Welcome to our Orthopedics Practice Workers’ Compensation Guide! This comprehensive resource has been created to provide you with a helpful overview of workers’ compensation in relation to orthopedic injuries. While we strive to offer valuable insights and guidance, it is important to note that this guide is not a substitute for professional advice.
For more detailed and specific information tailored to your unique situation, we encourage you to visit the official workers’ compensation portal. This portal serves as a reliable source for the latest regulations, forms, and additional resources, ensuring you have access to the most up-to-date and accurate information.
Your well-being is our top priority, and we hope this guide serves as a useful starting point for your understanding of workers’ compensation within the realm of orthopedic care.
New Jersey Workers compensation
Workers’ compensation functions as a “no fault” insurance program, offering various benefits to employees dealing with work-related injuries or illnesses. These benefits include:
- Medical Benefits
- Temporary Total Benefits
- Permanent Partial Benefits
- Permanent Total Benefits
Additionally, the program extends death benefits to the dependents of workers whose demise is a consequence of employment-related circumstances.
No-Fault Basis and Limitations
Regardless of fault, an injured employee is entitled to benefits. However, in exchange for these benefits, the worker forfeits the right to pursue a civil action against the employer for pain and suffering or other damages, except in cases of intentional acts.
Reporting Procedures and Medical Treatment
Prompt notification to the employer is crucial. This notice, which can be verbal, should be given to a supervisor, personnel office, or any authority figure at the workplace. If medical treatment is necessary, the employee should promptly request it from the employer. The employer or their insurance carrier has the authority to select the physician(s) for treating work-related injuries under NJ workers’ compensation law.
Claim Evaluation and Temporary Disability Benefits
Upon receiving notice of an accident, the employer’s workers’ compensation insurance carrier electronically files a First Report of Injury with the State. The carrier assesses the claim for compensability and communicates with the injured worker, employer, and medical provider. If accepted, the carrier directs the injured worker to an authorized medical provider. If the absence from work exceeds 7 days, temporary disability benefits are provided during the rehabilitation period.
Follow-Up Reporting and Dispute Resolution
Within 26 weeks of the worker’s return to work or reaching maximum medical improvement, the insurance carrier submits a Subsequent Report of Injury to the Division, with a copy sent to the worker for review.
Disputes regarding benefit entitlement may lead to the filing of a formal Claim Petition or an Application for an Informal Hearing with the Division of Workers’ Compensation. Disputed issues encompass work-relatedness, the nature and extent of medical treatment, and the payment of temporary disability benefits.
Legal Representation and Filing Procedures
In case of disputes, workers can file a claim petition with representation by an attorney or as a pro se litigant, and the case is assigned to a judge and district office based on the injured worker’s residence or the employer’s location.
