Is Your Injury Work-Related? – Part Two

Is Your Injury Work-Related? – Part Two

In an earlier blog, we explained the requirements to qualify for workers’ compensation benefits in New Jersey: you must have been injured and the injury must have been in the course of your employment. In that blog, we looked at whether you qualify for workers’ compensation if you were hurt during a work-related break or while traveling for your job. In this blog, we look at eligibility if you suffered injury at a company-sponsored event, or if your injury resulted from your own wrongdoing.

Injuries Suffered at a Company Outing or Event

It’s become pretty common for employers to sponsor team-building or employee appreciation events, such as golf outings or trips. What happens if you suffer an injury at a company-sponsored outing? In most instances, you’ll be able to seek workers’ compensation benefits, even if attendance was optional. There are exceptions, though. If you were engaged in some unreasonable conduct when the injury occurred, your claim may be denied. For example, suppose your employer sponsored a zip-lining event as a team-building event and you became drunk and suffered an injury. Unless your employer provided the alcohol, you probably won’t be able to recover workers’ compensation benefits.

Injuries Resulting from Your Own Wrongdoing

Workers’ compensation laws are generally no-fault statutes—that means that you are covered regardless of who caused the accident. Accordingly, your own negligence won’t prevent you from recovering benefits. However, if your employer can show that you intentionally injured yourself, or that you consciously disregarded company policy or safety rules, your claim may be denied.

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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.

Is Your Injury Work-Related? – Part One

Is Your Injury Work-Related? – Part One

Under New Jersey law, there are only two requirements to qualify for workers’ compensation benefits: you must have been injured, and the injury must have been suffered while you were performing the normal functions, duties and responsibilities of your job. If you have an accident while running a machine, loading a truck or in some other task clearly within your job description, there’s usually little question whether you meet the tests above. But there are situations where, even though you’re on the clock, questions may arise as to whether you were actually working at the time.

When You Are Hurt on a Break

Under state and/or federal labor laws, most workers are entitled to regular breaks, including a lunch break. Will you still qualify for workers’ compensation benefits if you slip and fall in the company cafeteria while at lunch? Does it make a difference if you leave company premises to get something to eat?

As a general rule, if you are still on company property and taking an authorized break, injuries that you suffer will typically qualify for workers’ compensation benefits, unless they are intentionally self-inflicted or unless you were engaged in horseplay or unauthorized conduct at the time. If you choose to go out to a restaurant for a meal, any injuries sustained to, from or while at the restaurant are generally not covered by workers’ compensation, unless you went to the restaurant on behalf of a supervisor or the company, picking up food for others, for instance.

When You Are Traveling for Your Employer

Injuries suffered on your commute to or from work are not considered work-related injuries, unless you deviated from your normal route to do some work-related task. If your job requires that you travel, or if you attend a conference, convention or seminar that is work-related, you may be able to recover workers’ compensation benefits for any injuries suffered getting to or from the event, or while at the event, provided the activity you were engaged in was not essentially or primarily personal. For example, if you slip and fall at the hotel while traveling for work, you will likely be covered, unless you were headed out to a nightclub or other personal trip on your down time. If, instead, you were headed to or from a session or other work-related event, you’ll likely be covered.

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.

Does Your Status as an Independent Contractor Prevent You from Filing for Workers’ Compensation?

Employers and workers’ compensation insurance companies both have a vested interest in minimizing the amount paid out for work-related injuries. Employers must pay higher premiums if there are more claims against them, and workers’ compensation insurance companies maximize their profits by minimizing the compensation they pay to injured workers.

A common ploy by employers and insurers is to deny coverage by alleging that you were not an employee, but an independent contractor. This strategy is used in a wide range of industries, covering a broad spectrum of workers, from sales people to construction workers. It’s important to understand, though, that many of the bases that companies and insurers use to deny coverage are without merit:

  • You don’t have to be on the company payroll to qualify for workers’ compensation
  • You don’t have to have payroll taxes withheld on your behalf to receive workers’ compensation
  • It’s not necessary that you have an office or a locker at any company location to be considered an employee for purposes of workers’ compensation

Here are some of the other tests for determining whether an employee is actually an independent contractor, and not eligible for workers’ compensation.

  • The worker must be able to act independently, free of any direction or control by the company paying the bill. The more control exercised, the greater the likelihood of an employer-employee relationship.
  • The worker is typically paid for the job, not by the hour or by salary
  • A person who provides his or her own equipment is typically considered an independent contractor
  • A person is not an independent contractor simply because there’s an agreement designating him or her as such. The nature of the work and the relationship will take precedence over what is alleged in writing.

Contact Us

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.

Consequential Injuries and Workers’ Compensation Benefits

When you’ve been hurt on the job, there’s an inclination to believe that your injury must be serious and catastrophic, and must be readily apparent, for you to be able to pursue workers’ compensation benefits. There are times, though, when a seemingly minor injury can become quite serious and can keep you off work for weeks, months or years.

What are Consequential Injuries?

Consequential injuries are those that arise because of an earlier injury, but which may not be visible or apparent in the immediate aftermath of an accident. Often, soft tissue injuries, such as muscle pulls, sprains, strains or even trauma to connective tissue (ligaments and tendons) take a period of time to fully manifest. Just after the accident, before nerves become inflamed, you may be able to move about without much restriction. You may initially make small adjustments in how you walk, stand, sit or lie down, though, and those small adjustments can have a significant impact over a period of time. As a result, you may discover that 2-3 months after your accident, you experience excruciating pain engaging in the most routine daily tasks.

As another example, suppose you sustain a small cut to your finger—maybe from a paper cut—and you experience minimal discomfort for a few days. But assume that the cut gets infected. It could cause you to experience limited use of a hand or arm for a while, or it could lead to infection throughout your body. You may not think it’s worth it to file a workers’ compensation claim for a paper cut, but it could be the reason you can’t work.

Contact Us

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.

Administrative Law Judge Says Work Comp Must Pay for Medical Marijuana

New Jersey has allowed medical marijuana for more than seven years, with the sale of the drug permitted in January, 2010. However, even though the drug is considered legal in the state, many employers have refused to reimburse injured workers for the costs of the drug. A decision last month by an administrative law judge may make it more difficult for employers to refuse to reimburse such costs in the future.

In the case before the administrative law judge, the injured party had been prescribed state-sanctioned medical marijuana after hurting his hand while working at a lumber company. He initially purchased the prescription drug, but stopped doing so when his employer refused to cover the costs. He opted, instead, to use prescription opiates, such as Percocet, to manage his pain. He ultimately sought a ruling from the administrative law judge that he be reimbursed for the costs of medical marijuana he had already purchased, and that the judge rule that future purchases of prescribed medical marijuana be covered under his workers’ compensation benefits.

After hearing all the evidence, the judge concluded that the expense of the medical marijuana should have been reimbursed, as it was based a prescription that was within the boundaries of the laws of New Jersey. Finding that the medical marijuana was not “as debilitating” as the Percocet and other opiates the injured man had resorted to, and that his use of the medical marijuana had been successful, the administrative law judge also ordered the workers’ compensation insurer to pay for any future prescriptions for state-sanctioned medical marijuana.

Contact Us

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.

Different Types of Benefits Available through a New Jersey Workers’ Compensation Claim

When you have been hurt on the job in New Jersey, you have the right to seek certain benefits. It’s all a part of what’s known as the “grand bargain,” designed to benefit workers and employers. Workers who qualify can often start receiving benefits within a few weeks of an injury, and employers don’t have to worry about exorbitant awards from a sympathetic jury. Here are the different types of benefits available.

Medical Benefits

After a workplace injury, you are entitled to reimbursement or payment of all reasonable and necessary medical expenses, including treatment, prescriptions and hospital services. Your employer retains the right, though, to choose your primary caregiver.

Temporary Total Benefits

Total benefits are payable if you cannot work at all because of your injury. You won’t be eligible for these benefits until you have been unable to work for more than seven calendar days. Payments, though, will be retroactive to the date of your injury. The amount payable is based on your average weekly wage for the 52 weeks prior to your injury. You will be entitled to up to 70% of that average weekly wage.

Permanent Partial Benefits

If you have a temporary disability that involves some degree of permanent bodily impairment, you will be entitled to weekly payments for the permanent disability, once your temporary disability ends.

Permanent Total Disability

If you cannot return to work, you will be entitled to total disability benefits (up to 70% of AWW) for up to 450 weeks. Benefits may continue after 450 weeks if you can show that you are still totally disabled.

Death Benefits

Surviving family members may have a claim for workers’ compensation benefits for the statutory period (up to 450 weeks) after a worker’s death. There’s also a right to reimbursement for death and funeral expenses, up to $3,500.

Contact Us

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.

What Are an Employer’s Responsibilities with Respect to Workers’ Compensation Insurance?

In New Jersey, all employers are required to either carry a valid policy of workers’ compensation insurance or obtain state approval to be self-insured (to pay claims directly). There are other requirements as well.

The Notice Requirement

Under New Jersey law, an employer must post and maintain a specific form mandated by the state’s Commissioner of the Department of Banking and Insurance. The notice must be conspicuously displayed in the workplace, and must notify employees that the employer has either obtained a policy of workers’ compensation insurance or has successfully obtained permission to be self-insured. The notice most identify the name of workers’ compensation insurance provider, as well as information as to how to contact that provider.

The Establishment of Clear Procedures

The employer must also communicate to any worker, upon hire and on a regular basis thereafter, the nature of the workers’ compensation benefits available; how to report an injury and initiate a workers’ compensation claim; and where the employee must seek medical care in the event of a work-related injury. This requirement can be met by obtaining a brochure available from the New Jersey Division of Workers’ Compensation.

Reporting a Work Accident

An employer must immediately notify the workers’ compensation insurance carrier after learning of any workplace injury. The carrier must then submit a “First Report of Injury” to the state of New Jersey. After the injured worker has returned to work or has reached what is known as “maximum medical improvement,” the workers’ compensation insurance provider has 26 weeks to file a “Subsequent Report of Injury.”

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.

What Are Scheduled and Non-Scheduled Losses?

If you have been hurt at work, it’s possible you’ve heard someone say something about “scheduled” and “non-scheduled” losses. Just what do those terms mean? What are the implications in your case?

A Scheduled Loss

A scheduled loss is one that is listed on a specific state schedule. These types of injuries typically involve readily identifiable body parts, including arms, legs, shoulders, hips, elbows, knees, wrists, ankles, fingers, toes, ears and eyes. If you suffer a permanent disability to a body part that is listed on the schedule, the amount of weeks you would receive benefits is calculated by looking at the degree of your disability and your “scheduled” number of weeks. For example, your injury may be listed as entitling you to 300 weeks, but the medical opinion is that you only have 25% loss of use with the foot—you’d be entitled to 75 weeks of compensation.

A Non-Scheduled Loss

Non-scheduled losses are those tied to other parts of the body, such as internal organs or your spinal cord. As will a scheduled loss, you will probably get a disability rating from the treating physician, which will estimate the degree of your disability. The number of weeks you’ll be able to recover benefits (at a rate of up to 70% of Average Weekly Wage) will be the percentage times 600 weeks.

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.

Expect that the Workers’ Compensation Insurer Will Try to Deny Your Claim

Two people playing tug of war

When you’ve been injured on the job and it’s obvious that the injury was caused by some careless or negligent act by your employer or a co-employee, it can come as a shock to have the workers’ compensation insurance provider initially reject your claim—but it shouldn’t. Insurance companies make their money by minimizing the amount they have to pay out to satisfy claims against their policyholders. They also understand that, if they deny your claim, you’ll have to incur the time and expense of hiring an attorney to get the benefits to which you are entitled. Often, they are gambling that you won’t do that.

The most common strategy used by employers and workers’ compensation insurance companies is to contend that your injury really didn’t happen at work, even if there were a number of witnesses who saw the accident. If there’s any evidence of any similar pre-existing condition, they’ll attempt to attribute any limitations on your ability to work to that pre-existing injury. In fact, don’t be surprised if the workers’ compensation insurer asks for a copy of your medical history and seeks to attribute the injury to some incident that happened years ago. Maybe you were in a car accident when you were young or hurt your back playing sports. It’s not uncommon for a workers’ compensation insurance company to try to blame any pain or discomfort have on a condition that has long-since healed.

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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