Workers’ compensation programs have been instituted in all fifty states, including New Jersey, to provide a streamlined process for injured workers to obtain benefits to cover lost wages and medical expenses. Unfortunately, a large percentage of claims, including many legitimate claims, are initially denied by workers’ compensation insurance companies. There are some valid reasons why a workers’ compensation claim will be denied:

• The injury was not work-related
• You didn’t report the claim within the period of time required by law
• The injury may not be one that is covered by workers’ compensation—for example, some states don’t allow coverage of psychological injuries, including stress-related clai
• The injuries are not serious enough to prevent you from working

If none of the above situations applies and your claim has been denied, you are not necessarily out of luck. Every state, including New Jersey, has a process by which you can appeal the denial of a workers’ compensation claim. Often, you will find specific instruction on how to appeal the denial in the denial letter itself.

Before filing any formal appeal, you should contact the insurance company that provides workers’ compensation coverage for your employer. The denial may have been a mistake, or may have been based on erroneous or incomplete information.

In New Jersey, there are two ways you can appeal the denial of a work comp claim. To obtain a formal hearing, you must file what is known as a “claim petition.” An informal hearing may be arranged by submitting an Application for an Informal Hearing.”

The informal hearing process typically moves faster. Once you file your application, you will be assigned to a workers’ compensation judge and will receive notice of a hearing date. If you are unsatisfied with the judge’s ruling, you may still file a formal claim petition and seek a formal hearing.

When you request a formal hearing, you will be assigned to a “judge of compensation,” and will also be scheduled with a hearing date. However, that hearing may not take place for six months or more. In addition, the hearing will look more like a trial than a conversation (the informal hearing usually involves the judge asking questions of both parties). The formal hearing may include witnesses, as well as documentary evidence.

Contact Taylor & Boguski

At Taylor & Boguski, we bring more than 70 years of combined legal experience to injured people throughout New Jersey. For a free initial consultation, contact our office online or call us at 856-234-2233.

Uber Drivers Seek Resolution of Workers’ Compensation Issue

Uber, the fabulously successful “rideshare” service that’s sweeping the nation, faces a potentially catastrophic legal challenge—at least two lawsuits have been filed against the company seeking to identify drivers as employees rather than independent contractors. If the lawsuits are successful, Uber and its competitors, such as Lyft, will be required to provide workers’ compensation benefits to thousands of drivers across the country.

Both lawsuits were filed in California and both seek class action status, allowing attorneys to represent Uber and Lyft drivers from coast to coast. Thus far, class action status has been granted, but only with respect to California drivers.

Under the workers’ compensation laws of most states, private employers must either purchase a policy of workers’ compensation insurance for employees or must self-fund a plan to compensate employees who are injured on the job. These requirements are not applicable to independent contractors.

According to a recent press release by Uber, more than 150,000 people drove at least four times for the company in December, 2014. Workers’ compensation premiums for that many workers could cost millions.
In determining whether a worker is an employee or an independent contractor, courts typically look at three factors:

• What is the behavior of the worker and the company? Does the company exert control over the duties and functions of the worker? Are there restrictions on time or assignments?
• How is the worker paid? Are expenses reimbursed? Who provides supplies, tools and information?
• What is the legal relationship between the parties? Is there any type of a written contract? Are any additional benefits paid, such as retirement, health or disability?

Contact Us

At Taylor & Boguski, we bring more than 70 years of combined legal experience to men and women throughout New Jersey. For a free initial consultation, contact our office online or call us at 856-234-2233.

The New Jersey Workers’ Compensation Process

In New Jersey, when you have suffered injury or illness because of work conditions, you have the right to pursue benefits for medical expenses and lost wages. The process, however, can be confusing and intimidating—many legitimate claims are initially denied.

The Steps Necessary to Obtain Workers’ Compensation Benefits in New Jersey

The first thing you want to do when you have suffered a work-related injury is get medical treatment. Even if you think you can keep working, you are better off to notify your employer immediately of your injury, and seek medic al care as soon as possible. You can pursue initial treatment from your own doctor or at a hospital or clinic, but may also be required to submit to an examination from a company-chosen physician.

If you don’t leave work to seek medical treatment, and have not notified your employer of your injury, you must notify your employer before you can become eligible for workers’ compensation benefits. In New Jersey, you have up to two years from the date of your injury or the date of your last paycheck to notify your employer, whichever is later.

Once you have notified your employer, your employer will contact its workers’ compensation insurance provider. The workers’ compensation insurance company will then prepare and file a “First Report of Injury” with the state workers’ compensation office, which initiates, but does not authorize your claim. The insurance company will then conduct an investigation and make a determination as to whether you qualify for benefits. If so, you will be notified that your claim has been approved.

Just because your request for benefits is denied, however, does not mean that you won’t eventually be able to receive benefits. You can request an informal hearing with the New Jersey Division of Workers’ Compensation, asking for a review. Conversely, you can file a formal request, known as a Claim Petition. The denial of your claim by the Division of Workers’ Compensation can be appealed in the state courts in New Jersey.

Contact the Law Office of Taylor & Boguski

At Taylor & Boguski, we bring more than 70 years of combined legal experience to injured people throughout New Jersey. For a free initial consultation, contact us online or call us at 856-234-2233.

When You are Hurt at Work in New Jersey

As in all states, when you suffer a workplace injury in New Jersey, you have a right to pursue benefits under the state’s workers’ compensation laws. You must notify your employer in a timely manner, and you must submit to a physical examination from a doctor chosen by your employer. If your claim is approved, though, you may be entitled to receive a broad range of benefits.

Compensation for Lost Income

If you are unable to return to your job within seven days of your injury, you have a right to receive what are known as “temporary total disability” benefits until you can return to work, subject to certain limitations. Under New Jersey law, the compensation for lost wages pursuant to a temporary total disability is approximately 70% of your average weekly wage for the last year, with minimum and maximum payouts under law.

You are entitled to receive payments for temporary total disability until:

• You are able to return to work, or
• Your doctor determines that you have reached “maximum medical improvement,” i.e., there is no treatment or care that will lead to a cure or complete return to health.

If your doctor finds that you cannot return to full health, you will be re-categorized as having either a permanent partial disability or a permanent total disability. If your doctor states that you can return to work in some limited capacity, you are considered to have a permanent partial disability, and are entitled to payment of benefits according to a schedule set forth in the New Jersey statutes. The schedule identifies the amount and length of payments based on the body organ—hands, arms, legs, feet, eyes, ears, etc.—that is disabled.

If you cannot return to work in any capacity, you will receive payments for a permanent total disability. These payments are also determined by the statutory schedule, and are typically for a minimum of 450 weeks. They may be extended, however, if you are still unable to work at the end to the designated period.

Contact Us

At Taylor & Boguski, we bring more than 70 years of combined legal experience to injured workers throughout New Jersey. For a free initial consultation, contact our office online or call us at 856-234-2233.

Repetitive Motion or Stress Injuries on the Job

Under the laws of New Jersey, when you are hurt during the course of employment, you have a right to pursue monetary compensation for lost wages, medical expenses and even job retraining, if you can’t return to your previous job. The injury, though, does not have to arise from a single traumatic event—a fall or the malfunction of a machine or tool. Often, the most debilitating injuries are those that develop over time, from standing, bending, lifting, squeezing or pinching over and over and over.

The New Jersey workers’ compensation laws allow you to pursue benefits for what are called repetitive stress or repetitive motion injuries. These types of injuries can take many forms, including:

• Carpal tunnel syndrome, a condition that customarily affects the wrists of workers. Carpal tunnel injuries afflict workers in a wide variety of occupations, from typists and keyboard operators to workers on an assembly line, from cashiers in retail operations to anyone exposed to repeated vibration in the hands or wrists.
• Tendonitis, which can cause severe pain in elbows, arms, knees, shins and other joints with tendons. Tendonitis may be caused by overuse of the tendons, or it can be caused by inactivity, such as standing in the same place and position for hours every day.
• Cubital tunnel syndrome, a condition similar to carpal tunnel syndrome, which affects the elbow, resulting in radiating pain and numbness in hands and fingers. Machine operators and truck drivers are particularly susceptible to this condition.
• Cervice radiculopathy, a compression or strain on the disks in your neck, causing substantial neck, back and shoulder discomfort. People who spend a lot of time on the phone are at risk for this condition.
• Thoracic outlet syndrome, usually caused by repetitive overhead motions. This injury typically manifests in pain in the breastbone, as well as numbness or tingling in your arms.

Contact Us

At Taylor & Boguski, we bring more than 70 years of combined legal experience to injured people throughout New Jersey. For a free initial consultation, contact our office online or call us at 856-234-2233.

What to watch out for when filing a workers’ compensation claim

We have represented workers’ compensation claimants for many years and have seen innocent mistakes by injured workers come back to haunt them later on. Here are some issues you should consider, and problems to avoid, when filing a workers’ compensation claim:

After a work-related injury, request medical attention and report the incident.

• If your injury requires more than first aid, document your injury or it may be used against you later in your claim.
• If you fail to get prompt, appropriate medical treatment, the claims adjuster or the defense lawyer will use this against you and argue that your injury is not work related or is minimal.

In the report, disclose everything the first time.

• Be very thorough and disclose all injuries, whether they’re major or minor.
• Failing to report a minor injury and only focusing on more serious ones
  • May result in a denial for claims covering minor injuries, or
  • What you think is a minor injury may actually be a major one. Its symptoms may only be clear later on.

Make a note of any witnesses to your accident and get written statements from them if possible. This can support your claim in case the insurance company tries to deny it.

Communicating with the workers’ compensation insurance company is a bad idea.

• Though they may sound like they are, insurance adjusters are not your friends. You are dealing with trained professionals whose sole purpose is to protect the employer and the workers’ compensation insurance company. They want to save money and pay you as little as possible.
• An experienced adjuster or defense attorney can use statements made by injured workers against them.

Not filing a claim because no work was missed is a mistake.

• Workers’ compensation benefits don’t just apply to time missed from work. These benefits include payment for medical services and prescription drugs. The insurance will likely also cover travel expenses related to getting to and from the doctor.

Be prepared to be watched, online and in public.

• It’s become common practice for insurance adjustors to hire investigators to gather evidence concerning your activities to disprove that you are injured or prove your injury is not as serious as you claim.
• They may monitor your movements and activities, even interview your neighbors. You may be video recorded while out in the public.
• Any postings on social media, especially those describing what you are doing and where you are going, may end up on the investigator’s computer. They would like nothing more than to see pictures or videos posted showing you engaged in any kind of vigorous, strenuous activities.
• It may only take about five seconds of video, a picture or a posting about your vacation to provide evidence contesting your claim.

When it comes to workers’ compensation, an ounce of prevention with a claim is worth a pound of benefits. If you have any questions about workers’ compensation, contact our office.