A person who is injured at work has a number of legal remedies to assure appropriate compensation for whatever injuries and other losses he or she may have sustained. There are, however, many limitations which restrict a person's rights when hurt at work.
The laws are governed by the New Jersey Statutes under the Worker's Compensation Act. It is not unusual that a person hurt at work might fear filing a claim against his or her employer. Many express concern that they might lose their job, that their employer would be financially hurt or that there might be some type of retaliation.
Such concerns are generally unfounded because the law requires that all employers maintain Worker's Compensation Insurance to cover such losses. In the event an employer tried to discriminate or retaliate against a worker for the worker's assertion of legal rights in attempting to collect worker's compensation, that employer would be breaking the law and would be subject to harsh penalties.
It is therefore very unusual that an employer would take any type of retaliatory action against an employee for filing a worker's compensation claim.
If you are injured at work, the law does not require that you prove that your employer or someone else was at fault and responsible for causing your injuries. An injured person is entitled to the same rights and remedies irrespective of whether he or she is totally responsible for the accident that caused the injuries or whether someone else is responsible for the accident that caused the injuries. This legal principle differs from other areas of law that normally require proving fault against another person before you can collect compensation. One of the major reasons for this difference is that when Worker's Compensation Laws were passed, the basic idea behind them was that the injured individual should receive quick compensation and that it was important to protect workers in the event they sustained injuries and financial losses resulting from inability to work.
There are, however, rather strict limitations imposed on the amount of money a person can collect for injuries sustained while at work, and this is in sharp contrast with other areas of the law. For example, if someone suffers a broken leg at work, the amount of money he or she could collect for that injury is generally governed by certain charts which indicate how much money a person would be entitled to collect based on that particular injury and the amount of disability that resulted from the injury.
Again, this is in sharp contrast with other areas of the law. If the same individual had broken his or her leg in a car accident as a result of another driver's fault, the injured person would normally have few legal restrictions imposed as to the amount of money he or she could collect for that injury. The ultimate decision would be in the hands of a jury which would hear the evidence and make a decision as what would be fair and reasonable compensation for that injury.
The net result is that a person often collects less money for a particular injury when that injury occurs while at work, than that person might otherwise have collected if injured as a result of someone else's fault in a non-work related incident. Many people would like to see the Worker's Compensation Laws changed so that injured persons are able to collect more money for their injuries, but that is something that the legislature would have to do.
Three Types of Compensation
In general, there are three types of compensation that a person injured at work is entitled to receive. First, the employer's insurance company must pay for all reasonable medical bills associated with the accident and the injuries. There are restrictions, however, because the employer has the right to designate an authorized doctor for the injured person to go to for treatment. If the injured person wants to go to another doctor, payment for that doctor's bill are the responsibility of the injured person and not the responsibility of the employer. If, however, the employer refuses to designate a doctor or provide reasonable medical treatment, the employee can choose his or her own doctor and require the employer to be responsible for payment.
There are occasions when the injured person might still feel that he or she needs more medical treatment but the employer's designated doctor says that the person is healthy and able to return to work. In such a situation the injured person can go to another doctor of his or her own choosing and if that doctor feels the person requires more medical treatment, the injured person may make an application to the Court to permit additional treatment and to require the employer to pay. It is important that you consult with a lawyer knowledgeable in the area of worker's compensation because there are many legal complexities in these types of situations, and your questions can best be answered by an attorney experienced in the area of worker's compensation.
The second major benefit involves payment to the employee for wage losses. Generally, if the employee is out of work for at least one week, he or she can collect about 70% of his or her gross wages for the period of disability. If the employer is not making these wage payments, the employee has the right to make an application to the Worker's Compensation Court for the immediate payment of such benefits. There may be situations where the employer's designated doctor feels the employee can medically return to work, but the employee does not feel he or she has returned to their former state of health and cannot work yet. In this type of situation, the employee has the right to make an application to the Worker's Compensation Court to determine whether or not the employer must continue to pay disability wage loss benefits.
The third worker's compensation remedy gives injured employees the right to collect money for their personal disability, if such a disability results from the accident. This normally comes into play after the injured employee has been released from medical treatment and recovered as fully as medically possible under the circumstances. By way of example, a person may have broken his or her leg, received medical treatment, and the fracture has healed and he or she is able to go back to work. Nevertheless, that person might continue to have pain and restrictions associated with that injury in the future. During bad weather his or her leg may hurt or get stiff, he or she might be unable to move his or her leg through a full range of motion, or there could be other restrictions associated with the injury that will not get any better.
In such a situation the employee can apply to Worker's Compensation Court for a monetary award that would provide reasonable compensation for any disability that is permanent in nature. Any disability of this type does not have to be a disability of the total person but merely a partial disability related to a certain part of the body.
Another example would be a back injury where the person has received the full benefit of medical treatment and can return to work, but still has pain and restrictions of motion and cannot do all types of activities they were able to do before the accident. While that person is not totally disabled from performing activities of daily living, the person might still have a partial permanent disability and the law recognizes that he or she should be given compensation for that disability.
How is Compensation Determined?
The amount of money the person can receive is governed by certain charts that are part of the law which indicate how much money the person can get based on what percentage of his or her body is affected by the disability. This can be a complicated area and it is always best to consult with an attorney experienced in worker's compensation so that you can fully understand all of your legal rights in this area.
The amount of money you can get for permanent partial disability is strictly limited by the amounts provided in the worker's compensation charts. By way of example, if you have a 10% disability of your back, there is a chart that will indicate how much money the person should receive for disability. It is normally best to consult with a lawyer in these types of situations because the employer's doctor might determine that, by way of example, the employee has a 5% disability of his or her back. The employee is not required to accept the decision of the employer's doctor as final.
The employee has the right to be examined by another doctor, experienced in evaluating worker's compensation injuries. It would not be unusual for such a doctor to make a determination that the employee in fact has a greater disability, possibly 20%. At that point you have two different doctors with two different medical evaluations and determinations of disability. The Worker's Compensation Court gives you the right to have a hearing before the judge, who will make a determination as to what your actual disability percentage is, and this will result in the individual receiving a monetary award based upon the final disability determination made by the judge.
If a person becomes totally and permanently disabled as a result of an injury sustained at work, he or she may be entitled to collect compensation for rest of his or her natural life. If a person dies as a result of a work related accident his or her estate is entitled to a monetary award which is governed by the Worker's Compensation Laws.
One area that might often be overlooked is that an injured individual may experience not only physical but psychological injuries. When a person is hurt at work and has a radical change in his or her lifestyle, it is not unusual that as a result of the injuries the person will become emotionally distressed, anxious, tense, nervous, depressed, suffer from anxiety or have other emotional problems that directly result from the injury. If there is a psychological or psychiatric problem resulting from the injury the person is entitled to receive appropriate treatment, and if there is a partial permanent emotional disability determined by the judge, under certain circumstances the person might be entitled to legal compensation for the emotional problems that have resulted from the physical injuries.
This is not an unusual situation because often times a physical injury causes the person to have emotional difficulties resulting from pain, disability, change in lifestyle, and other problems associated with the physical injury. The law recognizes that such emotional problems should be treated, and if they are permanent in nature, the person should receive adequate compensation for such problems.
After a person receives a worker's compensation award from the Court, he or she may still reopen the case within two years of the date of the last payment of compensation, if that individual's medical condition should worsen. The employer would continue to be required to provide reasonable and appropriate medical treatment under such circumstances, and if there was an increase in the individuals disability percentage, the judge would award the person more money for the increase in the disability.
One important restriction on Worker's Compensation Benefits is that the injured person cannot collect compensation for pain and suffering, loss of enjoyment of life, or any other non-economic losses. This law is in contrast with other areas of the law. For example, if you are injured in a car accident as a result of someone else's fault, you are sometimes entitled to collect not only for wage losses and permanent disability, but the law also may permit you to be compensated for pain and suffering you have undergone, any loss in the enjoyment of your life as a result of the injury sustained, and other non-economic losses.
The law requires that all employers carry Worker's Compensation Insurance and the law imposes strict penalties on employers that do not provide such coverage for their employees. If you are injured at work and your employer for whatever reason does not carry Workers Compensation Insurance, the employer can be subject to criminal charges and penalties that include imprisonment of up to 18 months and a fine of $7,500.00. There is also a civil fine of up to $6,000.00 that can be imposed.
The State has recently set up an Uninsured Employer's Fund to protect employees that are injured on the job in situations where the employer does not have Worker's Compensation Coverage. Ultimately, the employer will be held legally responsible, but in the meantime the State fund can provide payment for medical treatment and lost wages incurred by the injured employee. This is a complex area, and if your employer does not have Worker's Compensation Insurance it is always best to immediately contact an attorney to pursue all of your legal rights and remedies.
To summarize, there are three benefits available to the injured employee:
- Payment for all reasonable and necessary medical treatment.
- Payment for lost wages while the employee is unable to work.
- Payment for any permanent disability sustained, which would include a partial permanent disability of a part of the body, a total disability, or compensation to the estate of an individual who has died.
It is always best to consult with an attorney who knows worker's compensation law so that your rights can be fully protected. Do not be afraid that your employer is going to loose money if you make a worker's compensation claim. The worker's compensation insurance coverage normally provides all benefits and as long as your employer has insurance, your employer will not pay any money out of his/ her pocket. The employer cannot take any retaliatory actions against you because it is totally illegal to do so.If you know your rights, you can be protected. You are entitled to adequate compensation for your injuries as provided by law.
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