New Jersey Workers’ Compensation Lawyer
On-the-job injuries can cause major disruptions in your life. Your injuries may require extensive medical treatment and therapy. In the meantime, you might not be able to work to pay your doctor’s bills or even living expenses.
Worker’s compensation is supposed to take care of you when you suffer these injuries. But worker’s comp insurers often deny these claims, leaving injured employees to handle these challenges on their own.
A New Jersey worker’s compensation lawyer from Garces, Grabler & LeBrocq can help you fight worker’s comp insurers.
If we cannot resolve it, New Jersey provides many options for seeking a review of your claim, including mediation, a formal hearing, and an appeal. Contact our personal injury attorneys to learn how we can help you get worker’s comp benefits.
All employers with at least one employee in New Jersey must buy worker’s compensation insurance. This means you will likely be eligible for worker’s comp benefits if you are employed in the state.
State law uses two tests to determine whether the employer-employee relationship exists. If a worker meets either test, they qualify as an employee and can receive worker’s comp benefits for job-related injuries.
Under the control test, the state looks at who determines what the worker does and how, when, and where the worker performs their job duties. If the worker retains control, they may be an independent contractor. When someone else has control, the worker may be an employee.
Under the relative nature test, the state looks at whether the worker relies on the work for income and the business relies on the worker to operate. If a worker’s job meets both of these elements, the worker qualifies as an employee.
Once at least one of these tests is met, the employee will probably qualify for worker’s comp benefits, regardless of the nature of their employment. Specifically, you qualify for worker’s comp even if you:
- Work in New Jersey for an out-of-state employer
- Only work as a part-time employee
- Have a seasonal job
- Work for an independent contractor or subcontractor
New Jersey law only categorically excludes the following from the worker’s comp system:
- Unpaid interns
- Unpaid volunteers other than volunteer firefighters
- Independent contractors
- Sole proprietors with no employees
The system also exempts anyone covered by an alternative federal program. Thus, you will pursue a different type of claim under federal law for your injuries if you work as a:
- Federal employee
- Railroad worker
- Dock Worker
These workers can still pursue compensation for on-the-job injuries. But they must pursue a claim for federally mandated benefits rather than a claim under New Jersey’s worker’s comp laws.
Importantly, worker’s comp is a no-fault system. When you file a claim, you do not need to prove that your employer caused your injury. The insurer covers injuries caused by your employer’s negligence, your negligence, and those involving the negligence of third parties. It also covers injuries in which no one was negligent.
There are a few limits to the injuries covered by worker’s comp. Workers cannot get compensated for injuries that arise from:
- Being the aggressor in an assault
- Intoxication due to alcohol or illegal drugs
- Instigating horseplay that was a major deviation from work
In these situations, the cause of the injury was not work-related, even if the injury happened at the person’s place of employment. However, New Jersey law favors coverage for employees.
For example, New Jersey allows some instigators of horseplay to recover worker’s comp benefits when the horseplay was to be expected. Similarly, an intoxicated worker might still receive worker’s comp if the intoxication was not the cause of the accident.
If your claim is denied, you should speak to a New Jersey worker’s comp attorney from Garces, Grabler & LeBrocq to discuss the arguments we can make to overcome the denial.
Worker’s compensation benefits cover work-related injuries resulting from several situations.
You can pursue benefits for injuries resulting from a single accident or traumatic incident. Some examples of incidents that can produce these injuries include:
- Motor vehicle crashes
- Falls
- Falling objects
- Power tool and machine accidents
- Building or trench collapses
- Burns
- Electric shocks
- Chemical spills and splashes
- Exposures to hot or cold environments
These accidents cause acute injuries like:
- Lacerations
- Muscle and tendon strains
- Ligament sprains
- Fractured bones
- Amputations
- Nerve damage
- Internal injuries
- Brain injuries
- Spinal cord injuries
As a result of these injuries, you may require emergency care, medical treatment, and therapy. You may suffer from long-term or even permanent disabilities that limit your ability to work in the future.
Your job may expose you to toxic substances that cause debilitating injuries. The nervous system is particularly vulnerable to toxic exposures, producing symptoms such as:
- Confusion
- Amnesia
- Weakness
- Loss of coordination
- Tremors
Toxic exposure can also damage the lungs and skin. For example, inhaling asbestos fibers can produce a condition called mesothelioma, in which cancerous tumors grow in the membranes that line your internal organs.
Some hazardous substances known to injure workers include:
- Paint fumes
- Asbestos
- Insecticides
- Herbicides
- Mold spores
- Petroleum products
- Coal dust
- Industrial solvents
- Radioactive materials
Injuries from exposure to toxins develop over time. In many situations, you might not exhibit symptoms for decades after exposure.
These diseases often have no treatment. As a result, you may suffer from symptoms until the disease eventually takes your life.
When you stress your body, you develop small cracks in your bones and small tears in your soft tissues. Rest allows your body to repair these microscopic injuries and even build back stronger.
If you repeat the stresses without resting, the injuries accumulate and propagate instead of healing. Some examples of repetitive stress injuries include:
- Strained muscles and tendons
- Sprained ligaments
- Stress fractures
- Herniated or bulging discs
Repetitive stress injuries can, in turn, cause other problems. Swollen or deformed tissues can press on nerves, causing nerve damage.
A common example of these injuries occurs in carpal tunnel syndrome, in which inflamed wrist ligaments press on the median nerve. Another example happens when deformed spinal discs press on nerve roots branching from the spinal cord. Nerve compression causes symptoms such as:
- Pain
- Muscle weakness and spasms
- Numbness or tingling
These symptoms affect an otherwise uninjured body part. Thus, a herniated disc in your lower back might produce symptoms in your leg, while carpal tunnel in your wrist can affect your elbow and fingers.
These injuries often require rest to heal properly. In some cases, you may also require surgery. During your recovery, your doctor may limit your work activities. If you are out of work for at least seven days, you become eligible for temporary disability benefits.
What Kinds of Benefits Are Included in Worker’s Compensation?
Worker’s comp pays several types of benefits, including:
The insurer will pay for reasonable and necessary treatment and therapy for the injury, including:
- Emergency room treatment
- Hospitalization
- Surgery
- Physical therapy
- Prescription medication
Your employer or its worker’s comp insurer can designate the physician or medical practice you must use. You can only see someone else for treatment in an emergency or when the insurer improperly denies your claim.
The insurer must replace 70% of your lost wages up to a preset limit. The insurer calculates the wage replacement benefit using your average weekly wage and pays replacement wages weekly starting on your seventh day out of work. This benefit ends when you return to work or reach maximum medical improvement (MMI).
MMI means your medical condition will not improve with additional treatment, therapy, or time to heal. When you reach MMI, you can seek permanent partial or total disability benefits depending on your injury.
Total permanent disability happens when you cannot maintain any type of gainful employment. For example, if you suffer a spinal cord injury that produces total permanent paralysis, you can pursue permanent total disability benefits. These benefits equal 70% of your average weekly wage up to a preset limit.
Conversely, partial permanent disability happens when you permanently lose the use or function of a body part or system, but you can still maintain gainful employment without it. Thus, if your doctor needs to amputate your arm due to your injuries, you can seek permanent partial disability benefits.
The amount of partial disability benefits is set by a schedule based on the injury. For disabilities that do not appear on the schedule, the worker and their workers’ comp lawyer in New Jersey must battle the insurer to get a fair residual disability percentage.
This percentage estimates the worker’s remaining abilities and uses that number to calculate their permanent partial disability benefit. These benefits get paid weekly. Instead of sending a check every week, many insurers will negotiate with workers and their worker’s comp lawyers to agree on a lump sum payout.
What Is a Motion for Medical and Temporary Disability Benefits?
One of the most important procedural tools available to an injured worker is a motion for medical and temporary disability benefits, often called a motion for med and temp. This motion becomes necessary when an insurance carrier fails to authorize the medical treatment a worker needs, or when it stops paying temporary disability while the worker remains out of work. Before we file, we build the medical foundation of the case. We work with a treating or evaluating physician who can document, in a written report, that the recommended treatment relates directly to the workplace injury and that the worker remains unable to perform their job duties. Once that medical record is established, we bring the matter before a judge of compensation and ask the court to order the insurer to authorize treatment, resume temporary disability payments, or both. These motions receive priority scheduling within the Division of Workers’ Compensation precisely because delayed medical care can worsen an injury, so acting quickly once treatment stalls matters a great deal.
Under New Jersey Statutes Annotated Section 34:15-15, the employer and its insurance carrier, not the injured worker, hold the authority to select the treating physician. As a petitioner, you generally cannot choose your own doctor unless the insurer refuses or delays your care. This structure often puts injured workers at a disadvantage, since the professionals directing treatment answer to the party paying the claim. A motion for medical and temporary disability benefits gives our team a mechanism to push back. Beyond restoring your access to treatment, the motion allows our workers’ compensation attorneys to advocate for a treating physician who will provide a fair and thorough evaluation of your condition, helping to correct the imbalance built into the system.
Many of the cases where we file this motion share a common thread. The insurance company disputes that the workplace accident happened at all, often because there was no timely accident report on file. In these situations, the motion becomes your opportunity to appear before a judge of compensation and describe, in your own words, how the injury occurred and how it continues to affect you. For many of our clients, this hearing is their first real chance to be heard, and it often becomes the turning point in the case. In practice, the majority of workers’ compensation trials center on disputes over medical treatment and temporary disability, rather than the size of a final permanency award. This makes the motion for med and temp one of the most consequential tools available in your case.
Our workers’ compensation lawyers regularly appear before the New Jersey Division of Workers’ Compensation on behalf of clients throughout the state, including near our Newark, Trenton, and Jersey City offices. The process for these proceedings is under NJ Rev. Stat. § 12:235-3.2, which sets out how a motion for medical and temporary disability benefits must be filed and answered. Because these hearings can move quickly once filed, having an attorney who has already prepared the medical documentation can make a meaningful difference in how fast you get back the treatment and income you need. If your treatment has stalled or your temporary disability checks have stopped arriving, contact Garces, Grabler & LeBrocq to discuss whether a motion for med and temp is the right next step for your claim.
What to Do When You Are Injured at Work
Your actions after a workplace injury can affect your rights to pursue worker’s compensation benefits. The most pressing requirement for the worker is to report the accident to their employer, which should be done immediately upon suffering an accident. If you suffered an occupational disease, you should tell your employer as soon as possible upon receiving your diagnosis.
In some cases, you will not be able to notify your employer immediately. For example, if you lose consciousness during your accident and only regain consciousness in the hospital, the notice may be delayed. In these cases, you have several options.
First, your employer might have witnessed the accident, or someone else, like a co-worker or supervisor, might have reported it. This notice is enough to start the process.
Second, you can call or email your employer to notify them. You do not need to provide in-person notification.
Third, you have up to 90 days to notify your employer without losing your claim. However, you should notify them within 30 days to preserve your right to receive full worker’s comp benefits.
After receiving notice, your employer should notify its worker’s comp insurer. The insurer will reach out to you to gather the information needed to investigate your claim. You should not need to do anything except explain what happened and authorize the insurer to review your medical records.
If your employer fails to report your injury to its insurer, you can contact the insurer or the New Jersey Division of Worker’s Compensation. You can also contact a New Jersey lawyer, and we will take the lead on getting your workers’ comp claim started while you focus on your health.
