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No matter where you work, whether in a warehouse or a retail store, if you become injured at your job, you are eligible to collect Workers’ Compensation, which will help you financially. Workers’ Compensation is no-fault insurance that most New Jersey employers are required to carry.

It may not be apparent if your work accident qualifies you for this insurance or if your employer could be finding ways to deny your claim. While there are legitimate reasons why you could be denied, some employers might attempt to exploit those reasons to wrongly deny your claim. In those situations, speaking with a New Jersey Workers’ Compensation lawyer about your situation can provide you with the support you need.

What Benefits Can I Claim Through Workers’ Compensation?

Workers’ Compensation is no-fault insurance, meaning that injured employees are entitled to receive benefits without proving fault. Workers’ Compensation is federally mandated, although each state administers it; therefore, each state manages it differently. The insurance provides you with compensation for your economic expenses, and you are prohibited from filing a claim against your employer in exchange for these benefits.

You could file a claim against a third party if their actions caused your injury. This could include a claim against a machine manufacturer or even another driver if you were hurt in a car accident during work.

Workers’ Compensation benefits will include compensation you require for medical expenses. That would consist of visits to the doctor, any tests conducted, and treatments provided, including surgeries. It also includes any future expenses to treat your injuries, including rehabilitation. It is important to note that you will have to go to the doctor that your employer approves to qualify for Workers’ Compensation benefits. 

If a loved one was killed in an accident at work or due to their job conditions, Workers’ Compensation would provide death benefits for certain dependents, including up to $3,500 in burial and funeral costs. It will also compensate any dependents left behind with about 50 percent of the deceased’s salary. That amount will increase by five percent for each additional dependent, up to 70 percent of the deceased worker’s wages. That amount will last for up to 450 weeks from the date of the death.

Workers’ Compensation will also cover your lost salary, but only a portion. The state has different amounts depending on the severity of your injury and the amount of time you will be out of work. The benefits offered include: 

  • Temporary total benefits: These benefits are for those who sustain an injury that keeps them from returning to work for more than seven days. Those who fall into this category receive 70 percent of their average pay rate up to a maximum amount. That amount is determined by the Commissioner of Labor and Workforce Development. You would receive these payments for about 400 weeks. They could cease if your doctor says you are healthy enough to return to work or you have reached your maximum medical improvement (MMI) level.
  • Permanent partial benefits: Those who have suffered a permanent injury can receive permanent partial benefits. The amount received is based on the body part, the severity of that injury, and the functional loss of using that body part. Payments for this will start once your temporary benefits end, and they are paid each week.
  • Permanent total benefits: If your injuries are so severe that you cannot return to work at all, you can receive permanent total benefits. The amount is up to 70 percent of the worker’s average pay up to the maximum amount. The benefits are available for 450 weeks but can be extended if they are still disabled after that time. 

Workers’ Compensation will not compensate you for non-economic damages, such as pain and suffering or mental anguish. Non-economic damages can be sought in a third-party claim. A New Jersey Workers’ Compensation lawyer can determine if you are eligible to file a third-party claim for additional compensation. 

What Should I Do if My Workers’ Compensation Claim Is Denied?

There are legitimate reasons why an employer or insurance could deny your claim. If you were injured while you engaged in activities outside of the scope of your job, for instance, that could be grounds for denying your claim. This can include you being involved in a physical altercation with a co-worker or engaging in horseplay. You could be denied if you were intoxicated at the time of your accident. Workers’ Compensation will also not cover you if you fail to follow proper safety procedures around the workplace. You will also not be covered if you deliberately injure yourself or ask someone else to do it for you.

Some employers attempt to deny legitimate claims. If this happens, there is a formal appeals process. Hiring a New Jersey Workers’ Compensation lawyer before engaging in the process will ensure that you follow the proper steps and take full advantage of your opportunity to voice your concerns about your denial.

You have options to file an appeal: 

  • Informal hearing: A judge will be assigned to your case, and you will receive a date for your hearing, which will take place within a few weeks of your request for an informal hearing. A judge will listen to both sides of the case during this proceeding before issuing their recommendation. This is a non-binding decision. To request an informal hearing, you must submit an application.
  • Formal hearing: Your other option is a formal hearing. You need not go through the informal hearing before getting to this stage. The formal hearing takes significantly more time than the informal process, as the hearing date will not be for at least six months after your request. You will be assigned a judge who will hear both sides of the case, including testimony and evidence. After the hearing, the judge will issue a written decision. If you wish to have a formal hearing, you must submit a claim petition within two years of your injury or the last date you received a payment from your insurance, whichever occurs later.

If you are not happy with the results you receive with these two options, you can bring your case to the Appellate Division of the Superior Court. They will make a ruling on whether to accept or deny your benefits. 

New Jersey Workers’ Compensation Lawyers at Kotlar, Hernandez & Cohen, LLC Can Help You With an Appeal if Your Claim Has Been Wrongfully Denied

If your employer has denied your Workers’ Compensation claim, one of our skilled New Jersey Workers’ Compensation lawyers at Kotlar, Hernandez & Cohen, LLC can fight to get you your entitled benefits in a timely fashion. Call us at 856-751-7676 or contact us online to schedule a free consultation. Located in Mount Laurel, Cherry Hill, Trenton, and Vineland, New Jersey, and Trevose, Pennsylvania, we proudly assist clients across Pennsylvania and New Jersey.

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856-751-7676 16000 Commerce Parkway
Suite C
Mt Laurel Township, NJ 08054 Monday - Friday | 8am - 5pm

856-751-7676 1913 Greentree Rd
Suite C
Cherry Hill, NJ 08003 Monday - Friday | 8am - 5pm

856-751-7676 1234 Bridgetown Pike
Suite 200
Feasterville-Trevose, PA 19053 Monday - Friday | 8am - 5pm

Trenton, NJ Office
Vineland, NJ Office