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How Does Workers’ Compensation Work?

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How Does Workers’ Compensation Work?

workers' comp lawyer scotch plains njIf you know someone who has suffered an injury while on the job, you’ve likely heard of workers’ compensation. Under this system, injured employees are able to receive medical treatment and have a portion of their wages replaced after being injured in a work-related accident or becoming ill on the job. This system is governed by a set of laws, and under these laws the employers and the employees have a number of responsibilities. Here is a brief guide to workers’ compensation in New Jersey.

What Is Workers’ Comp?

Workers’ compensation is a type of insurance program that insures employees for illnesses and injuries that happen on the job. The program is mandated by state law, and in New Jersey that is Statute Title 34. Labor and Workmen’s Compensation 34 § 15-1. If an employee is injured on the job, they are entitled to receive medical care after sustaining that injury (or illness). Injured employees are also entitled to receive a certain portion of their wages while they are off work for the treatment of such injury or illness.

The workers’ compensation is considered a “no-fault” system. That means that a worker who suffers a work-related injury or occupational illness is entitled to workers’ compensation benefits from his or her employer (or the employer’s workers’ compensation insurer) without the need to prove the fault of the employer or any other party for the worker’s injury. The worker may still be entitled to benefits even if he or she was at fault for his or her own work injury or occupational illness. However, in exchange for the guarantee of defined benefits under workers’ compensation, the worker gives up his or her right to bring a personal injury lawsuit against his or her employer.

Under limited circumstances, a worker may step outside the workers’ compensation system for a work-related injury or illness. For example, a worker can bring a personal injury claim against his or her employer if the employer intentionally or recklessly caused the worker’s injury or illness (for example, by withholding safety equipment from the worker as a form of punishment). A worker is also entitled to bring a personal injury claim when his or her injury or illness was caused by a third party, such as a negligent driver or the manufacturer of a defective product; however, the employer will be entitled to recoup the workers’ compensation benefits it has paid from any recovery obtained from a third party. Conversely, an employer can deny workers’ compensation benefits for a worker’s injury caused by his or her recklessness or willful acts (such as horseplay at work or being under the influence of alcohol or drugs on the job).

Who Is Entitled To Workers’ Comp Benefits?

All New Jersey businesses with employees – except for those covered by federal programs – are required to carry workers’ compensation insurance. Whether or not you call the Garden State home, New Jersey employees are usually covered by workers’ compensation insurance as required by law. This includes even part-time and seasonal employees, and employees under the age of 18. There are exceptions to the requirement with regard to the types of employees who must be covered, including volunteers for nonprofits, farm workers, and most domestic workers. There are separate standards for these vocations.

Related blog: Can Delivery Drivers File For Workers’ Compensation?

What Injuries Are Covered Under Workers’ Comp?

Workers’ comp is meant to compensate employees who sustain work-related injuries. An injury is usually deemed work-related so long as it arises in the course and scope of a worker’s duties, from the time a worker’s shift or workday begins to the time that it ends. New Jersey also expands this definition to include illnesses that are work related, as long as it meets specific criteria dictated by law. The work-related injury may not have to be caused by a single incident. For example, repetitive stress injuries or an illness that results because of continued exposure to certain chemicals in the work environment may trigger a workers’ compensation claim.

Related blog: Can You Get Workers’ Compensation If You Work From Home?

What Benefits Are Available Under Workers’ Comp?

At a minimum, a worker who suffers a work-related injury or illness is entitled to all reasonable and necessary medical treatments for his or her injury or illness. Unless emergency medical treatment is required, an employer can direct a worker to use a particular medical provider in order to have his or her treatments covered by workers’ compensation.

If a worker cannot return to work for seven or more days, he or she will be entitled to receive temporary disability benefits, which are equal to 70 percent of the worker’s average weekly wage over the 26 weeks preceding his or her injury (subject to maximum and minimum limits set by the state each year). These benefits are paid until the worker can return to work, has reached maximum medical improvement (meaning the worker’s condition is unlikely to improve with further medical treatment), or 400 weeks, whichever occurs first.

If a worker cannot return to work after reaching maximum medical improvement, he or she may be entitled to permanent disability benefits. If the worker has some disability but can return to some form of gainful employment, he or she could receive permanent partial disability benefits which are calculated according to a schedule set forth by the state.

The Claims Process

If you are injured on the job, the first thing you need to do is seek medical attention and let your employer know about the injury. Some companies have a specific form you need to fill out to provide notice that a workers’ comp claim is necessary. Most companies required this notice within 14 days, and you have up to 2 years to file a claim. Be sure to ask your company about the notice process and time limits for filing a claim.

Sometimes your employer may reject your claim. This is when you should contact an attorney. Yes, you need an attorney!

Related blog: How To Decide On The Right Workers’ Compensation Attorney

If you feel that your claim has been wrongly rejected, you may be entitled to collect money by filing a formal claim with the New Jersey Workers’ Compensation Courts. Only a New Jersey licensed lawyer can file a formal claim, though. If you do not file a formal claim, you will not collect what you are entitled to and your rights to medical treatment may be negatively affected.

Contact a Wayne Workers’ Compensation Lawyer to Discuss Your New Jersey Workplace Injury Case

A workplace injury can be devastating, particularly if it prevents you from returning to work for an extended period of time. Although New Jersey Workers’ Compensation laws are supposed to provide you with reimbursement for medical expenses and replacement pay for missed time at work, it is not always easy to get the Workers’ Comp benefits you deserve. That is why you should speak with a knowledgeable Workers’ Compensation lawyer about your situation and get guidance throughout the claims process. The experienced Workers’ Compensation attorneys at Bramnick, Rodriguez, Grabas, Arnold & Mangan, LLC represent clients in Elizabeth, Union, Plainfield, Newark, and all across New Jersey. Call (908) 325-5571 or fill out our online contact form today to schedule a free consultation about your work injury case. Our main office is located at 1827 E. 2nd St., Scotch Plains, NJ 07076, and we also have offices in Westfield, Newark, East Brunswick, Clifton, Cherry Hill, and Elizabeth.

The articles on this blog are for informative purposes only and are no substitute for legal advice or an attorney-client relationship. If you are seeking legal advice, please contact our law firm directly.




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