While an employee generally cannot make a direct claim against his or her employer or a co-worker, an employee can make a worker’s compensation claim.
Generally speaking, in New Jersey, an employee cannot bring a claim in the Superior Court of New Jersey for pain, suffering, and loss of quality of life against his or her employer or co-worker for injuries sustained during the course of his or her employment. The one exception, which arises in infrequent circumstances, is if it can be proven that the employer intentionally injured or willfully exposed an employee to a known danger.
However, if you were injured at work a workers’ compensation lawyer from Cerussi & Gunn can help you make your workers’ compensation claim against your employer.
Even though a direct claim for pain, suffering, and loss of quality of life cannot be made, those elements are relevant to the extent they prevent the worker from doing their job. When making a workers’ compensation claim, an employee does not have to prove that the employer was negligent, only that the injury arose out of and in the course of the employee’s employment.
Injuries can be physical or psychological. With the right workers’ compensation law firm, you can ensure that your workplace accident and the injury won’t go unaddressed.
Our workers’ compensation law firm provides our clients with the avenue to get the benefits they are entitled to. Once it is established that an employee was injured during their employment, the employee is entitled to 3 benefits:
An injured worker is to receive medical treatment with no out-of-pocket expenses to him or her. However, the workers’ compensation insurance company or third-party administrator handling the claim on behalf of the employer is permitted to choose the doctors that the injured worker is allowed to seek treatment from. The insurance company or third-party administrator also must approve all treatment that the treating doctor recommends. If the injured worker goes and treats without the insurance company’s authorization or third-party administrator, he or she may be responsible for the cost of the treatment.
Unfortunately, this is where a lot of issues arise in workers’ compensation cases. The treating doctor will often recommend treatment, but it will not be approved, or the treating doctor will prematurely stop the injured worker’s treatment. A motion must be filed with the Court in these situations, and the Judge must get involved.
An injured worker who is unable to work becomes eligible for temporary disability benefits after a seven-day waiting period. On the eighth consecutive day of an absence, the worker becomes eligible for benefits retroactive to the first date of absence. A worker is entitled to 70% of their gross average weekly wages; however, there is a weekly cap on benefits each year. For work accidents occurring in 2021, the maximum weekly temporary disability benefit is $969.00. You should also be aware that you may be entitled to additional disability benefits through any private disability plan you have.
An injured worker is entitled to temporary disability benefits after the seven-day waiting period for the period that the authorized treating doctor keeps the worker out of work. Or until the injured worker reaches maximum medical benefit, no additional treatment will improve the worker’s condition.
Suppose the treating doctor indicates that the worker can go back to work with restrictions, and the employer can accommodate those restrictions. In that case, the employee’s temporary disability benefits will end, and the worker will have to go back to the position offered by the employer. However, suppose the employer cannot provide a position that accommodates the restrictions. In that case, the employee will continue to be eligible for temporary disability benefits and will not be required to return to work.
An injured employee may be entitled to a permanency award after treating if they have a partial or total disability despite the treatment they received. A permanency award is a monetary award based upon the percentage of residual disability an injured worker has as a result of his or her work injury.
If the injury, occupational injury, or disease results in the employee’s death, his or her dependent(s) may bring an action for dependency benefits.
Even after your workers’ compensation claim is resolved for a permanency award or your treatment is completed, the injured worker has two years from the receipt of his or her last workers’ compensation benefits (receipt of last permanency award check, receipt of last temporary disability benefit, or receipt of medical treatment) to reopen his or her workers’ compensation claim, if his or her condition substantially worsens. An employee can even reopen a case if they switch employers.
Again, it is essential to note that the injured worker cannot just go back to the doctor; they must request additional benefits through the insurance company or third-party administrator or their workers’ comp attorney.
Once the two-year period elapses, the right to reopen a case is forever lost; however if a new injury or incident occurs, the injured employee can make a new workers’ compensation claim. The prior settlement does not bar bringing a new claim.
Suppose a person or company other than your employer was responsible for your injuries. In that case, you will have both a workers’ compensation claim and what is called a third-party claim for pain, suffering, and loss of quality of life against the other person or company that was responsible for your injuries. However, you must prove that the other person or company was negligent, i.e., failed to act reasonably, and their failure to do so resulted in your injuries. Our workplace accident and injury attorneys can both your workers’ compensation and third party case.
Like most states, in New Jersey, workers’ compensation lawyers work on a contingency fee basis. This means that the lawyer attorneys’ fee for the work they do on your case comes from any permanency award you receive from your employer. If you do not receive a permanency award then there is no cost to you for the services of your attorney.
In a New Jersey workers’ compensation case, the maximum work injury attorneys’ fee is 20% of the permanency award; however, the attorneys’ fee is typically split between the injured worker and the insurance company, with the injured worker paying 40% of the fee from the permanency award and the employer paying 60% of the fee, in addition to the permanency award amount.
In addition to the contingency fees, the injured worker must pay for a portion of the cost of obtaining an expert report. In certain circumstances, an injured worker would also be responsible for the cost of obtaining medical records, and expert witness testimony, among other fees. You should discuss the potential fees and expenses with your lawyer at your initial consultation.
While a workers’ compensation case may seem simple, they become pretty complex. Unfortunately, the employers’ insurance companies are not always willing to provide the benefits the injured workers are entitled to without the insistence of a workers comp attorney or the workers’ compensation Judge. With the workers’ compensation law firm of Cerussi & Gunn, P.C. to represent you, you stand a far better chance of getting the benefits you are entitled to.
If you have been injured on the job, the experienced workers’ compensation attorneys at Cerussi & Gunn, P.C. can help you navigate through the workers’ comp system and get you all benefits you are entitled to. Our workers’ compensation law firm is here to help!
Our Monmouth County, New Jersey office is conveniently located in Shrewsbury, NJ. We service clients all over the State including client in the following NJ communities:
Our attorneys also handle non work related cases involving: