In the first blog about the workers’ compensation system in New Jersey, we discussed the initial steps—notifying your employer of your injury, and getting a medical examination. What happens next?
Once you’ve met with the company/insurance provider-selected physician, the workers’ compensation insurance company will receive a report and recommendation from its medical professional, and will decide to grant or deny your claim, based on that doctor’s findings. If your claim is granted, you should start to receive disability benefits within a week or so. The amount of your disability payments will be based on the degree of injury—partial or permanent—as well as your average weekly wage for the last 52 weeks. You will typically be eligible for workers’ compensation benefits until you are able to return to work or have reached what is known as "maximum medical improvement." If you cannot return to work, or if you have any degree of disability that is permanent, you may be entitled to a schedule award, based on the type of injury you’ve sustained.
If your claim is rejected and you disagree, you have the right to appeal. This can be done through a formal or an informal process. A workers’ compensation judge/referee will be present at either type of reconsideration hearing. With an informal proceeding, the recommendation is just that—a recommendation that is not binding on either party. However, with a formal proceeding, the judge’s ruling is binding.
It’s customarily at the reconsideration phase that you can bring in your own evidence to refute the findings of the workers’ compensation insurance company or the workers’ compensation judge. This can include reports from your own doctor documenting the extent of your injuries. If your doctor disagrees with the company doctor, the workers’ compensation judge may order a third opinion to resolve the matter.
Contact the Personal Injury Attorneys at Mallon & Tranger
We offer a free initial consultation to anyone who has suffered any type of personal injury on the job. To set up a meeting, contact us online or call us at 732-410-6094 (toll free at 877-320-0692) for an appointment. We have offices in Freehold, Toms River and Point Pleasant.