WORKERS COMPENSATION OVERVIEW
What are you entitled to?
Under the New Jersey Workers’ Compensation Act, if you are injured on the job, you may be entitled to several benefits regardless of fault. These benefits may include:
1) Medical Benefits: Employers must provide you immediate, necessary, and curative medical treatment until you reach maximum medical improvement.
- Maximum medical improvement (“MMI”): Maximum medical improvement is reached when additional medical treatment will no longer cure and relieve the effects of your injury. Medical treatment that only deals with pain and will not improve your condition is not required to be provided.
- Employer’s right to control treatment: Employers have an absolute right to choose your treating physician and are only required to pay for treatment which is deemed reasonable and necessary.
2) Lost wages: If a treating workers compensation doctor finds that you are unable to work, employers must provide you wage continuation benefits until you return to work or you reach maximum medical improvement.
3) A permanency award: Employers must provide you monetary compensation for any permanent injuries you sustained as the result of a workplace accident.
- Medical records: At the conclusion of your medical treatment, Seigel Law will obtain all your medical records from all your providers. These records will then be forwarded to the doctor who will be performing the permanency evaluation. When the doctor receives all your medical records, you will be scheduled for a permanency exam.
- Permanency examinations: In order to receive a permanency award, you must attend two permanency examinations. One examination will be performed on your behalf, and the other examination will be performed on behalf of your employer’s workers’ compensation insurance carrier.
- i. At these permanency examinations, a doctor will review your medical records, evaluate your present complaints and limitations, and determine the permanency of your injuries.
- Medical reports: Approximately six to eight weeks after the permanency examination on your behalf, Seigel Law will receive a permanency report. This report will provide an opinion, in percentage terms, regarding the permanency of your injuries. Similarly, six to eight weeks after your permanency examination on behalf of the insurance carrier, counsel for the insurance carrier will receive a permanency report.
- Pretrial conferences: After both parties have obtained their respective permanency reports, counsel for both parties will attend pretrial conferences in court. At these pretrial conferences, the parties will exchange permanency reports, make demands, and conference the case with the judge. In an effort to promote fair and reasonable settlements, the judge will often provide an opinion as to the value of the case.
- Settlement / Trial: If the parties are able to reach a fair and reasonable settlement, you will appear in court and the parties will offer a proposed settlement to the court. If the presiding judge finds the proposed settlement fair and reasonable, the judge will approve the settlement and award you a permanency award. If the parties are unable to reach an agreement, a trial will be held and the same judge will decide the outcome of your case.
4) Death benefits: Employers must pay benefits to the dependents of a deceased employee.
What are you not entitled to?
1) Pain and suffering damages: In personal injury cases, individuals that are injured due to the negligence of another are entitled to damages for pain and suffering. These damages often have a significant effect on the value of a case. However, in workers’ compensation, these damages are not available. Instead, an injured worker’s remedies are limited to medical treatment, lost wages, and a permanency award.
At Seigel Law, an injured worker will not pay attorney’s fees unless they receive a permanency award for their injuries. Attorney’s fees are set by the judge of workers’ compensation and will not exceed 20% of any recovery. In most cases, an injured worker will only pay 40% of the attorney’s fee, while the employer’s insurance carrier will pay 60%.
In New Jersey, an injured worker may be eligible to bring a workers compensation claim if the following requirements are met:
1) An employee/employer relationship exists, and: The Appellate Courts have applied two tests to determine if an employee/employer relationship exists. These tests include the "control test" and the "relative nature of the work test." Under the “control test,” an employee/employer relationship exists when an employer retains the right to control what is done and the manner in which the work is completed. Under the "relative nature of the work test" it is the extent of the economic dependence of the worker upon the business he/she serves and the relationship of the nature of his/her work to the operation to that business that determines whether an employee/employer relationship exists.
2) The accident arises out of, and in the course of employment: An accident arises “in the course of employment” when it occurs: within the period of employment, at a place where the employee may reasonably be, and while employee is reasonably fulfilling the duties of the employment, or doing something incidental thereto. “Arising out of employment” refers to the causal origin of the accident in relation to the employment. It requires an analysis of the risk which gave rise to the injury and whether such risk is contemplated as an incident of the employment.
Recognized Workers’ Compensation Claims
In New Jersey, there are two different classes of workers’ compensation claims that are recognized as compensable: These classes include:
1) Traumatic injury claims: Traumatic injury claims are claims that involve a one-time trauma that is physical or psychological in nature.
2) Occupational disease claims: Occupational disease claims are claims that involve injuries caused by repetitive activity or exposures over a period of days, months, or years. Occupational diseases may include, but are not limited to:
- Mesothelioma – Mesothelioma is a type of lung cancer caused by exposure to asbestos. It can be one of the most devastating occupational diseases. Manufacturers have been required to establish trust funds to compensate Mesothelioma victims and their families.
- Repetitive stress injuries — Repetitive stress injuries are injuries caused by repetitive work activities that wear the body down over time. Bursitis, carpal tunnel syndrome, degenerative disc disease, rotator cuff syndrome, tendinitis and tenosynovitis are common examples of conditions caused by constantly performing the same movements.
- Asbestosis — Asbestosis is chronic irritation from breathing in asbestos fibers that can develop into this aggressive form of lung cancer.
- Asthma — Asthma is spasms in the bronchi that cause individuals who suffer from this respiratory condition to have difficulty breathing.
- Byssinosis — Byssinosis, also called brown lung, is disease caused by inhaling dusts from vegetable fibers such as cotton, flax, hemp and sisal.
- Chronic obstructive pulmonary disease (COPD) —COPD is a weakening of the lungs caused by chronic bronchitis or emphysema that degenerates or loses the ability to function.
- Hearing loss — Hearing loss affects a primary sense and is considered a catastrophic injury. In the last several years, industries have finally recognized the need for ear protection for workers in loud settings. Firefighters, EMTs and other employees who suffered hearing loss because they were exposed to sirens and other loud noises have recently been able to obtain compensation for their injuries.
- Hypersensitivity pneumonitis —Hypersensitivity pneumonitis is a chronic lung inflammation caused by molds, dusts and chemicals.
- Pneumonoconiosis — Pneumonoconiosis is a chronic lung disease caused by exposure to metallic or mineral particles in the air.
- Silicosis — Silicosis is an occupational lung disease marked by swelling of the lungs caused by inhaling bits of silica from sand and mineral ores like quartz.
- White lung — White lung is a debilitating lung condition caused by exposure to corrosive chemicals, such as ammonia and chlorine.
Why Seigel Law ?
Maximizing value: According to a study performed by the American College of Occupational and Environmental Medicine, unrepresented injured workers receive almost fifty percent less compensation for their injuries than those that retain a workers compensation attorney. Seigel Law will ensure that any worker injured on the job receives the maximum amount of compensation available.
Medical treatment: In the world of Workers’ Compensation, it is commonplace for insurance carriers and insurance adjusters to offer inadequate treatment, delayed treatment, or no treatment at all. Seigel Law will ensure that any worker injured on the job receives the adequate and timely medical treatment they deserve.
Medical bills: In a Workers Compensation case, insurance carriers often overlook medical bills or fail to pay medical bills in a timely fashion. This results in the medical bills being forwarded to collections, which can have a negative effect on your credit. Seigel Law will ensure that any outstanding medical bills are paid, and paid promptly.
Experience: Seigel Law has an experienced staff that has handled some of the largest and most complex workers’ compensation cases in the State. It has represented workers from all different occupations including: construction workers, doctors, nurses, nursing aids, orderlies, attendants, janitors, truck drivers, police officers, and firefighters, to name a few.
Since 1976, Seigel Law has also represented injured workers from various unions including: the Police Officers Union, Firefighters Union, Corrections Officers Union, Healthcare and Institutional Workers Union, Transportation Workers Union, Truckers Union, Meat Workers Union, Chemical Workers Union, Electricians Union, Iron Workers Union, Carpenters Union, Phone Company Workers Union, Laborers Union, and the Plumbers Union.
Litigation skills: Seigel Law employs attorneys that are willing to litigate cases to ensure that any injured worker receives the best possible outcome for their case. This has the practical effect of producing larger settlements and recoveries on behalf of injured workers.