Frequently Asked Questions Regarding Workers’ Compensation

What is the Deadline for Filing a Workers’ Compensation Claim?

A formal Claim Petition must be filed within two years of the date you last received medical treatment authorized by the workers’ compensation carrier. If no benefits were provided through workers’ compensation, the two-year deadline starts from the date of the accident.

Am I Required To Use All My Sick And Vacation Time Before I Am Entitled To Receive Workers’ Compensation Benefits?

No. Workers’ compensation temporary disability benefits begin after you have been out of work for 7 consecutive days. Once that 7-day waiting period is over, temporary benefits are payable from the first day, but you cannot receive both workers’ compensation and sick leave benefits. If your employer paid you sick leave benefits or vacation time before workers’ compensation kicks in, the carrier will normally reimburse the employer for the amount you should have been paid temporary disability benefits for the period you were paid sick/vacation time. Thereafter, those sick/vacation days should be restored to you.

Do Workers’ Compensation Claims Cover Pain And Suffering?

No, they do not. The New Jersey Workers’ Compensation Act was passed as a compromise in which workers gave up their right to sue for pain and suffering in exchange for the access to quick medical care and disability benefits without the need to prove negligence. You may only collect damages for pain and suffering if your injuries were caused by the negligence or wrongdoing of a third party (an individual or company other than your employer or co-workers). The Division of Workers’ Compensation does not have jurisdiction to hear such third-party claims.

Is My Employer Required to Pay For My Health Insurance Benefits While I Am Out Of Work?

No, many companies require injured workers to pay their share of the health insurance premium, even when they are out on workers’ compensation. Some larger employers will assume responsibility for paying the employees’ share of the premium, but they are not required to do so. Check with the human resources department if you are unsure of your employer’s policy. Unfortunately, the Division of Workers’ Compensation does not have any jurisdiction over the issue of health insurance.

Can My Employer Fire Me While I Am Receiving Workers’ Compensation Benefits?

Yes; an employer may fire you while you are receiving workers’ compensation benefits, as long as you are not terminated in retaliation for filing a workers’ compensation claim. Your workers’ compensation claim will not protect you from being fired for other reasons, such as violating company policy. In addition, if the entire company is downsizing, or you work for a small company which needs to fill your position in order to stay in business, the employer may legally terminate you. See, Chapter 15 for further information regarding employment law claims.

I Am Afraid That My Employer Will Fire Me If I File a Workers’ Compensation Claim. Wouldn’t The Safer Course Of Action Be To Just Use My Health Insurance To Pay For Medical Treatment?

No; you are not protecting your job by failing to assert your rights under the Workers’ Compensation Act. On the contrary, you are putting your job in greater jeopardy if you fail to report a work injury through workers’ compensation. It is illegal for an employer to retaliate against you for filing a workers’ compensation claim. Moreover, health insurance generally denies coverage for any medical treatment which is clearly related to a work injury. You will be committing insurance fraud if you lie about the cause of your injuries to your doctor.

If your injury is serious, your failure to report the work injury could have long-term implications, including the loss of income once your sick time runs out, and loss of health insurance if your employer eventually terminates you due to your inability to perform your job.

Although retaliation certainly does occur in the workplace, do not make the mistake of believing that you will be protecting your job by declining to file a workers’ compensation claim. If an employee fails to report a work injury due to fear of retaliation, but is later terminated, that employee may be left without recourse to any benefits. For example, this same employee may advise his doctor that an injury occurred at home to obtain health insurance coverage and stay in the good graces of his employer. If he is unable to work full duty for a significant period of time the employer may grow tired of accommodating him, and once enough time has passed, feel safe enough to terminate the employee. With the termination, the employee’s health benefits end. Since the work accident was never documented though, the employee will find it difficult to successfully pursue a workers’ compensation claim.

By contrast, if the work injury is documented and medical care provided by the workers’ compensation carrier, a reasonable employer will think twice before terminating that employee. Especially if you believe that your employer is looking for an excuse to fire you, the safest course of action is to file a workers’ compensation claim right away. Many employers are apprehensive about terminating an employee who has filed a workers’ compensation claim, since they are fearful of being accused of retaliation.

What If My Employer Does Not Have Workers’ Compensation Insurance?

An employer which fails to secure workers’ compensation insurance coverage in New Jersey is potentially liable for criminal and civil penalties. The employer may be charged with a crime in the 4th degree and fined up to $5,000 for the first 10 days, and up to $5,000 for each additional 10-day period. These penalties can’t be discharged in bankruptcy. Corporate officers may also be held individually liable. Accordingly, it is crucial for New Jersey businesses to acquire workers’ compensation insurance for their protection as well as for the protection of their employees.

If your employer fails to carry workers’ compensation insurance you may apply for benefits through the New Jersey Uninsured Employers’ Fund (“UEF”). The UEF provides both medical and temporary disability benefits. However, the procedural hurdles necessary to obtain those benefits are substantial. In addition, the UEF does not pay permanent disability benefits. To avoid the long process of obtaining benefits from the UEF, depending upon your injuries, it may be preferable to accept a “lump sum” settlement directly from an uninsured employer.

How Long Does It Take To Settle a Workers’ Compensation Claim?

As a rule of thumb, most cases take 9 to 12 months to settle from the date you are released from medical treatment. Your attorney cannot begin to negotiate a settlement of your claim until you have been discharged from active medical care and attended all expert examinations. So if you receive five years of active medical treatment, you should not be surprised if it takes six years for a settlement to be reached in your case, or to begin the Trial process.

For more information on FAQs on 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.