Are Torn Meniscus Injuries Covered by Workers’ Compensation?

Understanding benefits and medical care for New Jersey workers

Work-related knee injuries are common in New Jersey, including a torn meniscus. This type of joint damage is a hazard in all industries, but the risk is especially high for employees in construction, transportation, education, health care, and utilities.

In New Jersey, employees with work-related meniscus tears are covered by workers' compensation. However, that doesn’t mean getting the benefits you deserve is easy. Sometimes, workers’ comp insurance providers challenge legitimate knee and meniscus injury claims. They may dispute the injury's relationship to work or say it was a pre-existing condition. They may even try to say the worker isn’t an employee of the company and, therefore, ineligible for benefits.

Employees who are informed about occupational knee tears and recovery stand a better chance of securing maximum financial benefits. For advice on your specific situation, contact Shebell & Shebell for a free consultation.

What is a torn meniscus?

The meniscus is a C-shaped piece of cartilage in the knee that acts as a cushion between the shinbone and thighbone. It provides stability and aids joint movement. Meniscus injuries at work are often due to sudden twisting or rotating movements during tasks like lifting, carrying heavy loads, or navigating uneven surfaces. There are two basic types of meniscus injuries:

Traumatic lesion tears, which result from a sudden movement or work accident.
Degenerative atraumatic lesion tears, which develop over time due to repetitive motions.

Sometimes, meniscus tears are confused with other types of occupational knee injuries like Anterior Cruciate Ligament (ACL) injuries or Posterior Cruciate Ligament (PCL) injuries. While there can be some overlapping symptoms between meniscus and ligament tears, there are also distinct differences. For example, hearing a “pop” at the time of injury may be a sign of meniscus injury, but it is more likely indicative of a torn ACL. Symptoms of a work-related meniscus tear include:

Pain, especially when twisting or rotating the knee.
Swelling.
Stiffness.
Difficulty bending or straightening the knee.
“Locking” or “catching” sensation in the knee joint during movement.

Is a torn meniscus covered by workers' comp?

A torn meniscus falls within the scope of injuries covered by the New Jersey workers' compensation program. Benefits for a torn meniscus may include:

Medical benefits coverage for reasonable and necessary medical treatment, including but not limited to surgery, medication, physical therapy, and follow-up appointments.
Temporary disability compensation for lost wages due to injury and recovery.

A pre-existing knee injury could complicate an employee’s eligibility for workers' compensation benefits. While workers with pre-existing conditions are not automatically disqualified, the challenge may lie in proving that the work-related activities aggravated or worsened the existing injury. If the torn meniscus is a result of a new workplace incident or exacerbation of a pre-existing condition due to work activities, workers' compensation benefits may still be available.

Medical treatment under the NJ workers’ comp system

There are specific rules and procedures regarding the choice of healthcare providers for injured workers in the workers’ comp system. An injured worker in New Jersey seeking treatment for a work-related knee injury first needs to report the injury to their employer and file a workers' compensation claim. It is important to report the injury right away to avoid missing the legal filing deadline. Claims not filed by the deadline can be denied. A work injury lawyer can help workers determine their window of opportunity.

Generally, employees are required to seek initial medical treatment from a list of approved healthcare providers supplied by their employer or the workers' compensation insurance carrier. This is often called the "designated provider" or "panel of physicians" list. After the initial visit or under certain circumstances, there may be provisions for injured workers to see their own doctor.

For medical treatment of a meniscus tear, an injured employee may see an orthopedic surgeon, physical therapist, and other specialists. The specific course of treatment will depend on the severity of the injury. While many individuals with meniscus injuries can expect positive outcomes and a return to regular activities, some may experience long-term effects such as persistent pain or limited mobility, especially if the injury is severe.

Permanent disability for meniscus tears

If a worker with a permanent knee injury is unable to work at full capacity, workers' compensation can provide various benefits to support them. The goal is to provide financial support and resources to accommodate the worker's permanent disability and help them maintain a reasonable quality of life. Assistance may include:

Permanent disability benefits: Compensation for the permanent loss of function or impairment due to the injury. Assistance is typically determined through a medical assessment that may include an impairment rating.
Lost wage compensation: If the permanent disability results in a reduced earning capacity, workers' compensation may provide ongoing wage replacement benefits or a lump sum settlement.
Vocational rehabilitation: Assistance in retraining for a different type of work if the individual cannot return to their previous job due to permanent disability.

While obtaining permanent disability benefits can be challenging, it is not impossible. Establishing permanent disability often requires comprehensive medical documentation, including expert opinions and assessments. Clear and thorough medical evidence is crucial to support the claim. Seeking the guidance of an experienced workers' compensation attorney can be crucial.

How can a New Jersey workers’ compensation attorney can help

Seeking prompt medical attention, documenting the injury and treatment, and consulting with the right lawyer can help injured workers ensure that they receive necessary care and support for their meniscus injury. An experienced New Jersey workers’ compensation attorney can help employees with meniscus injuries get the most out of the workers' compensation system. An attorney can:

Offer legal guidance on the workers' compensation process, eligibility, and applicable laws.
Properly file workers' compensation claims and ensure all necessary documentation is submitted.
Negotiate with insurance companies to secure fair compensation for medical expenses, lost wages, and rehabilitation.
Work with healthcare providers to ensure proper documentation of injuries and treatment for claim support.
Provide legal representation in hearings if a settlement cannot be reached.
Handle appeals if the initial workers' compensation claim is denied or disputed.
Pursue additional compensation through third-party claims or lawsuits if someone other than the employer contributed to the injury.
Advocate for the worker's rights and best interests throughout the legal process and ensure they receive the maximum benefits available.

If you have a work-related torn meniscus, contact Shebell & Shebell, LLC

At Shebell & Shebell, LLC in New Jersey, our work injury lawyers help workers successfully navigate the workers’ comp system and pursue other injury compensation when there is a case to be made. We understand how the workers’ compensation system works in New Jersey and have handled complex claims for maximum results throughout the state. If you sustained a knee injury at work in New Jersey, contact Shebell & Shebell. LLC, for a free case evaluation. We can listen to the details of what happened, discuss timelines and eligibility, and explain your options for work injury compensation. We can help you get started on your recovery today.

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