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  • NJ Work Comp Laws New Jersey

    I had a small work comp claim in Florida many years ago & received mileage for all of my injury related driving needs. Does NJ offer the same? I asked my attorney but got no reply. I'm having problems with this attorney, he's far from attentive. I hired him with hopes that he would protect me as much as possible & make sure that I get the best care possible in a very timely manner. In the meantime it's been 7 months and 11 doctors later that the work comp ins. company has sent me to including a hand specialist for 2 months. Not good considering I have 3 severely herniated discs in my lower back. My attorney has done nothing to speed up the process or fight them on sending me to so many doctors & the lack of treatment. Because of compensating so heavily I now also have a torn ACL that has to be dealt with. I have lost my job & all of my benefits because the work comp doctors have dragged this out so long, my allowed FMLA time has been exhausted. Should I seek another attorney? Can the work comp ins. company be held responsible for neglegence of dragging this out and not giving me proper timely treatment? Can they be sued after the claim is finished? There were periods where I've gone 4-6 weeks with no treatment at all ! This is a very stressful & depressing process that has taken a heavy toll in every single aspect of my life. Any and all information would be greatly appreciated.
    Scott

  • #2
    No you can't sue the WC insurer. If they aren't covering something they should be covering, then you need to file issues and get it resolved by the state DWC.

    I will say that WC is not the fastest process in the world. It also often takes time to get appointments with specialists. That said, if you are unhappy with the service you are getting from your attorney, you need to find another one or at least dismiss the one you have.
    I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

    Comment


    • #3
      Attorney & Mileage

      Being very inexperienced in law, how can I truly tell if my attorney is doing his best for me & to protect me? I'm sure it wouldn't be easy to find a new attorney to take over a 7 month old case.

      In New Jersey am I eligible to receive medical mileage reimbursement? I've searched the NJ State website & internet search engines but can't find any info on the subject for NJ.

      Comment


      • #4
        How do you know if any professional you hire is doing the best job they can for you? How do you know that your tax advisor is preparing your taxes correctly? You don't. But you can ask around and get referrals and you can gauge based on how they treat you. If your attorney isn't getting back to you in a timely manner when you contact him, and is dismissive when you ask questions, that isn't a good sign.

        My source says NJ does not mandate mileage be paid but I'd contact the carrier and ask.
        I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

        Comment


        • #5
          NJ Work Comp

          Originally posted by ElleMD View Post
          How do you know if any professional you hire is doing the best job they can for you? How do you know that your tax advisor is preparing your taxes correctly? You don't. But you can ask around and get referrals and you can gauge based on how they treat you. If your attorney isn't getting back to you in a timely manner when you contact him, and is dismissive when you ask questions, that isn't a good sign.

          My source says NJ does not mandate mileage be paid but I'd contact the carrier and ask.
          Hi, this case is still ongoing. I've FINALLY gotten the back surgery I needed in June. I'm set to be released this week even though I'm still in pain and have limited mobility. The Dr says there's nothing more he can do. I had a prior knee surgery in 2001 that has given me no problems at all since it was done, not one visit to any knee doctor since I was released from P/T in 2001. About 6 months after the back injury my knee started to hurt and swell real bad. It's gotten considerably worse with pain, swelling, clicking and buckling. The people from P/T and even the work comp Dr believe it's from work comp dragging this out so long and my knee having to take all the compensating from my back and limping from the pain and numbness going down my leg into my foot. No one will state this on the record though. My attorney says unless I get (and pay for out of pocket) the $2200 IME we can't fight it with work comp for them to cover it. Is this true? Is there ANYTHING I can do? They expect me to go back to work next week (a new job because I was fired while on work comp for taking too much time for work comp) How can I start a new job if I can barely walk with a blown ACL? I need help desperately here and have no where to turn. This is my 2nd attorney and I have no money because work comp is playing games with money and I'm living on 70% pay (when I get it!) PLEASE HELP !

          Comment


          • #6
            Yes you would have to pay for the IME just as the carrier would need to pay for any IME they request. Typically this is not an out of pocket cost and is paid out of your award. $2200 for an ortho IME is very high. I'd be talking to my lawyer about either finding another doctor or negotiating the fee down.

            It is questionable whether there would be enough of a link between the back injury and the knee hurting six months later. If the knee wasn't injured as part of the first claim, getting it added after surgery is going to be tough. You *may* qualify for care for the knee under worsening of condition if this one was also WC and you did not settle out the knee claim.

            Do you have a job to go back to? Will it accommodate your restrictions? I'd start talking to the lawyer about voc rehab if you are no longer able to perform the same kind of work because of the back injury. I know how I'd run the claim, which is to set up an FCE, then enter you in voc but your lawyer is in a better position to advise you based on the particulars of your claim.
            I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

            Comment


            • #7
              Originally posted by ElleMD View Post
              Yes you would have to pay for the IME just as the carrier would need to pay for any IME they request. Typically this is not an out of pocket cost and is paid out of your award. $2200 for an ortho IME is very high. I'd be talking to my lawyer about either finding another doctor or negotiating the fee down.

              It is questionable whether there would be enough of a link between the back injury and the knee hurting six months later. If the knee wasn't injured as part of the first claim, getting it added after surgery is going to be tough. You *may* qualify for care for the knee under worsening of condition if this one was also WC and you did not settle out the knee claim.

              Do you have a job to go back to? Will it accommodate your restrictions? I'd start talking to the lawyer about voc rehab if you are no longer able to perform the same kind of work because of the back injury. I know how I'd run the claim, which is to set up an FCE, then enter you in voc but your lawyer is in a better position to advise you based on the particulars of your claim.
              To be honest, it seems because my attorney is not receiving 30% of my claim and just a flat fee determined by the court, he seems very unwilling to help me or put any time or work into my case. It's very frustrating, I'm already dealing with pain, getting laid off, losing all my benefits and battling not sinking into depression over the past 14 months. Now I have this attorney who tells me to call or email if I have questions or concerns and he almost never replies or calls back. He said as long as I'm getting paid and getting treatment for my back I shouldn't complain.

              The knee problem started about 5-6 months after the start of the back claim and about 4 months prior to back surgery. I asked the attorney to contact my physical therapist and see if she'd be willing to write a letter but he won't. He told me if I could get someone to just say "It IS possible that the knee was caused due to the back injury" he'd fight it but it could take two years and he won't do anything without an IME to help me. He also stated it would HAVE TO be out of pocket. There's no way I can afford that, maybe a $300 office visit but not $2200.

              No, I have no job to go back to. My physical therapist says there's no way I can do all that sitting, lifting and twisting anymore. No one said anything about an FCE or voc rehab. I had no choice but to take the matter into my own hands and I signed up for real estate school which I start Oct 15th. It gives me a lot of freedom, I only need to be in the office twice a week for 4 hours each and the rest of the work is from home, driving and showing homes. I've been in retail for 25 years so I'm hoping this is a good career move at 41 years old.

              It's scary. I lost my job, all health, dental and eye insurance, all my retirement and 401K packages also. I was told if I need, I can collect unemployment. No one seems to care on my side or theirs and there are no laws that protect me from my employer or the work comp ins. carrier. All laws seem to be geared towards protecting the employer and not the employee. I've gone many times 4-6 weeks with no pay from the ins. carrier and sent to numerous (9-11) docotrs including a hand specialist for my back injury.

              Comment


              • #8
                Frankly without a statement from the therapist or doctor relating the knee to the back claim you really have no option. There just isn't anything to pursue. "Well it might be related" or "It only started hurting after the back injury" isn't going to cut it. You hold the burden of proof. An IME is a waste of money without some sort of statement from a treating physician on causality.

                Was the knee claim also WC? Did you ever settle that claim? How long has it been since you received any money or treatment on the knee?

                If you already took the initiative to go back to school to sell real estate then you aren't a candidate for voc and an FCE is of limited use. You are far better off having done this on your own though. It sounds like you made a good choice for yourself.
                I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

                Comment


                • #9
                  Originally posted by ElleMD View Post
                  Frankly without a statement from the therapist or doctor relating the knee to the back claim you really have no option. There just isn't anything to pursue. "Well it might be related" or "It only started hurting after the back injury" isn't going to cut it. You hold the burden of proof. An IME is a waste of money without some sort of statement from a treating physician on causality.

                  Was the knee claim also WC? Did you ever settle that claim? How long has it been since you received any money or treatment on the knee?

                  If you already took the initiative to go back to school to sell real estate then you aren't a candidate for voc and an FCE is of limited use. You are far better off having done this on your own though. It sounds like you made a good choice for yourself.
                  My physical therapist and my back doctor will not go on the record stating their opinions about my knee because ESIS, (work comp) hired them.. I asked my attorney to write them letters asking them to write up something very simple stating "It could be related" which he said is enough to go to court with, but he hasn't and obviously isn't go to take the initiative to do that and I cannot afford an IME.. My previous attorney had his own orthopedic doctor which I didn't have to pay for, this attorney says he doesn't have one..

                  Is it true I can collect unemployment?
                  Do I need to claim work comp pay on my taxes?

                  The knee was not a work comp. incident. I haven't had any need for treatment for the knee since 2001 when I had the surgery.

                  Thank you for the last comment in your post. It helps to hear someone say I made a good choice in something regarding this whole matter. I feel confidant that this is a good career choice for my future as well as financially.. No one was helping so I had to take the bull by the horns.. I swear if I wasn't so old and broke I'd go to law school and become an attorney to help people like me go after the big corporate firms that screw us.. I REALLY appreciate all your help.

                  Comment


                  • #10
                    The treating doctor and therapist do not work for the carrier. The carrier pays the bills but they can not prevent a doctor from making a medically related statement. My suspicion is that there isn't enough medical evidence to support a link between the back and knee. Truthfully, it would be rather extreme circumstances that would lead the knee to be covered by WC when it was a back injury. Wear and tear on a preexisting problem is an uphill battle at best. Even if your doctor and the IME were to state the knee problems were related, I'd put your chances at about 50-50 that it would be covered. Attornies do not have doctors on payroll either but many do have relationships with certain physicians who will permit them to delay payment until the claim has been resolved. No doctor works for free.

                    You can always file for UC. It never hurts to apply. If you are still receiving money from WC, no you are not eligible but once released, you very well may be. The money you receive from WC is tax exempt.
                    I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

                    Comment


                    • #11
                      Originally posted by ElleMD View Post
                      The treating doctor and therapist do not work for the carrier. The carrier pays the bills but they can not prevent a doctor from making a medically related statement. My suspicion is that there isn't enough medical evidence to support a link between the back and knee. Truthfully, it would be rather extreme circumstances that would lead the knee to be covered by WC when it was a back injury. Wear and tear on a preexisting problem is an uphill battle at best. Even if your doctor and the IME were to state the knee problems were related, I'd put your chances at about 50-50 that it would be covered. Attornies do not have doctors on payroll either but many do have relationships with certain physicians who will permit them to delay payment until the claim has been resolved. No doctor works for free.

                      You can always file for UC. It never hurts to apply. If you are still receiving money from WC, no you are not eligible but once released, you very well may be. The money you receive from WC is tax exempt.
                      So basically what you're saying is I should stop about the knee and move forward to end this case without it correct? I agree if that's what you're saying, to be 100% honest, I'm so tired of it dragging me and my life down, I just want it over with already. I did ask my attorney to try to get the carrier to pay my attorney's fees which I heard is very possible. I already attended an appointment with the carriers doctor for an IME and go back to the surgeon for my final visit on Thursday.. My attorney hasn't set up an IME of his own but he should correct? The only thing I'm concerned about is I still have a good amount of pain and my mobility is limited.. My P/T person told me it's doubtful I'll be able to do the hobbies I've done since I was a child like hiking/rock climbing, surfing & offshore fishing.. I hope the pain and imobility doesn't persist or even get worse, that's my biggest fear.. I gather the IME's are to determine the percentage of disability for the courts to decide on my final payment.. So sad that the payment isn't even enough to cover the 30% I lost in pay alone this past year.. At least that's what the attorney told me.. If I'm lucky $30K...

                      Comment


                      • #12
                        I'm not telling you what you should do with your claim as that is your lawyer's job. I'm just trying to explain how it works in general. Listen to your lawyer.

                        The carrier is not going to pay your legal fees. They will come out of your award.

                        An IME can be for many things but yes, among those reasons is to determine that you are as good as you are going to get and assign a "rating" which is the % of disability. Yes, your attorney will probably send you for one as well. He is probably waiting to see the results of the carrier's IME first but you'll have to ask him what his plans for you are.

                        No one gets rich off a WC claim. The system wasn't designed for that.
                        I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

                        Comment


                        • #13
                          Huh?????

                          SMILLER,

                          You are most likely suffering from a "compensable consequence" of your initial industrial injury. It is a WELL ESTABLISHED Principle of W.C. law that one injury can in fact be the LEGAL AND MEDICAL causal NEXUS for the subsequent injuries which flow from them.

                          You need to ask the Doc if there is a REASONABLE MEDICAL PROBABILITY that the symptoms in your leg are because of your back injury. Medically, it can also be referred to as Overcompensation.

                          I am not familiar with NJ laws, as I represent IW's in CA. However, I CANNOT believe that a well founded medical and legal principle would be that freaking different in another state.

                          Hope this has shed some light on your problem.

                          LL

                          Comment


                          • #14
                            Originally posted by ElleMD View Post
                            I'm not telling you what you should do with your claim as that is your lawyer's job. I'm just trying to explain how it works in general. Listen to your lawyer.

                            The carrier is not going to pay your legal fees. They will come out of your award.

                            An IME can be for many things but yes, among those reasons is to determine that you are as good as you are going to get and assign a "rating" which is the % of disability. Yes, your attorney will probably send you for one as well. He is probably waiting to see the results of the carrier's IME first but you'll have to ask him what his plans for you are.

                            No one gets rich off a WC claim. The system wasn't designed for that.
                            Believe me I am NOT looking to or expect to get rich off of this claim. But there is something seriously wrong with the system if at the end of the hearing I walk away with not even enough money to cover pay lost during this period. That means I will not be reimbursed for a ton of mileage and gas on a leased vehicle, severe pain, the destruction of my credit, the loss of all of my commissions over 14 months, the cost of school for a new job because they dragged the case out and compensation for losing my job, health benefits and retirement packages. That hardly seems fair due to an injury doing my job.

                            It makes me sick to watch the news and see a woman that worked for MSG (the same owner as my employer - Cablevision) receives over 11 MILLION dollars for being called a "*****" (excuse the language) and losing her job.. I think that I suffered WAY MORE than her.. This woman has a new job right away and lost NOTHING in the process from the SAME man. James Dolan. This to me is sickening.

                            Comment


                            • #15
                              Originally posted by LoisLane View Post
                              SMILLER,

                              You are most likely suffering from a "compensable consequence" of your initial industrial injury. It is a WELL ESTABLISHED Principle of W.C. law that one injury can in fact be the LEGAL AND MEDICAL causal NEXUS for the subsequent injuries which flow from them.

                              You need to ask the Doc if there is a REASONABLE MEDICAL PROBABILITY that the symptoms in your leg are because of your back injury. Medically, it can also be referred to as Overcompensation.

                              I am not familiar with NJ laws, as I represent IW's in CA. However, I CANNOT believe that a well founded medical and legal principle would be that freaking different in another state.

                              Hope this has shed some light on your problem.

                              LL
                              Overcompensation is what my doctor and physical therapist caused the issue with my knee. The problem is that neither want to get involved with the issue for whatever reason. As I've stated, since my last knee surgery I have had NO PROBLEMS in any way shape or form or been to see a doctor for this knee since being released from P/T. The problems didn't start until AFTER being forced to compensate for the back and leg pain due to the nerves being crushed. The back doctor told me that normal herniated discs show faint white when they see them during operations, mine were bright white which is caused by having pressure on them for long periods of time. If the carrier wasn't so busy sending me to numerous second opinions for their own doctors and to hand specialists, all this and my knee and job situation would have been avoided.

                              Getting the doctor to say there is "reasonable medical probability" is possible but he won't put it on the record or in my report or his notes for the carrier.

                              I don't understand what you wrote in the first paragraph. Can you explain more in depth please?

                              Comment

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