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Workers’ compensation refers to the practice of compensating employees who have been injured while on the job. It stems from the logic that if someone is injured while on the clock, their employer should be culpable. This compensation can be medical and/or financial in nature.
Workers’ compensation is not only mandatory Cherry Hill but the State of New Jersey, as well. The injury has to have occurred in the course and scope of employment and once that is established, then benefits are provided. If you need help pursuing Cherry Hill workers’ compensation benefits, consult an experienced legal advocate that can help you.
Necessity of Providing Benefits
Every employer in the State of New Jersey is required by law to provide or to carry workers’ compensation insurance coverage for their employees. Typically, what they do is they go out and buy an insurance policy just like we all go out and buy a car insurance policy or a homeowner’s policy to ensure our home. The employer purchases a policy of insurance through an insurance company.
What Benefits Can a Person Access?
Some employers are self-insured where they provide the benefits directly at their own cost and they might hire an insurance company to act as a third-party administrator where they are not actually paying premiums but they are just paying the company to deal with their workers’ compensation claims. The Cherry Hill workers’ compensation benefits a person can expect to recover are financial and medical benefits.
One of the most important benefits a person can claim are medical benefits. The insurance carrier has to provide medical benefits for treatment of whatever was injured in the workers’ compensation or the work-related accident.
If the injured worker is out of work as a result of the injury, then they must provide a weekly check which is supposed to be 70% of the worker’s average weekly wage. What happens there is the carrier will calculate an average weekly wage based on six months prior to the injury. Those are referred to temporary benefits. Number three, they have to provide permanency benefits if the injury results in a permanent injury.
When calculating the amount of Cherry Hill workers’ compensation benefits a person can access, the insurance company will look back and calculate how much money the worker earned in that six-month period. They do a calculation to come up with an average, and the temporary payment is 70% of that average weekly number and that money is not taxable.
The third benefit is permanency which is based upon a schedule of disability. What happens there is when all the treatment is completed and the doctors have told the worker that there is no more treatment they can provide, they have done everything they can do and they have reached what is called maximum medical improvement, then at that point, the patient or the injured worker may not be fully recovered.
What are Re-Opener’s Rights?
In most cases, when a settlement is reached, if there is an agreement made and that settlement is approved by a judge, the injured worker has rights into the future. If the injured party can show that their disability has gotten significantly worse, then they can ask for more money, more benefits. This is called re-opener rights. They have the right to re-open the claim.
Re-opener rights for Cherry Hill workers compensation benefits last for two years from the date of the last check that the injured worker receives. Therefore, if they reach a settlement and an insurance company sends them a check which they are obligated to do no later than 60 days after the settlement is approved, then the date on that check starts the two-year re-opener period. It is important to know that that future right is only the right to ask for more treatment and to ask for more money. It is not automatic acceptance for more treatment or money.
Pursuing Benefits for a Permanent Injury
The injured person may have some permanent residuals, like having aches and pains, but the doctors might tell the injured party that they have done all that they can, and cannot provide further treatment. When that happens, a person’s workers’ compensation lawyer might gather up their treatment records and send the patient for a permanency exam, and this is the one and only time when these attorneys might choose a doctor.
The attorney may pick the doctor to do that permanency exam and at or about the same time, the insurance company will do the same. They will send the patient or worker to another doctor for a permanency exam and both of those doctors will report back by issuing a report, telling us what they believe the permanent injury is, and they will speak in terms of percentages.
Deciding the Percentage of Permanency Benefits Someone Can Recover
When deciding the percentage amount that someone should recover, attorneys refer to a schedule of disability that is published as part of the Workers’ Compensation Act and each percentage translates to a certain dollar amount. For X percentage, someone gets a certain amount of money and those are their permanency benefits. That is generally what Cherry Hill workers’ compensation benefits look like.
For example, if the worker had a low back injury with a herniated disc and had surgery, then the doctor might say, there is a 70% disability for the low back injury that resulted in surgery, and they will give a diagnosis of some level and provide a percentage rating. The insurance company’s doctor will do the same and, typically, they will provide a percentage rating that is much lower, however, the truth lies somewhere in between the two numbers.
How an Attorney Can Help
A skilled workers’ compensation lawyer can be instrumental in filing a benefits claim. Not only can your legal advocate help you navigate the benefits application process, they can also advocate for you. An attorney can advocate for you by negotiating with the insurance company’s lawyer to see if they can reach an agreed-upon disability rating. A determined workers’ compensation lawyer can fight tirelessly to ensure that you recover the benefits that you deserve.