An attorney had a question regarding a Workers' Compensation Claim. Our Managing Partner answered the question and a Workers' Compensation judge in Mt. Holly praised his answer. Please see below, hopefully this will help other people as well.
Question: I had a potential client see me concerning a workers compensation claim. The first accident occurred about a year go to her back. She reported the accident right away and received temporary disability and medical treatment. Unfortunately, at some point, she decided to go to her own doctor and get treatment for that first accident. About 6 months later she hurt her knee while working. She never noticed her employer and never received compensation. Instead, she filed for disability and received treatment by her own doctors. She essentially received a knee replacement. She is a nurse's aide and would routinely have to lift patients, etc.
My question is, is it advisable to file a claim and treat it as occupational? Or treat as two separate accidents? She says that one of the treating doctors said that her knee injury may be related to the back injury she had. Not sure how, right now, but perhaps it can be causally related.
Answer: She had 90 days to report her injury to her Employer for the knee case.
It looks like the claim would be barred if the Insurance company uses this defense. She filed for State Disability for her knee. If you look at her application I would wager she said it was NOT work related.
I would also assume that she did not tell the doctors who treated her knee that she injured it at work.
You can file an occupational claim within 2 years from the date she knew or should have known of the relationship between her work activities and her knee problems.
You have the first injury that you can file for her within 2 years of the accident or 2 years from the date of last authorized treatment or receipt of WC benefits. The fact that she went to her own doctors does not affect her 1st claim. It only effects a possible lien by her health insurance carrier to be reimbursed for payments they made in a workers' compensation case.