Workers’ Compensation FAQs
Workers’ compensation claims lead to many questions. Here’s a selection of some of the most frequently asked questions our attorneys at Jacobs, Schwalbe & Petruzzelli, P.C. receive.
If these answers lead you to have additional questions or if you need more information, feel free to call us for a no-cost consultation. To speak with an attorney, call our Cherry Hill office at 856-528-7991.
Frequently Asked Questions And Answers
Q: Who will pay my medical bills?
A: All authorized medical and prescription bills are the responsibility of your employer’s insurance carrier. However, you must go only to the doctor authorized by your employer’s insurance carrier. If you go to any other physician you will be responsible for the unauthorized bills. Additionally, please understand that workers’ compensation insurance is responsible only for treatment that helps to cure or improve your condition.
Workers’ compensation will not be made to pay for medical treatment that only makes you feel better temporarily. When the doctor determines that your treatment has gotten you as well as you are going to be, the medical treatment and any temporary disability benefit payments being made to you may stop. If you feel that the authorized doctor who is chosen by the insurance company of your employer is not providing proper treatment for you, we can discuss with you getting a second opinion or filing a motion with the court. Please mail copies of any medical bills that you receive, which pertain to your workers’ compensation claim to our office.
Q: What amounts of money will I collect while I am temporarily totally disabled?
A: You will receive 70% of your pay up to a maximum amount, which varies each year and is set by the New Jersey Department of Labor and Workforce Development. The carrier will calculate your average salary over the 26 weeks prior to your injury, including overtime, if you do not have a set weekly salary.
Q: How long will my temporary total disability benefit payments continue?
A: You will receive temporary total disability benefit payments if the authorized treating physician feels you remain temporarily totally disabled, or as long as you are treating and have a light duty restriction that your employer is not able to accommodate. Once the doctor determines that you can return to some gainful employment or you have reached your maximum amount of recovery your temporary total disability benefits will be stopped. You should call us if you believe that you cannot return to work even though the authorized doctor says that you can. Your temporary total disability can last up to 400 weeks, after which your permanent disability will be determined.
Q: When will my claim petitions be filed?
A: All petitions must be filed within two years of the date of the accident or two years from the last payment of any temporary disability, permanent disability, or date of last authorized medical treatment by the insurance company. You also should keep in mind that a work related injury must be reported to your employer within 90 days of your injury.
In an occupational disease case, you have two years from the date the injured party knew or should have known that there was a relationship between your illness and your work exposure to file a claim. The office will file the petitions immediately if there is a potential problem with the statute of limitations.
In many cases, we will not file the claim petitions until your benefits are discontinued. It is your responsibility to advise us of any change in your status. Please notify our office immediately if your disability benefits are discontinued, if you are released to return to work or if your medical treatment is terminated. If your spouse dies from a work-related injury or occupational exposure, a dependent must file a within two years from the date of death.
Q: When will my case be listed in court?
A: Normally we receive notification from the Workers’ Compensation Division that your case is listed for a pretrial hearing between six to nine months from the date the claim is filed. This does not mean that your case will be resolved the first time it is listed. In fact, most cases are listed several times before a claim can be resolved, and after you have been examined by our doctor and the insurance company’s doctor to determine their opinion on how the injury affects your working ability or daily living.
Q: How will I know when to be in court?
A: You will be notified by mail on those occasions when your appearance may be required or we may need to contact you from court. Each day a judge is assigned a list of cases that may total 70 or more.
Obviously, before we get to court we do not know whether or not your case will be reached. However, we must be able to reach you at least by telephone to discuss the case if needed and call you to court if your appearance is required.
If you are notified by mail to be “in court” you should be at the address indicated at the time indicated in the notice. You must notify us in writing of any move, change of address or change in your telephone number. If you fail to advise us of where you can be reached, your case can be dismissed and you may lose your benefits.
Q: Are there other public benefits that I can collect?
A: If you are not receiving workers’ compensation benefits, you may be eligible for private or New Jersey State Temporary Disability Benefits. However, please be aware that this money may have to be reimbursed out of your workers’ compensation amount or paid by the employer’s insurance company. You may apply for this benefit through the New Jersey Department of Labor and Workforce Development Disability Insurance Service. It is important to discuss this with one of our attorneys as soon as possible as there is a time limit to file this claim.
If your disability lasts or is expected to last 12 months, you may also be eligible for Social Security disability. Apply for this benefit through your local Social Security office. Please advise our office when you file your Social Security disability claim. We may be able to help you with this claim.
There is some interaction between your workers’ compensation and Social Security Disability so please advise us if you apply. Please review with us any Social Security Disability decision favorable or unfavorable so that we may determine how it affects your workers’ compensation claim and whether or not a Social Security disability appeal is appropriate.
Please ask our receptionist for a Social Security information sheet. Please be advised that our office will be glad to consult with you at no charge and possibly handle your Social Security Disability claim.
Q: What attorney’s fee will I be charged?
A: An attorney’s fee is a fee for services rendered by the law firm. This fee is payable only if benefits are awarded to you. This fee is subject to a 20% maximum. Under our workers’ compensation law, the judge presiding over a workers’ compensation claim determines the amount of the fee.
Usually, the judge orders that the fee be paid partially by you and mostly by the insurance company. In some cases, however, the judge orders that the fee is paid entirely out of your award if the claim was denied or the settlement is resolved with a payment to you and a dismissal of your claim.
Q: Are there any other costs that I will need to pay?
A: Yes. You are eventually responsible for all costs of your claim at the time your case is settled. In most cases, our doctors fee will be split between the insurance company and your benefits that you receive from the award we obtain for you. These costs only involve one or two medical evaluations to determine permanent disability after all treatment has resolved.
Their cost is for their medical evaluation, their review of your medical records, and for their report to the law firm of your permanent disability. These fees are paid at the end of your case as approved by the Workers’ Compensation Judge.
Q: May I go to any doctor for a permanent disability evaluation?
A: In order to obtain the best amount of benefits for you, you must be evaluated by a doctor who is familiar with workers’ compensation matters. Not every doctor is familiar with the workers’ compensation law and the percentages of disability used in workers’ compensation court.
For this reason, you must attend the evaluations requested by our firm and by the insurance company. You will receive written instructions concerning the medical examinations that are set for you.
You must attend the evaluations as scheduled or there will be a missed examination charge for which you will be responsible for at the end of your case. Additionally, missed exams will mean that your case is subject to dismissal upon motion by the insurance carrier.
Q: Will I have to have a full trial of my case?
A: Most workers’ compensation claims do not require a full trial. Most can be settled with the judge considering your testimony and the various evaluation reports. If an offer of settlement is made it will be discussed with you so that you can decide whether to accept it.
If your workers’ compensation claim cannot be settled and must be tried fully you will be asked to come into our office to discuss the trial with the attorney. At that time, the problems in your case will be outlined and your testimony will be prepared.
At that time also, you will receive a full description of the costs that you may anticipate in a workers’ compensation trial. As with medical evaluations, trial costs must be approved by the workers’ compensation judge.
Q: Will my case be settled without court?
A: No. All workers’ compensation matters must come before a Judge of compensation for the final disposition and you will be notified when your appearance is required in court. Many cases are now resolved by affidavit and without your need to come to court. This is especially true while the courts are not allowing clients or attorneys to appear due to COVID 19.
Q: How much will I receive after the judge decides my case?
A: At your hearing, all temporary total disability benefits which are due to you will be awarded and you will also receive an award for any permanent disability you have as a result of the accident. To receive an award of permanent partial disability does not mean you cannot return to work.
The insurance company must pay the award for benefits within 60 days from the settlement of your case. Many insurance companies pay before the 60 day period. If they fail to pay within the 60 day period, we will file a motion with the court for payment. Usually it takes six to eight weeks after an award is entered for the checks to be received. However, you must understand that your disability must be severe enough to prevail. If we can prove that your injury affects your working ability or normal life pursuits you can usually prevail.
Q: How do I get information on my case?
A: The firm permits the secretaries and paralegals that work in our workers’ compensation unit to discuss compensation cases by phone if they recognize the client. These individuals are not lawyers, however, and cannot give legal advice. They can assist you, however, regarding doctor’s appointments and scheduled court hearings. When you call our office, please inform us of any changes in your work status or medical condition. Please be sure to leave a current telephone number and address.
If you desire to speak with an attorney regarding your workers’ compensation case, appointments (either in office of by telephone) can be made. Our attorneys are in court almost every day. Generally, only afternoon appointments can be set up. It is very difficult to answer all the telephone calls that come into our office, and it is for this reason that we ask that you help us in responding to your needs.
Please call when you find it necessary to call, and leave a detailed message indicating exactly what information you wish to obtain. This will allow our attorneys to get the information to you as soon as possible either from court or through one of our staff members. We can make telephone appointments with you at a time convenient for you and our attorneys.
Q: How long will it take for my case to be completed?
A: Usually, it is six months to one year after the last authorized treatment is given for your injuries. However, in many complicated cases with complex legal issues, it is sometimes much longer. Many of our clients are unable to work for a year or more due to the seriousness of their injury or illness.
Q: What if I hurt myself again before my compensation claim is resolved or before my right to re-open my workers’ compensation claim expires?
A: If you are involved in any new accident you must contact us immediately so that we can protect your rights and advise you of any impact on your workers’ compensation claim. Our office also handles slip-and-fall cases and motor vehicle accident cases, but we refer you back to the attorney who referred you to us if that is how you were told about us.
Q: Can I re-open my workers’ compensation claim once it is settled?
A: In many cases, you have a right to re-open your workers’ compensation claim. Under some settlements, you do not get this right. However, in most cases, you will have the right to re-open your claim for two years from the last benefit paid.
If you wish to re-open your claim, please make an in-office appointment to meet with our attorneys to discuss the matter fully within two years from the date you were last in court or two years from the date on the last check you received. At that time, your potential rights and benefits can be explained to you. Please do not wait until the last month prior to the expiration of the two year period. Call us as soon as you think your condition has worsened, and if you need to see a doctor for your work-related injury that already went to court. Let our attorneys tell you whether the two year period has expired. Sometimes you may have over two years to re-open your case.
Q: Which attorney in the law office will be handling my case?
A: As you know, we have seven attorneys who practice workers’ compensation. Our attorneys cover at least six workers’ compensation courts in addition to the other areas of our practice. So that no client’s case is delayed due to our personal schedules, all our attorneys work together on our files. The attorney primarily responsible for your case will be determined by the location of the workers’ compensation court to which your case is assigned and the day on which it is listed.
More Questions? We Can Help
We can represent you for all your dealings with the Division of Workers’ Compensation. We provide legal guidance to clients throughout New Jersey, call our Cherry Hill office at 856-528-7991. You can also email us to make an appointment with a lawyer.