New Jersey Postal Worker Faces Workers’ Compensation Fraud Charges

Allegedly Posted Photos of Zip-Lining Vacation While Collecting Medical Disability Payments

Worker Faces Workers’ Compensation Fraud ChargesA grand jury has returned an indictment against a former New Jersey postal employee, charging him with theft by deception and insurance fraud. The indictment came after the former postal worker posted online photos showing him ziplining and rappelling while on vacation in 2015.

According to prosecutors, the defendant first sought workers’ compensation in 2008 for what he alleged was a fall on the job. He obtained a medical opinion then that his injuries made him unfit to perform the requirements of his job as a letter carrier. He had been receiving workers’ compensation payments ever since, even though medical assessments in 2009, 2010 and 2012 all said he was able to return to work. He also turned down offers from the Postal Service to take less physically demanding jobs, regularly providing his employer with reports from a personal physician that attested to his inability to work.

In addition to the Facebook photos showing him ziplining, prosecutors also said they had documentary evidence of the man engaged in other strenuous activities, including climbing, using a chain saw and a hand saw, throwing large logs and participating in other types of yard work. The man allegedly signed a waiver just prior to going ziplining. The New Jersey Attorney General’s office says the crimes with which the man is charged can carry up to 15 years in prison, as well as more than $150,000 in fines.

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New Jersey Supreme Court to Consider Whether Employee Can Waive Right to Sue

Case Looks at Employment Contracts that Waive Third-Party Claims

New Jersey Supreme CourtWhen you’ve been hurt at work, and your injury is caused in part by someone other than your employer or a co-employee, the workers’ compensation laws in New Jersey do not prevent you from filing a “third-party claim” against that unrelated party. A number of employers have attempted to prevent third-party claims by employees by having them sign an employment contract that specifically waives that right. The New Jersey Supreme Court has heard oral arguments on a case that will determine whether such provisions in an employment contract are void as contrary to public policy.

In the case before the New Jersey Supreme Court, Schering-Plough (now Merck & Co.) filed an appeal, asking the court to overturn a ruling by the Appellate Division. In the lower court ruling, the court affirmed the trial court ruling denying Schering-Plough’s motion for summary judgment. Schering-Plough had asked the trial court to throw out a claim by a security guard injured at one of its facilities, arguing that the security guard had entered into an employment agreement whereby he agreed not to sue a third party for any injuries suffered on the job. The guard was not an employee of Schering, but worked for Allied Barton Security Services, a contractor with Schering-Plough. The Appellate Court concluded that the contract between the security guard and Allied Barton violated public policy, as well as the intent and spirit of the New Jersey Workers’ Compensation Act.

In arguments before the New Jersey Supreme Court, Schering argued that the agreement between the guard and Allied Barton was an enforceable contract and should be honored. In response, the security guard’s attorney referred to the contract as an “adhesion contract,” one that the guard had no choice but to sign if he wanted the job. He noted that the courts have long discouraged the enforcement of contracts where one side has all the bargaining power.

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To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all workers’ compensation cases on a contingency basis. There will be no attorney fees unless we get compensation for your losses.

Toms River Business Owner Sentenced for Workers’ Compensation Fraud

Admits to Defrauding Insurance Carrier of $600,000

Business Owner Sentenced for Workers Compensation FraudA New Jersey business owner pleaded guilty to conspiracy and insurance fraud in connection with a workers’ compensation fraud scheme that allowed the company to reduce its workers’ compensation insurance premiums by nearly $600,000 over a three-year period. According to the criminal complaint, filed by the New Jersey Attorney General’s Office, the business owner conspired with a local insurance agency to intentionally misclassify warehouse workers as office personnel in order to pay lower workers’ compensation insurance premiums.

State officials say that the company had as many as 72 employees at any given time, with most of them working in high-risk occupations where they were disassembling and refurbishing a wide range of electronics products, including computers and televisions. When filing its application for workers’ compensation insurance, and in subsequent reports to the workers’ compensation insurance provider, the company reported that most workers were office staff.

Workers’ compensation insurance premiums are based, in part, on the type of work being performed. The premiums are higher for jobs that are inherently more dangerous. Because the warehouse positions were more dangerous and required a higher premium, the misclassification cost the insurer approximately $600,000.

The owner of the company was sentenced to three years on prison on the fraud count, and the company was ordered to make restitution and pay a $100,000 fine. In addition, another employee of the company and three employees at the insurance agency were charged.

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To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all workers’ compensation cases on a contingency basis. There will be no attorney fees unless we get compensation for your losses.

Can You Collect Workers’ Compensation and File a Personal Injury Lawsuit at the Same Time?

Can You Collect Workers CompensationIf you have been injured on the job, you may have been told by your employer, or by someone else, that your only recourse for your losses is to file a workers’ compensation claim. The workers’ compensation laws are often the “exclusive” remedy for a work-related injury, but there are exceptions. Here’s how it works.

Under the workers’ compensation laws in New Jersey, a workers’ compensation claim is intended to operate as your sole means of redress for the negligence of your employer or a co-employee. Accordingly, if you were injured because your employer failed to provide adequate safety measures, or because a co-worker was careless in his or her duty, you must apply for workers’ compensation benefits to cover any losses.

However, if your injury was caused, in part or in whole, by the wrongful acts of someone other than your employer or a co-employer, you may be able to bring a civil suit (a personal injury lawsuit in court) against that person. Examples of situations where this option may be available include:

  • When you are injured because of exposure to or the breakdown of a dangerous or defective product
  • When you are injured in a motor vehicle accident where the at-fault driver was neither your employer, nor a co-employee
  • When you are injured by the carelessness or negligence of an adjoining property owner, a customer, vendor or other person not a co-worker

There is nothing to prohibit you from filing a workers’ compensation claim for the wrongful activities of your employer or a co-employee, and simultaneously filing a lawsuit for injuries caused by an unrelated third party. You cannot, however, recover twice for the same loss. If you have medical expenses paid by a workers’ compensation claim, you can’t seek to recover the same losses in a personal injury lawsuit in court.

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To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all workers’ compensation cases on a contingency basis. There will be no attorney fees unless we get compensation for your losses.

Protecting Yourself during a Workers’ Compensation Medical Exam

Workers’ Compensation Medical ExamWhen you are injured on the job and file a workers’ compensation claim, your employer (and the workers’ compensation insurance provider) have the right to require that you submit to a medical examination by a doctor of their choosing. It’s called an independent examination, but the doctor will be looking for justification to either minimize or deny your claim. There are certain things you should always do, and measures that you can take, to protect your claim and your right to recovery.

Be Honest

The best approach is always the honest one. Don’t minimize your injury, but don’t exaggerate it, either. Don’t try to guess what you should say to make certain your claim is approved. Tell the doctor what you can and cannot do without pain. It’s not unlikely that your employer or the workers’ compensation insurance company will send a private investigator out to observe you in your daily activities. If you’ve told the doctor you can’t walk without pain, but you are videotaped jogging around the block, your claim will probably be denied (and you may not need workers’ compensation benefits, anyway).

Be Thorough

One of the common mistakes that personal injury victims make is focusing on “obvious” injuries to the exclusion of less-visible, but potentially more serious physical problems. Tell the doctor everything that happened and everything that’s out of the ordinary. Don’t focus on the broken leg and forget the strained neck or back, which may ultimately be more debilitating.

Ask to Have the Exam Videotaped

You have the legal right to have your exam videotaped. If the doctor refuses to comply, get an attorney involved.

Contact the Law Offices of Voorhees Law, LLC

To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all workers’ compensation cases on a contingency basis. There will be no attorney fees unless we get compensation for your losses.

The Death Benefits Available in a New Jersey Workers’ Compensation Claim

Death Benefits AvailableIf you are injured or become ill because of your job, New Jersey law allows you to pursue workers’ compensation benefits to cover temporary and permanent disability, as well as medical expenses. There are, as well, death benefits that will be paid if your loved one dies in a workplace accident or because of a work-related disease.

The Death Benefits Allowed in a New Jersey Workers’ Compensation Claim

If you qualify as a dependent of a worker who has died from a work-related injury or illness, you will be entitled to payment of 70% of the decedent’s average weekly wage over the 52 weeks prior to death or illness, capped at the statutory amount. As the spouse or biological child who is living with and dependent on the deceased at the time of death, you will automatically be presumed to be a dependent. However, even if you were not living with the deceased at the time of death, you can still receive benefits if you can prove to the workers’ compensation judge that you were actually dependent on the decedent.

A biological or natural child of the deceased will be considered a dependent until the age of 18, or until the age of 23, if a full-time student. A child who suffers a physical or mental disability may qualify as a dependent, regardless of age.

In addition to the weekly benefits, surviving dependents are also entitled to payment of funeral and burial expenses up to $3,500.

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To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all workers’ compensation cases on a contingency basis. We won’t charge you any attorney fees unless we are able to get compensation for your losses.

Your Right to Appeal a Workers’ Compensation Denial

Your Right to Appeal a Workers' Compensation DenialYou’ve been hurt on the job or are suffering a work-related illness and you’ve filed an application for workers’ compensation benefits, but your claim has been denied. Unfortunately, it’s a fairly common occurrence. Your employer and the workers’ compensation insurance provider both have a vested interest in minimizing or denying your claim for benefits. You do, however, have the right to appeal the rejection of your claim. Here’s how you do that.

The Initial Appeal

Upon the initial denial of your application for benefits, you have a choice—you can request a formal hearing through a Claim Petition, or you can ask for an information hearing.

A petition for a formal hearing must be filed with two years of the date of your injury or the last date you received any workers’ compensation benefits, whichever came last. If your claim is based on an occupational disease, the period is two years from the date you became aware of the illness and that it was likely caused by something related to your work. The formal hearing is pretty similar to a trial, as you’ll have the opportunity to introduce evidence and to bring in witnesses to testify on your behalf, such as doctors and co-workers. Once all the evidence has been considered, the workers’ compensation judge will render an opinion (in writing). If the judge rules against you, you have the right to appeal to the Appellate Division of the Superior Court in the state of New Jersey.

With an informal hearing, you’ll probably have your case reviewed more quickly. You’ll be assigned a judge, who will schedule a hearing, but the proceeding will be far less formal. The judge may make a recommendation, based on the evidence provided, but either party can reject that recommendation. Typically, if you don’t resolve the matter at an informal hearing, the next step is to request a formal hearing.

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To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all workers’ compensation cases on a contingency basis. There will be no attorney fees unless we get compensation for your losses.

Permanent Partial Disability vs. Permanent Total Disability

Permanent Partial Disability vsUnderstanding Your Rights in a New Jersey Workers’ Compensation Claim

If you have been hurt at work, and your injuries are permanent, you will be entitled to additional cash benefits, which will vary based on whether your disability is partial or total. As a general rule, these benefits do not start until your temporary disability benefits cease, either because you have returned to work or reached maximum medical improvement (MMI).

Permanent Partial Disability

If you are able to work in some capacity, but you’ve reached maximum medical improvement without full recovery, you can return to work and receive permanent partial disability (PPD)payments at the same time. Once your treating physician has certified that you’ve attained maximum medical improvement, the doctor will evaluate you and determine the extent of your permanent disability or impairment. The doctor will give you a disability “rating,” based on the nature of the permanent injuries you’ve sustained. The amount you receive will depend on whether your injury is “scheduled,” involving hands, arms, feet, legs, ears, eyes or teeth; or whether it is “non-scheduled,” relating to some other part of the body.

Permanent Total Disability

If you can’t return to work at all because of your injury, you’ll be entitled to receive permanent total disability (PTD) benefits. Similar to the temporary disability payments previously received, these payments are based on your average weekly wage for the 52 weeks prior to your injury, and are capped at 70% of that amount. Permanent total disability payments are initially awarded for a period of 450 weeks, but may continue if you are still unable to work in any capacity at the end of the initial period.

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To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all workers’ compensation cases on a contingency basis. There will be no attorney fees unless we get compensation for your losses.

The Benefits You Can Expect if Your Workers’ Compensation is Approved

Expect if Your Workers' Compensation is ApprovedIf you have been injured on the job, or have contracted an occupational disease because of exposure to work-related conditions or substances, the New Jersey workers’ compensation laws allow you to recover benefits to cover the costs of medical treatment, as well as payments to compensate you for your disability.

Medical Benefits under the New Jersey Workers’ Compensation Laws

According to the New Jersey workers’ compensation guidelines, you are entitled to receive reimbursement or payment of all “proper, necessary and reasonable” medical care necessitated by your work-related injury or illness. This includes payment of all doctor’s appointments, any trips to urgent care or the hospital, all physical therapy or rehab prescribed by an approved doctor, and the cost of equipment, prescriptions or surgery, if necessary.

Under New Jersey law, your employer (and the workers’ compensation insurance company) have the right to choose your treating physician. If you want to go to another doctor (your own physician, for instance), you must either obtain permission or risk having to pay those bills yourself.

Disability Payments under the New Jersey Workers’ Compensation Statute

The disability payments you receive after an occupational injury or illness in New Jersey will be categorized as either temporary or permanent, and either partial or total. You can only receive temporary disability benefits if your injury prevents you from working. During your recovery period, you will be entitled to 70% of your average weekly wage before the accident. Temporary benefits will cease when you either return to work or have been deemed by your treating physician to have reached “maximum medical improvement (MMI).”

Contact Our Office

To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all workers’ compensation cases on a contingency basis. There will be no attorney fees unless we get compensation for your losses.

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