Steps in Filing a Workers’ Compensation Claim

Steps in Filing a Workers' Compensation Claim

steps workers compensation

If you are injured in a work accident, become ill due to conditions at your workplace, or suffer other harm or injury from your work duties, workers’ compensation ("WC") may be a suitable remedy for you. Workers' Compensation benefits include medical treatment, wage replacement and permanent disability compensation. No matter how severe or minimal the injury or illness, it’s important that you follow the established process to ensure you receive the benefits you are entitled to.

Notification of Injury

If you’re involved in an accident at work, you need to notify your employer as soon as possible. You should do so verbally and in writing, if possible. This is also the case if you learn that you may have an occupational disease or illness from your workplace and/or work duties. If you wait too long, you run the risk of losing your right to receive WC benefits.

Some companies have established protocols for accident and injury notification. If that’s the case with your employer, you should follow that process. If not, provide notification to a manager, supervisor, human resources, or someone else in charge. Be sure to let them know if you don’t feel physically able or well enough to continue working.

Your employer should ask you to provide an injury report, and get specific details about the incident, your injury/illness, information on any witnesses, and medical care authorization. Ask for a copy of the completed paperwork. Your employer should inform their WC insurance carrier ("Carrier") of the incident right away so that you can begin receiving benefits.

Medical Treatment

After reporting an accident, you should seek medical care through WC, even if you don’t believe the injury is serious. In many cases, the severity and/or extent of an injury is not immediately evident. By documenting your condition with a medical professional, it will be easier to substantiate your claim later if need be, so that you can receive the benefits you deserve.

The Carrier will contact you, your Employer, and the treating medical provider to discuss your accident to determine whether your injury is compensable. If your claim is approved, you should begin receiving medical treatment right away. The employer and/or Carrier will choose the medical provider who will be providing treatment.

WC Claim Benefits

If your injury prevents you from working for more than seven days and your claim has been approved, you should become eligible for temporary disability benefits. If your claim has been denied and you believe you are entitled to medical care and/or temporary disability benefits, you may file a Motion for Medical and Temporary Disability Benefits. If you file a motion, the court will set a date for a hearing and the Carrier will have an opportunity to file an opposition to your motion.

Claim Petitions

Formal claim petitions must be filed within two years of the date when you were injured, or the date when you last received a WC payment or medical treatment for your injury, whichever is later.  Upon filing a claim petition, the Division will assign a judge to your case and assign a docket number and place of venue. Cases are usually venued in the WC court closest to where the injured workers lives. The Carrier will then file an Answer to the claim petition, or otherwise plead.

Court Conferences and Workers’ Compensation Hearings

Court conferences are scheduled periodically throughout the duration of a claim. These conferences provide an opportunity for the attorneys to meet with the court to discuss case management and other issues affecting the claim. Once medical treatment is complete, permanency exams are conducted and the parties typically either reach a settlement as to permanency benefits, or a trial is conducted.

Hearings are typically held on motions for Medical and Temporary Disability Benefits.  The WC judge presides over the hearing renders a decision on the motion.  Testimony of the injured worker and medical experts may elicited during these hearings.

Settlement or Award

It is common for WC cases to settle before trial. Often, this is beneficial to the injured worker and their family. However, if a settlement isn’t possible, your case will proceed to trial. A trial in WC is a lot like a Superior Court trial, expect in WC trials there is no jury. Thus, both sides present witness testimony and other evidence to the WC judge, who ultimately weighs all the evidence and issues a decision. If the judge rules against you, you may be able to file an appeal in the Appellate Division of the Superior Court.

If you are injured at work, a knowledgeable New Jersey Workers’ Compensation lawyer can make all the difference. Contact The Reinartz Law Firm today to discuss your WC claim.