What Is Workers’ Compensation?
Workers’ compensation law first developed during the Industrial Revolution in response to high levels of serious injuries among factory workers. Prior to the advent of workers’ compensation laws, injured employees would be forced to sue their employers for negligence in order to obtain compensation for pain and suffering, medical bills and lost wages. Workers’ compensation laws were crafted as a “grand bargain” between labor and industry, in which employees gave up their right to sue for pain and suffering, in exchange for swift access to medical care and lost wage benefits. Each State has adopted such remedial social legislation to compensate employees for work injuries, while at the same time preventing catastrophic injuries from bankrupting American businesses. It is mandatory for employers to purchase workers’ compensation insurance coverage to cover such claims.
Does Workers’ Compensation Cover Only Sudden Accidents Or Other Long Term Problems And Illnesses As Well?
In New Jersey, work-related medical conditions which develop over an extended period of time are referred to as “occupational exposure” claims. Examples of occupational claims include: carpal tunnel syndrome caused by repetitive typing; pulmonary disability of a fireman stemming from smoke inhalation over the years; hearing loss from being exposed to constant loud noises over an extended period of time; back injuries from years of heavy lifting; or shoulder impingement brought on by the repetitive use of tools. Any activity which requires the use of the same muscles or systems repeatedly has the danger of causing an occupational injury.
Occupational claims are notoriously more difficult to litigate than specific accident claims because the Court must compare what activities the person does in their daily life to their occupational efforts. Since it is inherently challenging to pinpoint when a degenerative type injury began, it is more difficult to prove such claims.
Who Is Liable for the Payment of a Worker’s Compensation Claim?
If there is insurance coverage through a worker’s compensation carrier, then the insurance carrier pays all of the benefits owed to an injured worker. The employer itself does not pay any benefits if a valid workers’ compensation insurance policy was in place at the time of the accident or injury. The insurance carrier is responsible for the payment of all medical bills, temporary disability benefits, and permanent disability benefits to the injured worker.
If the employer is uninsured, however, then the employer must pay the benefits directly to the injured worker. If the uninsured employer is a corporation or legal entity which does not have access to adequate funds to pay these benefits, the owner of company may be held personally liable to pay the claim. In addition, there are criminal penalties in New Jersey for an employer which fails to secure the necessary workers’ compensation insurance coverage. For these reasons, it is critical for all employers to take out a workers’ compensation insurance policy. Business owners may purchase a rider to the policy, to cover themselves as “employees” in the event that they are themselves injured during the course of working in their own business.
Does A Worker Have To Be Injured At Their Physical Place Of Employment To Qualify For Workers’ Compensation Benefits?
The location of the injury is not as important as the question of whether an injury occurred during the “course of employment.” Many jobs are performed at varying locations, such as a sales position which entails traveling on a regular basis. The location of where the injury occurs will not alone determine whether the salesperson is qualified to receive workers’ compensation benefits. Rather, the issue is whether or not the salesperson was performing work on behalf of the employer at the time of the accident.
New Jersey follows the “Going and Coming” Rule, which provides that injuries which occur when an employee is traveling to and from the workplace are not covered by workers’ compensation. The question such cases is when an employee is deemed to have actually “arrived” at work. For instance, does the employee arrive when he drives into the parking lot, when he walks through the door of a multi-tenant building, enter the elevator, or when he sits down at his desk? Generally, the answer depends upon whether the employer owns or controls the location of the accident. So if your employer owns the building and the parking lot, if you trip in the parking lot then the injury will be covered through workers’ compensation.
How Important Is My Medical History In A Workers’ Compensation Claim?
Medical history is extremely important in the arena of worker’s compensation. However, just because a person has pre-existing medical condition does not disqualify her from receiving workers’ compensation benefits. Workers’ compensation carriers will always attempt to utilize a prior injury or condition as the basis to deny a claim or provide only limited medical treatment. Claimants with pre-existing medical conditions may need to fight to receive medical treatment. Moreover, at the time of settlement, the insurance carrier would be entitled to receive a credit for any pre-existing permanent disability.
How Long Does Someone Have To File A Workers Compensation Claim From The Time Of Injury?
The “statute of limitations” for filing a workers’ compensation claim is two years from the date that worker’s compensation benefits were last paid, including authorized medical treatment. If no medical treatment was provided though workers’ compensation, then a Claim Petition must be filed with the Division of Workers’ Compensation within two years of the date of the accident. For occupational claims, the Petition must be filed within two years of the date you knew or should have known that you sustained an injury related to your employment.
For more information on Workers’ Compensation Claims in New Jersey, 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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