How Do I File a Workers’ Compensation Claim in New Jersey?
Legally reviewed by Lisa J. Pezzano, Esq. - Laddey Clark & Ryan Pezzano Law Group Division
When your workers’ compensation claim is denied, it can be frustrating and scary to face unpaid medical bills and a loss of income due to an injury. Learn your rights regarding New Jersey workers’ compensation denials and consult with an attorney who fights to get your claim accepted and paid. .
Workers’ compensation is a no-fault insurance system that provides medical coverage and wage replacement to employees who suffer an injury or illness arising from their work duties. When you file a claim, you are essentially applying for insurance benefits under a policy paid for by your employer.
In New Jersey, it is mandatory for all employers to carry workers’ compensation insurance. As a “no fault” system, employees do NOT need to prove that their employer or a co-worker was negligent to qualify for these benefits. In exchange for guaranteed benefits, the employee typically forfeits the right to sue the employer for pain and suffering related to the injury.
For an injury to be covered, it must occur while performing work duties or arise out of the course of employment. Workers’ compensation claims may include both sudden, traumatic accidents and occupational injuries which develop over time. Traumatic accidents covered by workers’ compensation may include motor vehicle collisions, slip and falls, construction accidents, machinery accidents, lifting incidents – any event which causes a sudden injury. Occupational claims may include:
Below are some of the most common reasons for workers’ compensation denials.
Even valid claims are sometimes denied at first, so it is important to understand your options.
If your workers’ compensation claim is denied in New Jersey, there are several steps which must be taken to challenge the decision and pursue the benefits you deserve. It is crucial to act quickly, as the more time which passes between the work accident and medical treatment, the more difficult it will be to prove causal relationship. New Jersey imposes a strict two-year statute of limitations from the date of the accident, if no benefits are paid through workers’ compensation. Failure to meet this deadline usually results in a final dismissal of the claim.
The New Jersey Division of Workers Compensation [“DWC”] offers claimants the option of filing a request for an “informal hearing.” This option is NOT advisable, as the filing of an informal hearing request does not extend the statute of limitations for filing a claim. Moreover, the Judge of Compensation cannot approve of any settlement unless the claimant is represented by an attorney.
Instead of requesting an “informal” hearing, the most efficient and safest course of action is to immediately file a formal Claim Petition with DWC. The filing of a Claim Petition stops the statute of limitations from running and results in obtaining a settlement hearing before a Judge of Compensation. The Judge will mediate all disputes regarding medical treatment, entitlement to temporary disability, and the award of permanent disability benefits.
Given the complexity of the legal process and the tactics insurance carriers use to discredit claims, it is strongly recommended that you consult with an experienced workers’ compensation attorney. A knowledgeable lawyer can help you navigate the filing requirements, represent you in court, and negotiate with insurers to ensure your rights are fully protected.
For more information and to secure the help of an experienced legal professional, schedule your free consultation at the Pezzano Law Group today.
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