Workers’ Compensation FAQ

Answers to Frequently Asked Questions

1. (Q). What benefits can I receive?

(A). Workers’ Compensation provides employees who are injured on the job with three basic benefits, and only these three: medical benefits, temporary disability benefits for lost time from work, and benefits for the permanent residuals of injuries which are either partial or total.

MEDICAL CARE: Your employer must provide you with reasonable medical care for your work related injury. In New Jersey, the employer or its insurance carrier has the right to direct treatment and to designate which doctors, clinics, or hospitals you go to for treatment. It is important for you to see the physician authorized by your employer so that your medical bills will be paid by your employer. If you do not go to the “authorized doctor,” you may have to pay those bills from your own funds. This does not mean that you cannot request authorization for other doctors or additional treatment than the authorized doctors recommend, and under the appropriate circumstances you can petition a Workers’ Compensation Judge to order the employer to authorize another doctor or additional treatment.

LOST TIME FROM WORK: You should receive 70% of your average weekly wages based upon your earnings prior to your injury, up to the statutory maximum rate (set annually) for time lost from work in excess of seven days. Time lost from work must be authorized by the doctor. It is your responsibility to make sure the doctor’s written authorization is provided to your employer in order to be eligible. You will receive these payments until you have reached the end of curative treatment, at which time your employer has a twenty-six week time period to have you evaluated and to make an offer for a permanency award. If your employer does make an offer, you can accept it without prejudicing your ability to seek additional compensation.

PERMANENT INJURY: This is an amount based upon a schedule in the Workers’ Compensation Statute which provides for a total award determined by your percentage of permanent partial or total disability. This is based upon a number of weeks at a scheduled rate, calculated from when you reached Maximum Medical Improvement (MMI). Depending on how many weeks go by between MMI and your receipt of the payment of the award, you may receive a lump sum or a combination of lump sum and monthly payments as compensation for the residuals of your injury.

2. (Q). How long will all this take?

(A). Each case is different, depending on how long you are under treatment, how fast you recover, or what your employer offers. On average, Workers’ Compensation cases are completed approximately six to twelve months after you reach MMI.

3. (Q). How is my case prepared?

(A). After an initial interview, a claim petition is file on your behalf with the Division of Workers’ Compensation, and we will begin monitoring your progress and treatment. When treatment has either been completed, or if the assistance of the court is required, we will send for your medical records. The medical records are important in order to evaluate your case to determine whether additional treatment should be sought, or whether, if the circumstances are right, efforts to resolve your claim should be started.

If you have been fully released from treatment, we will make an appointment for you to see an evaluating doctor, and coordinate with your employer, who will also schedule an evaluation. After the permanency evaluations are received, if settlement cannot be negotiated, we will submit your case to a Judge to decide as to how much of an award you are entitled.

4. (Q). The Employer’s doctor has released me back to work, but I don’t’ feel that I am ready. What can I do?

(A). You can talk to the doctor and make sure that he or she understands the nature of your work and the physical requirements of your job. Make sure if there are physical restrictions that those are put in writing to give to your employer.

Report to your employer that you have been released and are willing to try to work, and provide your employer with the restrictions suggested by the doctor.

Attempt to perform your job.

If you cannot perform your job, report this your employer and ask to return to the doctor.

It is important that your employer understands that you are making a good faith effort to return to work as soon as possible.

If you cannot perform your job, but the employer will not send you back to the doctor, or wants you to work beyond the restrictions given by the doctor, or the doctor will not release you from work, contact your attorney immediately.

5. (Q). Will I get fired for making a Compensation claim?

(A). It is illegal to retaliate against an employee for either pursuing or filing a claim, continuing with the claim, or testifying about a Workers’ Compensation claim. If you suspect that such retaliation has occurred you should contact your attorney so that appropriate actions can be taken.

6. (Q). Is my job protected if I make claim?

(A). Unfortunately, Workers’ Compensation does not protect your job unless there is some other reason, such as a contract. You may be eligible for up to an unpaid twelve week leave of absence under the FMLA (Family Medical Leave Act) during which time you could also receive Temporary Disability benefits from the state, but after the twelve weeks, you still have to report your status to your employer. If you are able to go back to work, your employer should have held your position, but your employer is not obligated to do so thereafter.

7. (Q). If I am fired or lose my job, will my benefits be lost?

(A). No, your Workers’ Compensation benefits should continue as long as your are eligible under the statute, regardless of whether you go back to work for your employer or not. All of the other requirements, i.e., authorized medical providers, need for curative treatment for the work related injury, residuals from the work related accident, still apply, and you have two years from the last payment of compensation, including payment for authorized medical care, to seek the assistance of the Court if you do not receive those benefits.

8. (Q). What can I do to help my case?

(A). Keep your attorney informed of your status, treatment, new doctors, surgeries, hospitalizations, your discharge from treatment or return to work, and other important information at or near when those events occur. If you are having problems with reimbursements, prescriptions, or receiving bills, let your attorney know.

Once you are represented, no one should be contacting you without your attorney’s knowledge. Do not provide any information except your attorney’s name and phone number, or obtain theirs so your attorney can contact them.
Forward all documents relevant to your case, such as receipts or bills, to your attorney so they can be forwarded to your employer.

Be sure to keep all scheduled medical appointments. If you have a conflict or are unable to keep an appointment for any reason, let your attorney know right away, so that arrangements can be made to reschedule. Failure to keep appointments may result in benefits being delayed, treatment interrupted, and will cause the settlement of your claim to be delayed.

Keep your attorney aware of your current address and phone number so that information can be given to you promptly.

9. (Q). What is the best way to get in touch with you or your law firm?

(A). CALL ME. Let the person who takes your phone call know why you are calling and where you can be reached if we are out of the office, in court, or otherwise unavailable. With the proper information and a way to get back to you, we can respond as soon as possible. In the alternative, one of our staff may be able to assist you in expediting your case.

10. (Q). How Do I pay for legal services?

(A). Workers’ Compensation attorneys are paid on a contingent fee basis, and get paid a percentage of the benefits obtained for you. If there is no recovery, there is no fee. The amount of the fee is determined by the Judge of Compensation and is capped at 20 percent. Depending on how your case resolves, you may only be required to less than half of the twenty percent fee, with your employer paying the balance. The expenses to litigate your case may be advanced by the law firm, in which case the Judge will be requested to allow reimbursement from your share of the recovery. Generally, records from authorized doctors are provided without cost. The evaluating doctor will charge a fee for his exam and report, but that fee is usually split 50/50 between you and your employer.


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