Workers’ Compensation FAQ
Our Workers’ Compensation Lawyers Fight for Your Rights
When you’ve been injured in a workplace accident, you may not be sure what to do next. You know there are workers’ compensation benefits, but you may not know much about the process. You have a lot of questions. The experienced workers’ compensation attorneys at Shebell & Shebell, LLC can help you find answers.
Our firm has been helping injured workers in New Jersey for generations. We know the impact an injury can have on workers and their families. Medical expenses add up quickly, just as there is less income coming in. We are dedicated to helping our clients get the benefits they need and deserve.
Some of the frequently asked questions we get:
- What should I do if I’m injured at work?
- Do I need a lawyer to file a workers’ compensation claim?
- Who pays my medical bills?
- Can I be treated by my own doctor?
- How long do I have to file a claim for benefits?
- What kind of benefits can I receive?
- What can I do if my claim for benefits is denied?
- What if the accident was my fault?
- Can I be fired or get in trouble if I file a workers’ compensation claim?
- I haven’t worked here for very long. Can I still collect workers’ compensation benefits?
- Can I go back to my old job?
- If the insurance company disputes my claim, can a settlement be reached?
- Will workers’ comp cover me for work-related illness or injuries that aren’t the result of an accident?
- What if my employer does not have workers’ compensation insurance?
We are happy to answer any other questions that you have. Contact us to schedule a free consultation with one of our experienced workers’ compensation attorneys. We can review the details of your claim and explain your options. There’s no cost and no obligation. We just want you to have the information you need before deciding what to do next.
What should I do if I’m injured at work?
Get medical attention immediately so a doctor can diagnose your injury and begin treatment. Report your injury to your employer as soon as possible – legally, you absolutely must report within 14 days, but the sooner you make the report, the better. This can help protect your right to benefits. Then contact an experienced workers’ compensation attorney. A lawyer can review the details of what happened, go over your options and answer your questions.
Do I need a lawyer to file a workers’ compensation claim?
You are not required to have a lawyer to file a claim for benefits. Having an attorney is the best way to make sure you get all the benefits you deserve, however. Insurance companies and their lawyers know how to use the system to their advantage. They’ll question the extent of your injuries. They’ll challenge the need for certain treatment. They have also been known to pressure workers into returning to the job even though they are still recovering from their injuries. Insurance companies hope that you don’t get a lawyer and will just accept their decisions. Our attorneys know how to fight back against insurance companies. We build strong cases and present convincing arguments in front of workers’ compensation judges. If needed, we are ready to fight for your benefits in court.
If you are approved to receive medical benefits for your injury or illness, your employer – through insurance coverage – is responsible for paying the full cost of treatment that is necessary and reasonable. There are no out-of-pocket expenses with workers’ comp, like co-pays or deductibles. Your employer also has the right to choose the doctors that treat you.
However, employers and their insurance companies may disagree on which types of treatment are considered necessary and reasonable and may challenge your claim. That’s why it’s important to have experienced legal representation on your side. Our lawyers can help you get a second opinion and if necessary, file an appeal of any decision denying coverage for treatment.
Can I be treated by my own doctor?
Unfortunately, no. Under the state workers’ compensation law, your employer’s insurance company chooses the doctors and specialists who will be treating your work-related injury. Sometimes, that can be a problem. Doctors paid by the insurance company may not have your best interests in mind. They may feel a sense of obligation toward the insurance company. So, they may not order extra physical therapy you feel you need or decide that there is no need for further tests. They may determine that you are ready to return to work even though you have not fully recovered from your injuries. Our attorneys can help you prepare for independent medical examinations (IME) with doctors chosen by the insurance companies. We can also arrange for you to be examined by a reputable doctor or specialist for a second opinion.
How long do I have to file a claim for benefits?
The law sets a statute of limitations of two years to file a claim for benefits. The clock starts ticking on the date of the injury or the date of the last payment of compensation. If you are suffering from an occupational illness – such as hearing loss, asthma or lead poisoning – the clock starts on the date you first become aware that your condition was related to your job. There are also other deadlines that apply to claims. That’s why it’s important to have an experienced workers’ compensation lawyer on your side. We know the laws and the requirement for filing claims. We can keep you informed about the steps you need to take in order to protect your right to benefits.
What kind of benefits can I receive?
There are many types of benefits. Medical benefits will pay the cost of all necessary and reasonable medical treatment for your injury or illness. Temporary total disability benefits will pay 70 percent of your average weekly wages if you are out of work for more than seven days. Permanent total disability benefits will pay 70 percent of your average weekly wages if you are unable to return to any type of employment. You may be eligible for vocational rehabilitation services. Death benefits pay expenses and compensation to families if a work-related injury or illness was fatal. An attorney can tell you which benefits you are eligible to receive.
What can I do if my claim for benefits is denied?
An insurance company may deny your claim for medical treatment or wage benefits. By law, you have a right to a trial before a workers’ compensation judge. There are different steps in the trial process, including informal hearings, formal hearings and legal action in state court. Our attorneys know how to build strong cases based on medical opinions, witness statements and other evidence. We present convincing arguments in front of workers’ compensation judges. We are determined to help you get the benefits that you deserve. We may also be able to settle your claim with the insurance company in a way that meets your needs. If not, we will be ready to fight for your benefits in court, if that’s what it takes.
What if the accident was my fault?
In general, you can still receive workers’ compensation benefits for a workplace injury, even if you were responsible for causing the accident. New Jersey is a no-fault state. That basically means that as long as your injuries were sustained in an accident while you were doing your job, you are eligible for benefits. It doesn’t matter who caused the accident that left you hurt. However, there are certain exceptions. For example, if the accident occurred because you were under the influence of alcohol or other drugs, you may not be able to receive benefits. If you caused the accident, it may also prevent you from taking legal action against a third party that was involved. An experienced workers’ compensation lawyer can review your claim and explain your rights.
Can I be fired or get in trouble if I file a workers’ compensation claim?
No. It is against the law for an employer to fire you for simply filing a claim for workers’ compensation benefits. In addition, an employer cannot discriminate against you or retaliate in any other way. For example, when you come to work, an employer may try to cut your pay, increase your workload or change your shift. It is your legal right to seek workers’ compensation benefits after being injured at work. If you are fired or suffer any other type of retaliation, our attorneys can help. We will demand that your employer put a stop to the retaliation. If needed, we can also take legal action, as provided by law. You can discuss your situation with one of our workers’ compensation lawyers, who can explain your options.
I haven’t worked here for very long. Can I still collect workers’ compensation benefits?
Yes. If you are an employee, and suffered a work-related injury or illness, you are eligible to file a claim for workers’ compensation benefits. It doesn’t matter if you have been at that job for two years or two days. Some employers try to avoid their responsibility by insisting that an injured employee is an independent contractor – and is therefore not eligible for benefits. Or they may take the position that your injury or illness had nothing to do with your job. Our experienced workers’ compensation attorneys know all the tactics that insurance companies use to minimize or dismiss claims. We help injured workers fight back by building strong cases built on facts. We are determined to help you get the benefits you need and deserve.
It depends on your situation. If a doctor has medically cleared you to return, you can go back to your job. An employer can’t fire you because you were hurt on the job and filed a claim for benefits. However, you may be pressured to return to work before you are ready. If you are unable to return to work, you may be eligible for permanent total or permanent partial disability benefits, or vocational rehabilitation services to help you find a new job. An attorney can go over your options.
If the insurance company disputes my claim, can a settlement be reached?
Settling a claim through negotiation is an option, and many workers’ compensation claims are resolved in this way. There are generally two types of settlements – the type of settlement that can be reached depends on whether the insurance company is disputing any part of your claim. A Section 22 settlement results in benefits paid weekly and your claim can be reopened in the future, if needed. A Section 20 settlement is a lump sum payment that does not allow you to reopen your claim. A settlement can be reached at any stage of the workers’ compensation claims process. It is often reached with the assistance of a judge who hears both sides present their cases. Our attorneys are skilled negotiators and will only agree to a settlement that meets your needs. If the insurance company won’t agree to a settlement, we will be ready to fight for your benefits at hearings and all the way to state court, if that’s what it takes.
Will workers’ comp cover me for work-related illness or injuries that aren’t the result of an accident?
In general, yes. Not every work-related injury or illness is caused by a one-time accident. Cumulative injuries such as repetitive motion injuries develop over a long period of time. Some employees may develop cancer or another illness as a result of long-term exposure to hazardous substances in the workplace. Exposure to loud noises over months or years can result in hearing loss. An experienced attorney can investigate and help you gather evidence that proves your injury or illness was work-related.
What if my employer does not have workers’ compensation insurance?
All New Jersey businesses that have employees are required to have workers’ compensation coverage – or be approved for self-insurance. Some businesses are exempt if they are covered by federal programs. However, there are instances in which an employer has failed to get the required insurance coverage, let existing coverage lapse or failed to make premium payments. An experienced attorney can go over your options for compensation, which may involve taking legal action.