Video Learning Resource Center – The Epstein Law Firm, P.A.

A New Jersey worker who’s injured in the course of their employment cannot be retaliated against for filing a worker’s compensation claim. An employer or respondent is not required to hold your job until you return to work. So if you’re out for an extended period of time and they fill the position, they don’t have to hire you back, but they cannot terminate you solely because you filed a worker’s compensation claim.

Do you have to see the doctor your employer sends you to? The answer is yes. In New Jersey, the insurance carrier has the right to control treatment. When I say insurance carrier, the respondent, the employer has the right to control your treatment because they’re paying for it. There are some instances where you can see your own doctor. For example, in New Jersey, if the insurance carrier, the respondent or the adjuster is simply just not doing what they need to do and are required to do under the statute, you could seek your own medical treatment. But that is a very detailed analysis to determine when you can do that. And you know, if you’re not getting the treatment you deserve, I always recommend that you seek an attorney to help you in that situation.

Workers’ compensation cases take from start to finish generally a long time. What happens is that a injured employee will receive treatment by an authorized treating physician. An authorized treating physician is someone who the insurance carrier selects to manage your care. Once the injured worker has finished treatment, they would then be sent to what’s called permanency evaluations. The respondent or the insurance carrier has the ability to wait six months after someone has finished treatment until they send you for an evaluation. So a worker’s compensation case can take a long time depending on what the treatment is. But that said, it’s a process that can be navigated successfully.

One of the most common mistakes that injured workers make before they call me is they don’t report the accident or they don’t seek medical treatment. If you don’t report the accident on time, your claim may be barred. And if you don’t seek medical treatment, it may be hard to relate the injuries and symptoms that you have to the accident and when you were actually hurt at work.

New Jersey Worker’s Compensation covers injured employers for a variety of benefits. They are entitled to wage replacement benefits, what’s called temporary total disability. They’re entitled to have their medical bills paid for. They’re also entitled to devices, things around the house, equipment that they may need. And lastly, they’re entitled to a payment for any permanent loss of function. If their treatment has stopped, the insurance carrier will generally try to dispute a claim if there is an issue with causation, the injuries don’t seem to be extremely significant or if there is a problem with how the accident happened. New Jersey Worker’s Compensation insurance companies will dispute a claim for a variety of reasons, and that’s why having an attorney to speak with the adjuster or consult you on how to speak with someone about this injury is always a good idea.

Injured workers in New Jersey should understand that there is something called a return to work on light duty. A doctor can return a injured worker to duty before they finish treatment. Light duty is something where you go back to work, but you cannot perform the functions of your job before you were injured, which means you might have a restriction. For example, you could be restricted to only lifting five or 10 pounds. Or you could have a restrictions where you need to be in a chair the entire time. In New Jersey, it’s important to know and understand that being returned to light duty only can really happen if your employer or the type of work that you had offers light duty. If there’s no offer of light duty, there isn’t a return to work.

When someone gets hurt at work in New Jersey, the first thing that they should do is report the claim to a supervisor or their boss. By reporting the claim, you preserve your right to pursue a worker’s compensation case and you start the process. It’s a long process, but what you can do is when you report it, you can then get treatment paid for by your insurance carrier.

Everyone gets a declaration sheet as part of their insurance policy. It is at the front of the insurance policy. Most people don’t know what their coverages are and most people don’t know how to read the declaration page. The first thing you’re going to see is what is your liability coverage. That means if you injure someone else in an accident, how much will your insurance company pay for someone else’s injuries and compensation for economic losses? Then you go down and what is your own coverages? In New Jersey, we are a no fault state. And a no fault state means that if you’re in an accident in New Jersey involving a car, your own car insurance will pay for the property damage to your car and it will also pay for your medical bills. There will be on your declaration page a line for property damage. How much coverage do you have for physical damage to your car? That’s property damage. Then you get to what is personal injury protection benefits? That is the medical coverage in your car insurance. The other thing that’s important to know in your declaration page is underinsured or uninsured motorist coverage. They’re two different things. Uninsured motorist coverage means what it says. If you are hit or you are injured as a result of an uninsured driver, they don’t have liability coverage. You look at your own policy. And when you look at your own policy, you determine what are my limits. Underinsured motorist coverage is if you’re injured by someone who doesn’t have sufficient coverage to pay or compensate you for your losses and injuries, you are allowed to look at your own underinsured motorist coverage to go from the limit of the defendant or the tort feeser or the wrongful actor up to your own underinsured limits. So the driver of the car has $100,000. You have a $500,000 underinsured motor motorist coverage claim and your total injuries and compensation are worth more than $500,000. You could look at your own car insurance for 500,000 -100,000 and get $400,000. That’s an example of how undercharged motorist coverage works. And the last part of the declaration page that’s important. Limitation on lawsuit or no limitation on a lawsuit. What does that mean? So it’s also known as a tort threshold. Some people call it the verbal threshold. Some people call it the limitation on lawsuit in New Jersey. If you have the no limitation on lawsuit, you can sue for personal injuries with no restriction for anything temporary and permanent. If, however, you have the limitation on lawsuit, which is a cheaper policy or the premium is less, if you take the limitation on lawsuit. Likewise, if you take the no limitation, it’s more expensive. What does it mean to have the limitation on lawsuit? Limitation on lawsuit means that you can only sue for pain and suffering or personal injuries if your injury satisfy one of six categories that is in the state law and they are death, dismemberment, loss of the limb, loss of a fetus, significant disfigurement or scarring displaced fracture, meaning a fractured bone goes all the way through or six where we see a lot of the lawsuits fought out, fought over in the courthouse. Permanent injury. What is permanent injury mean? It means an injury that has not healed and will not heal with future treatment. And it needs to be shown with objective medical evidence. So limitation on lawsuit makes it harder to sue for pain and suffering. And you need to know if you have that. And again, it will cost you more money to have no limitation. I do recommend it to people. I think it provides you with more rights. But I do understand it is more expensive and not everyone can afford it. And it’s up to you and your family.

How much coverage you should have in your car insurance policy is determined by a few factors. What can you afford? Everyone has different spending requirements. Everyone has different budgets. Everyone has different income. I do believe that everyone should have certain minimum coverage limits in their policy because you need to have certain minimum coverage limits to protect yourself and protect your family. For liability coverage, I do believe that every person should have at least $100,000 of coverage if you injure someone else and they have a claim for paying and suffering and lost economic damages, you want to make sure you have $100,000, because if you have a smaller policy, you don’t want to make yourself subject to anything above your policy limits. What amount of coverage should you have for underinsured and underinsured motorist coverage? You typically cannot exceed the liability coverage when you have underinsured and uninsured motorist coverage. You really should have no less than $100,000 because if someone injures you and they do not have any coverage, you want to make sure you have a minimum of $100,000 to help yourself during your time of need. When you’re recuperating or recovering from your injuries. If you can afford more than that. I strongly recommend that you do so, and it will not cost you a significant amount of more money from your policy or your insurance company. How much coverage should you have for PIP benefits for your medical coverage? I strongly urge people not to make health insurance their primary in their car insurance, because if you’re in an accident, sometimes you need to pay the health insurance company back. There is no payback obligation when you have your medical bills paid for under the PIP coverage. And I tell you and I tell all my clients to take the $250,000, if you are involved in an accident and you are seriously injured. $250,000 of coverage will provide you with a lot of coverage for medical treatment. And if you need to have a claim for pain and suffering and you’re looking for compensation, medical bills will not need to be repaid or hopefully will not need to be repaid.