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Every worker has the right to a workplace that is objectively characterized as safe. The failure to account for worker safety has the potential to cause serious injury as well as debilitating illness.  Thankfully, those injured while performing work-related activities are empowered to file for workers’ compensation by way of the New Jersey Division of Workers’ Compensation.

The Basics of Workers’ Compensation

Workers’ compensation is a form of insurance meant to replace wages, provide medical treatment and permanent disability compensation for those injured at work.  If an employee endures a fatal injury while performing work-related activities, those who depend on him are also provided with death benefits by way of the workers’ compensation system.

Workers’ compensation is considered a no-fault program.  This means the injured worker is provided with benefits regardless of the individual at fault for the accident.  The injured worker gives up the right to levy a civil lawsuit against his or her employer in exchange for the financial benefits guaranteed through the workers’ compensation system.  This way, the employee is provided with the compensation necessary to cover medical treatment and indemnity payments for lost wages by forfeiting the right to pursue litigation for compensation attributable to pain, suffering and other damages.  The only exception is an intentional act on behalf of the employer that led to pain, suffering, disability, illness, etc.

It is possible for employees to file personal injury lawsuits against third-parties.  In some cases, such a personal injury lawsuit can be filed on top of the workers’ compensation claim, especially if the third-party’s negligence played a part in the injury.   A personal injury lawsuit empowers injured employees to recover damages unavailable by way of the workers’ compensation program.  Such a lawsuit holds third-parties liable for allowing unsafe work conditions.  New Jersey workers’ compensation law is administered through:

• Guaranteeing injured employees are provided with just and prompt workers’ compensation benefits through employers as well as insurance providers.

• Enforcing the law that mandates employers obtain workers’ compensation insurance coverage through commercial insurance providers or self-insurance programs.

• Providing benefits for temporary disability along with medical expenses to employees enduring injuries classified as compensble while laboring for uninsured employers.

• Providing indemnity payments to employees totally and permanently disabled resulting from the prior work-related injury along with pre-existing disability.  Such benefits commence when the employer’s benefit payments are exhausted.

How to Proceed if Injured at Work 

Those injured on the job should immediately report the injury or illness to their employer.  Ideally, this notice will be provided to the human resources department within minutes or hours after the incident.  Do not wait longer than 90 days to report the injury or illness.  When detailing the injury to your employer, make sure to communicate the fact that it was caused by work-related activities as opposed to your personal activities.

The failure to report your work-related injury has the potential to cause the employer to argue the accident did not occur or insist the accident occurred outside the scope of work.  It is also in your interest to ensure you understand your employer’s specific deadlines for reporting injuries that occur in the workplace.  The failure to report the accident in the designated time frame can result in a suspension from work or the issuance of a citation.

Obtain Medical Treatment

If your workplace injury is harsh, it is imperative you receive prompt medical attention.  However, if the injury is delayed and you do not immediately notice it or if the extent of the injury is unclear immediately after it occurs, it is still in your interest to obtain medical treatment without delay.  This medical treatment should be provided by a board-certified physician.  Treatment from such a qualified party will enhance your claim for medical expenses.  Furthermore, meeting with a doctor in New Jersey makes it that much easier for the medical specialist to testify if medical testimony is required for your workers’ compensation case.  Ensure the doctor understands you suffered the injury/illness at work.  This way, he or she can note the fact that the injury has resulted from work-related activities when creating the medical report.

Meet With an Attorney

It is in your interest to meet with an experienced workers’ compensation attorney as soon as possible after your workplace accident or work-related illness.  You have the right to be represented by an attorney who gathers all related evidence including medical records and medical evaluations to present at subsequent hearings.  A savvy workers’ compensation lawyer like Richard Schibell understands the nuances of the workers’ compensation system.  This professional can help you obtain the compensation you need during this challenging chapter of your life.

Defining Work-related Injuries

The Occupational Safety and Health Administration (OSHA) states injury and illness fall under the umbrella of “work-related” if the incident or exposure to something in the work environment caused or even contributed to the subsequent injury/illness or meaningfully aggravated the pre-existing injury/illness.  If the illness or injury occurred in the realm of the workplace, it is automatically assumed it is work-related unless one of the exceptions below exists:

• The worker was in the workplace in the form of a general member of the public rather than in an employment capacity when the injury or illness occurred.

• When the worker is completing personal tasks not related to employment outside of the working hours assigned.

• The workers’ injury or illness is characterized by symptoms that manifested while at work yet strictly result from vents or exposure unrelated to work.

• The injury/illness strictly results from the employee’s voluntary participation in a recreational, fitness or medical activity or wellness program.  As an example, participating in a company softball game, donating blood, being examined by a physician and getting a flu shot are all voluntary activities employees participate in on their own.

• The injury/illness is strictly the result of the worker consuming food/drink or preparing food/drink for his or her own consumption.  As an example, falling ill after consuming a sandwich bought at the workplace cafeteria will only qualify as work-related if the sandwich is contaminated or poisoned.  If the employee chokes on the sandwich due to his or her own err, it probably won’t qualify as a workers’ compensation-covered injury.

• The injury/illness is the result of personal grooming, self-medication for a condition unrelated to workplace activities or personal grooming.

• The injury results from an auto accident and occurs in the employer’s parking lot or on an access road when the employee is commuting to work.

• The injury is a mental illness unrelated to work.  However, if a doctor or another healthcare profession indicates the mental illness is related to workplace activities, it can fall under the umbrella of workers’ compensation coverage.

Workplace Injuries Resulting From Negligence

Employers are provided with specific protections in accordance with workers’ compensation laws.  One such protection is protection against civil lawsuits levied by injured employees.  The injured employee can file a lawsuit against a party aside from the employer.  Plenty of workplace injuries lead to workers’ compensation claims as well as personal injury lawsuits.

Third-party negligence that plays a part in workplace injury/illness differs in accordance with the workplace and the details of the accident.  Every single worker in the United States has the right to a safe work environment void of unnecessary hazards and negligent employees.  Examples of third-parties who can be determined liable for an injury in the workplace include vendors who create safety hazards, equipment manufacturers who make unsafe equipment, negligent drivers that crash into employees, construction site contractors who fail to maintain a safe work space and those who distribute unsafe materials/chemicals.

Filing a personal injury lawsuit empowers you to collect compensation for damages not covered through workers’ compensation programs.  Workers’ compensation does provide compensation for pre-approved medical costs, about 2/3rds of worker wages and disability.  However, a third-party personal injury suit opens the door to collect financial compensation for lost wages, expected medical care and employer contributions for retirement.

What Types of Benefits Does Workers’ Compensation Provide? 

Workers’ compensation programs provide injured employees with the following benefits:

Temporary Total Benefits: This type of benefit compensates the injured employee who is incapable of working for a period beyond seven days.  Such benefits are retroactive to the initial day of lost time and paid at 70% of the employee’s average weekly earnings.  However, this figure will not exceed the max rate or dip below the minimum rate as set by the Commissioner of Labor and Workforce Development.  Such benefits are issued until the employee returns to the workplace, hits the 400-week max or has attained MMI.  MMI is a commonly used acronym in the context of workers’ compensation injuries that stands for maximum medical improvement.

Medical Benefits: Medical benefits include reasonable and necessary medical treatment, hospital services and prescriptions related to the injury or illness suffered in the workplace.  Employers and insurance providers are provided with the right to specify medical providers for the treatment of injuries related to work.

Permanent Partial Benefits:  This type of benefit is paid to employees who endure permanent bodily impairment stemming from an injury related to workplace activities.  Such benefits are provided on a weekly basis for 450 weeks.  The benefits are still paid beyond this point if the injured employee can prove he or she remains totally disabled.  It must be noted permanent partial benefits are provided at 70% of the employee’s average weekly wage yet are not to exceed or dip below the legally required amount.

Death Benefits: Death benefits are provided to those dependent on the employee killed by an injury or illness suffered in the workplace.  Death benefits and funeral costs top out at $3,500 and paid at 70% of the perished employee’s weekly wage.  This benefit is not to fall beneath or exceed the requirements set by law.

Why Every Injured Worker Should Lean on an Experienced Attorney for Workers’ Compensation

Injured employees are entitled to legal representation throughout the entirety of the workers’ compensation process.  The employer and that group’s insurance provider team up to engage in legal battle against the injured employee, making it awfully difficult for a pro se claimant to succeed.  Pro se is a legal term referring to an individual who represents him or herself without the assistance of an attorney.  If you are injured or become ill due to a workplace activity, it is imperative you obtain assistance form a proven attorney willing to fiercely advocate on your behalf for financial compensation.

Attorneys are not allowed to charge a fee at the outset of the process for legal services to be rendered for the goal of obtaining workers’ compensation benefits.  A compensation judge is necessary to award legal fees.  Such fees cannot be awarded if workers’ compensation is not provided.  This means every injured worker will need the assistance of an experienced workers’ compensation attorney in his her or quest to obtain workers’ compensation benefits.  If the claim results in payment or another form of compensation, the attorney will be able to charge a fee.

Schibell Law, LLC has years of experience taking on all different types of workers’ compensation challenges.  Whether you are injured, ill or lost a loved one due to a workplace accident, we can help.  Reach out to us at 732-774-1000 to coordinate a no-cost and completely confidential consultation.  Our talented, hardworking and experienced workers compensation team led by Richard Schibell are here to ensure the negligent individuals and businesses responsible for your pain or illness are held accountable for their wrongdoings.

Richard N. Schibell, Esq.

is the founding partner at Schibell Law LLC concentrating in all aspects of Workers’ Compensation throughout New Jersey. Mr. Richard N Schibell graduated from Boston College with a Bachelor of Arts, concentrating in both Philosophy and History. He went on to receive his Juris Doctorate degree from Seton Hall University School of Law.

Following his graduation from law school, Mr. Schibell served as a Judicial Law Clerk to the Honorable Richard W. English, J.S.C., in the Civil Division of the Monmouth County Superior Court.