What is the workers’ compensation claims process?

What is the workers’ compensation claims process?

If you've suffered an injury within the scope of your employment in New Jersey, you may be eligible for workers' compensation benefits. Workers’ compensation benefits are intended to provide financial compensation for the medical costs associated with your injuries, lost wages while you are temporarily disabled and unable to work, and benefits for permanent disability associated with the injury.

To submit a claim for benefits, the following criteria should normally be met:

  • You must be injured while performing the functions of your job
  • You must be an employee and not an independent contractor
  • Your injury or illness must related to duties performed at work

For you to be eligible for benefits you will need to follow the claims process which we have outlined below.

Step 1. Get medical treatment.

If you're injured on the job you should report the injury to your employer as soon as possible so that a claim can be made on your behalf and a doctor's appointment scheduled through your employer's workers' compensation insurance. If you do not do this, your medical costs may not be covered by workers' compensation. If you require emergency medical treatment for the injuries, authorization is typically not required.

Step 2. Follow the doctor's orders.

Explain to the authorized workers' compensation doctor what happened and how you were injured. Informing the doctor of the nature of the incident will ensure that the doctor can properly treat your injuries. Follow the doctor's medical advice and treatment and keep copies of all the paperwork including prescriptions, invoices, and medical records.

Step 3. Checking on your claim status.

After you report your injury, your employer is obligated to file a First Report of Injury with the Division of Workers' Compensation within 21 days of your injury notice. You should inquire with your employer within this timeframe and ensure the report has been filed. If not, it may be a good time to work with a workers' compensation attorney to help understand your rights.

Step 4. Receiving benefits.

If you are authorized to receive workers' compensation benefits for your injury, you will begin a course of treatment with an authorized medical provider or providers. If you are authorized to be out of work during this time, you may receive temporary disability benefits to replace a portion of your lost wages. You must follow the treatment protocols administered by the authorized treating physicians, or risk losing benefits during this time.

Step 5. File a formal claim.

A workers' compensation attorney can file a formal claim petition with the state on your behalf. A workers' compensation attorney can not only ensure that your benefits are administered properly while you treat for the injuries, but can seek an additional award of compensation for permanency of the injuries after treatment is complete. This involves retaining expert witnesses, typically doctors, who review all available medical information and provide opinions as to the permanent aspects of the injuries.

At The Reinartz Law Firm, we go to work when you can't. Call us for a free consultation and evaluation of your work injury claim.