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Common Questions Regarding Workers' Compensation

A: If an accident occurs, you should immediately report it to a supervisor. Thereafter, your employer should notify its workers’ compensation insurance carrier of the accident. You should thereafter expect to receive a letter from the workers’ compensation carrier, providing a claim number, and the name and address of the physician who is authorized to treat you. If your employer does not notify the workers’ compensation carrier of the accident, you may do so. A poster should be posted in a common area of your workplace, with the name of the workers’ compensation carrier and policy number. Your attorney may also be able to identify the insurance carrier through the New Jersey Compensation Rating and Inspection Bureau.

A: No, not for continued medical treatment. You may go to your own doctor initially to obtain an opinion on whether or not you need treatment related to the accident. If so, and if the workers’ compensation carrier refuses to provide this treatment, you should immediately contact an attorney. The attorney should then file a “Motion for Medical Treatment” with the Division of Workers’ Compensation. The health insurance carrier will be able to seek reimbursement from the workers’ compensation carrier for any medical bills it paid related to the work injury.

A: Your health insurance carrier will be able to assert a lien on your workers’ compensation claim, in order to obtain reimbursement from the workers’ compensation insurance carrier for any benefits it paid on your behalf. However, if you fail to disclose the work accident at the time you obtain your medical treatment, in order to obtain the treatment coverage through your health insurance, then you are arguably committing insurance fraud. Accordingly, you must request treatment first through workers’ compensation. Once the workers’ compensation physician discharges you, or if you are unhappy with the treatment you are receiving through workers’ compensation, you may obtain a second opinion through your health insurance. Your attorney may then use the second medical opinion as a basis to file a Motion with the Court to force the workers’ compensation carrier to pay for further treatment.

A: Yes; some injuries occur over a period of time, from constant, repetitive, physical motions, and/or emotional stress, or exposure to chemicals and other irritants. Such injuries are considered “occupational,” rather than traumatic in nature. Occupational injuries are recognized under the NJ Workers’ Compensation Act, although they are more difficult to prove, and insurance carriers rarely accept such claims without litigation. Examples of occupational injuries include: carpal tunnel syndrome, obstructive pulmonary disease, asbestosis, degenerative disc disease, and post-traumatic stress disorder. If you have reason to believe that you suffer from such an occupational injury, you should immediately report it to your supervisor, and request medical treatment. If the employer refuses to provide medical treatment, you may then seek a medical opinion outside of the workers’ compensation system and should thereafter contact an attorney.

Pezzano Mickey Law

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