What do I need to know about workers’ comp claims in NJ?

State law often requires employers to hold workers’ compensation insurance. Workers’ comp benefits provide funds to workers who are injured or develop a disease as a result of their job. In most cases, the benefits are set at 70% of your average weekly wage. An injured or ill worker is generally able to receive these payments after unable to work for seven days. The payments take approximately two weeks to process.

How do I get workers’ compensation?

First, notify the employer as soon as is practical. This could be a boss, direct supervisor or the office’s personnel department. Under New Jersey law, the employer can often choose the physician to provide ongoing treatment of the workers’ injuries or disease.

Once the injured worker gives notification, the insurance provider will likely investigate the claim. During the investigation, the provider will determine whether or not the injured worker is eligible for benefits.

Does it matter who was at fault?

In New Jersey, it does not matter who was at fault. Workers compensation coverage is available even if the worker made a mistake that contributed to the accident.

What if my employer does not believe me?

In theory, the workers’ compensation system is a great idea. In actuality, an injured worker may face some hurdles in getting the benefits they deserve. One hurdle: an employer who does not believe the injury occurred during the course of employment. It is not uncommon for workers’ insurance providers to deny claims or offer a much lower than anticipated payment. Workers who are in this situation have rights and can fight back. If the employer or the workers’ compensation insurance provider take issue with a request for benefits, you can file a Claim Petition or Application for an Informal Hearing. These forms are filed with the Division of Workers’ Compensation. In most situations, a local judge will then review the case.

To build a successful appeal, it is helpful to know why the provider denied the claim. Common reasons for a denial include a failure to report the injury within an accepted time period, a failure to file the claim on time, a question as to whether the injury or disease is work related and insufficient evidence to support the claim. It is important to note that there is also often a time limit to file an appeal. An injured worker must file a formal complaint within two years of the date of injury.