Many times an employer will restrict medical treatment to parts of the body that were reported as injured in the initial report only. Accordingly, it is imperative that all parts of the body injured in your accident be stated in your initial report even if the injury is mild in nature when it occurs.
An example would be where you trip over a box at work and injure your back but also fracture your leg. Obviously, the fractured leg is the main injury. However, unless you report the back injury in a timely fashion, you may be denied medical care in the future if that injury becomes worse over time. Again, it is imperative that all complaints associated with any given injury are reported to your employer.
A workers’ compensation case happens not only when you suffer a specific injury as a result of a specific cause, but may also occur because of the nature of your job duties which may require repetitive motion. Employees often develop conditions such as carpal tunnel syndrome, ulnar neuropathy and other conditions related to the repetitive nature of their body movements while performing their job. For example, these types of injuries may occur in assembly line type of work. With regard to these types of injuries, you should report any pain or limitation in any given body part directly to your employer when you first become aware that the pain or limitation in that body part was caused by the repetitive nature of your work.
Other than seeking emergency care, reporting the accident to your employer immediately or as soon as possible should be your first priority after an accident. The second phone call should be to the New Jersey workers’ compensation lawyers at Taylor, Taylor, Cohen & Bowles.
In the State of New Jersey, your employer (through their insurance company) tells you which doctor or medical facility you must use to obtain medical care. This is known as the “authorized treating physician”. This doctor has complete control of the medical aspect of the case. More often than not, these doctors are more interested in keeping the workers’ compensation insurance company happy than providing proper and complete medical care. These doctors often deny the patient proper medical testing such as MRI’s and often decline to take the injured worker out of work. Even in those situations where the authorized treating physician does take the injured worker out of work, more often than not it is for a shorter period of time than may be medically necessary.
The attorneys at Taylor, Taylor, Cohen & Bowles aggressively pursue your rights so that you get the medical treatment and time off that you require. If and when you are wrongfully denied your benefits, the workers’ compensation lawyers at Taylor, Taylor, Cohen & Bowles immediately file what is known as a motion for temporary and medical benefits. We bring the workers’ compensation insurance company’s conduct to the attention of the workers’ compensation judge, and with supporting medical documentation, we force the workers’ compensation insurance company to provide proper medical care to pay temporary disability benefits for the appropriate period of time. We have been extremely successful with respect to the filing of these motions resulting in our clients receiving proper and complete medical care as well as the money that they are entitled to while they are out of work.
NJ law provides that when you are medically unable to work, you are entitled to receive 70% of your wages up to a maximum amount which changes year to year and is set by NJ law. To be eligible for temporary disability, you must be disabled for 7 days, which do not necessarily have to be consecutive days.
After completion of medical treatment, you must notify the workers’ compensation team at TTCB that you have been discharged from care. At that time, the workers’ compensation team at TTCB will schedule you for an evaluation by a doctor who is recognized by the workers’ compensation court as an expert in permanency impairment. The workers’ compensation insurance company will also schedule you to be evaluated by their permanency physician. The permanency physicians will be doctors other than the treating doctors. Both of these permanency doctors will offer an opinion as to the degree of permanency associated with the injured body part. These percentages correspond to a chart published by the NJ legislature, which sets forth a dollar figure for the different percentages of permanent injury as to that body part. Depending upon the body part injured and the degree of the injury, this can be worth a substantial amount of money.
After permanency evaluations are completed, the case will be scheduled by the workers’ compensation court for a hearing and, at this time, the case may be settled by consent of the parties or by a hearing with the workers’ compensation judge. Very rarely are cases tried in the workers’ compensation court. An overwhelming majority of cases settle after permanency evaluations.
When a case settles through an Order Approving Settlement or where the case is successfully litigated to conclusion, New Jersey law provides that you have an additional two years from the date of the last payment by the workers’ compensation insurance company, to reopen your case and to obtain additional medical care, additional temporary disability benefits, and to obtain additional money in the event your condition substantially worsens after the date of the permanency award.
Accordingly, if at any time during the two year period from the last date of payment by the workers’ compensation insurance company you find that your condition has substantially worsened, you are to contact the workers’ compensation team at TTCB immediately so that the proper steps can be taken to ensure additional benefits are paid to you by the workers’ compensation insurance company.
Third Party Claim
A workers’ compensation case is not a third party claim. Under New Jersey law (with a few limited exceptions) the only remedy an injured worker has against their employer for a work related accident is to bring a workers’ compensation claim against their employer by filing a workers’ compensation claim petition. This is the case even if the employer is responsible for causing the accident.
What is a Third Party Claim
A third party claim is a claim against any individual or company other than the injured workers employer whose conduct may have contributed to the happening of the accident and injury. For example, when a bus driver is stopped at a red light and is struck in the rear by a tractor-trailer, the bus driver has two separate and distinct claims. The first claim is a claim for workers’ compensation benefits against the bus driver’s employer and the second claim is a third party claim against the owner and operator of the tractor-trailer. When this situation occurs the workers compensation team at TTCB works hand in hand with the litigation team at TTCB to ensure that our client receives the maximum recovery under both claims.
Under New Jersey law where a recovery is made in the third party claim, the workers’ compensation insurance company does have a lien against the third party recovery such that they are entitled to be reimbursed two-thirds of any monies paid by the workers’ compensation insurance company for medical benefits, temporary benefits and for permanency benefits up to $750 in actual costs. The theory behind this reimbursement is an injured worker is not entitled to a double recovery for the same injury. However, in a third party claim, pain and suffering, which is not available in a workers’ compensation claim, is an element of damages. Additionally the money repaid to the workers’ compensation carrier for temporary benefits and medical benefits are also an element of damages in the third party claim thereby potentially increasing the value of the third party claim by the amount of the repayment to the workers’ compensation insurance company.
Other examples of a work related third party claim would be a pizza delivery person being bitten by a homeowner’s dog, or a construction worker falling as a result of improperly erected scaffolding by a contractor other than his employer.
Any time you are injured in the course of your employment and that injury is caused in whole or in part by a person or entity other than your employer, you have both a workers’ compensation claim as well as a third party claim. At Taylor, Taylor, Cohen & Bowles, we explore every possible and potential claim for our clients with both our workers’ compensation team and our litigation team working side by side to achieve the maximum recovery for our clients for each of these types of claims.
Communication With Our Office
It is important for our workers’ compensation clients to communicate with our workers’ compensation team regarding any problems or concerns they have with regard to their case. All concerns are addressed within 24 hours and the attorneys at Taylor, Taylor, Cohen & Bowles do provide their clients with their cell phone numbers.