What Damages Are Available In A Workers Compensation Claim?
There are only three types of benefits available under the New Jersey Workers’ Compensation Act: (1) Medical Benefits; (2) Temporary Disability Benefits; and possibly, (3) Permanent Disability Benefits (either partial or total disability).
What Medical Coverage Is Provided Through Workers’ Compensation?
If you are hurt during the course of your employment, 100% of your medical bills are covered through workers’ compensation, with no deductible or co-payment. However, you cannot choose your own doctor. The insurance carrier has the right to direct your care to a specific medical provider. If the insurance carrier fails to assign a physician after you request treatment, you may then seek treatment with the physician of your choice, for at least an initial consultation and treatment recommendation. A workers’ compensation attorney may then file a Motion for Medical Treatment on your behalf, to compel the insurance carrier to authorize the recommended medical treatment.
Who Will Pay My Wages If I Am Unable To Work As A Result Of An Accident?
The Workers’ Compensation Act provides that an employee is entitled to receive temporary disability benefits equaling 70% of his average weekly wage, up to the state maximum, for the period of time that the authorized treating physician indicates he is unable to work and needs active medical treatment. The average weekly wage is calculated based upon the employee’s gross wages before taxes, and it is generally although not always computed over the six month period immediately prior to the date of the accident. The workers’ compensation insurance carrier pays the temporary disability benefits, not the employer.
What If I Never Fully Recover From My Injuries?
You may be entitled to receive an award of partial permanent disability benefits if you suffer from a loss of function, even if you returned to work at the same job. In order to evaluate your degree of permanent disability, both the carrier and your attorney will retain medical experts who are familiar with the New Jersey disability schedule. Both experts will provide exaggerated estimates of the disability for the purposes of negotiating a settlement of the claim. Most claims settle prior to trial, at a percentage of permanent partial disability benefits somewhere between the estimates of the medical experts.
The amount of your permanent disability benefits will be based upon the schedule of disabilities in effect in the year in which your work accident occurred. The benefits will vary based upon your wages, up to the maximum rate at the time of the accident, and the number of weeks of benefits available for the injured body part under the New Jersey Workers’ Compensation Act.
You will not be entitled to collect damages for “pain and suffering” in connection to the work injury, unless the negligence of a third party (someone other than your employer or co-worker) caused the accident.
Can An Employee Receiving Workers’ Compensation Also Be Eligible For Unemployment And/Or Social Security Disability Benefits?
A person can be eligible for a combination of worker’s compensation, unemployment, and/or social security disability at varying times following an injury.
If you are unable to work due to an injury you should be receiving workers’ compensation temporary disability benefits, even if your position was terminated following the accident. You will be ineligible to receive unemployment benefits unless you are medically ready, willing, and able to work. You cannot receive both temporary disability and unemployment benefits over the same period of time. However, you may file for unemployment benefits if job is no longer available once you are discharged from medical treatment.
In the event that your physician believes that you will be out of work for an entire year, you should apply for social security disability [“SSSD”] benefits, even if you are still collecting workers’ compensation benefits. You must advise the Social Security Administration of the amount you are collecting from workers’ compensation. Your SSD benefits may be adjusted so that you are not receiving more than 80% of your average earnings between your SSD and workers’ compensation benefits.
Why Do I Need An Experienced Workers’ Compensation Attorney To Handle My Claim?
For extremely minor injuries, primarily limited to the fingers and toes, it may not be necessary to hire an attorney to file a workers’ compensation claim. The more significant the injury, the more critical it is to obtain legal representation at the beginning of the claims process. A competent workers’ compensation attorney will ensure that you are paid at the correct temporary disability rate and should fight for you to receive the medical treatment you need to recover from your injuries. It is not uncommon for insurance carriers to deny medical treatment on the basis of a “pre-existing condition,” which the patient was never aware even existed. It is thus critical to have an advocate on your side to deal with the insurance carrier as early in the process as possible.
For more information on Damages Available In A Workers’ Comp Claim, an initial consultation is your next best step. Get the information and legal answers you are seeking by calling (908) 923-0020 today.
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