety all negatively impact an employee’s performance. These mental factors will manifest themselves at work in a lack of focus, inability to address details, or lack of thoroughness. All of these effects can have serious consequences for employees and employers. Despite this, sleep deprivation, chronic stress, and anxiety …Read More