The simple answer is that if you were hurt during the course of your employment, you most likely have a valid workers’ compensation claim.
In New Jersey, workers’ compensation is basically a no-fault system. In other words, an employee does not need to prove that an employer committed negligence in order to obtain workers’ compensation benefits. You can trip over your own two feet and still collect workers’ compensation as long as you weren’t engaging in behavior which could be construed as a major deviation from your employment.
All industries which perform work in the state are covered by the New Jersey Workers’ Compensation Act. Even out-of-state employers may need workers’ compensation coverage if a contract of employment was signed in New Jersey, or if the work is performed in New Jersey. Virtually all individuals who work in the state are covered by the Act, with the exception of longshoremen and employees of the United States government, who are protected by separate compensation systems.
The Act applies to both traumatic injuries from specific accidents as well as occupational injuries which occur over time as a result of the work effort. Examples of occupational injuries include carpal tunnel syndrome caused by repetitive typing, pulmonary disability of a fireman who repeatedly suffered from smoke inhalation, or a factory worker who experiences hearing loss due to constant loud noises. Back injuries may also be caused by years of heavy labor in the construction industry. Shoulder impingement may be caused by the repetitive use of tools. Any activity which requires the use of the same muscles repeatedly has the danger of causing an occupational injury.
Occupational claims are generally more difficult to prove than specific accident claims. Many insurance carriers in New Jersey automatically deny occupational claims as a matter of course. With all occupational claims, the personal risk factors of the injured worker, such as smoking, are always at issue. It is undoubtedly more difficult to prove that an employee with a 30-year smoking industry developed a pulmonary disability due to chemical exposure, than it is to prove causal relationship in a case involving a non-smoker.
It is critical for the injured worker to be able to demonstrate that his activities on the job were more taxing than those outside of his employment, to successfully litigate an occupational claim. Therefore, it is important to have a very specific list of job duties at work, with a description of each duty (for example, how much is lifted, what tools/machines are utilized, and a log showing the length of time of each activity). The injured worker should be prepared to provide her doctors with a complete description of the activities which led to the symptoms, to enable the physician to document how the injury is related to her employment. Since litigation often takes years to conclude, and memories fade, it is advisable to write down the job duties while still employed or shortly after employment ends. If a formal job description from the employer is available, that document should also be obtained. If possible, it is helpful to save the names and contact information of co-workers who would be able to corroborate your testimony regarding the nature of the work.
Insurance carriers are notorious for pointing to a pre-existing injury as the cause of an employee’s symptoms. However, if a pre-existing condition was asymptomatic prior to the work accident, it should not be used as a basis to deny workers’ compensation benefits. For example, if you were diagnosed with pre-existing arthritis which never caused any symptoms before the accident, the carrier should not use that condition as a basis to deny benefits, although they often try to do so. In short, while workers’ compensation insurance will not cover the arthritis which existed prior to the accident, it should cover any exacerbation or acceleration of the arthritis which became symptomatic because of the work injury.
The difficulty of proving that a pre-existing condition was aggravated by a work injury usually depends upon the severity of the trauma and a review of the medical reports. For example, it is undeniable that arthritis may be present yet asymptomatic for years. Whether or not medical treatment becomes necessary due to a traumatic event often boils down to the strength of the medical testimony and how persuasive the employee is in explaining how active he was prior to the accident. Employees must be prepared to release copies of all prior medical records which are relevant to the work injury in order to pursue a claim.
For more information on Claims Covered By NJ Workers’ Compensation, a free initial consultation is your next best step. Get the information and legal answers you are seeking by calling (908) 923-0020 today.