What is Workers’ Compensation and How Does it Help Your Claim


What is Workers’ Compensation?

You might have heard about several incidents about employees getting injured at work. Work-related injuries are inescapable despite several precautionary measures adopted by the employer. Ryan, an employee at a private manufacturing unit, injured himself while trying to operate an ‘out of order’ machine. He was not aware that the machine was not to be touched as the machine wasn’t labeled ‘out of order.’

Ryan, in this case, is eligible to receive workers’ compensation because the incident occurred due to employer’s negligence. Under workers’ compensation laws, an employee who gets injured during work is entitled to insurance coverage including cash benefits or medical care provided by the employer.

Workers’ compensation requires the employer to pay the medical expenses and lost wages of the injured employee. And no employee is asked to contribute to such compensation as instructed by the Workers’ Compensation Board, which is a state agency. The Board processes the claims and determines the settlement amount. It also decides whether the injured employee should get medical care, cash benefit or both if a dispute arises.

Though the workers’ compensation policy may vary from state to state; the New Jersey State Department of Law and Public Safety, provides legal advice and litigation support in such cases. The workers’ compensation cases are primarily handled by the DRM (Division of Risk Management). They are responsible for deciding the budget, approving and processing the claims including cash benefits, expenses for medical treatment, permanent or temporary disability and any other related claim.

Workers’ compensation facts are treated as ‘no-fault’ cases, and thus, the amount that the claimant receives doesn’t decrease due to his/her negligence nor does it increase due to the employer’s fault. But if you are an employee and addicted to drugs or alcohol; you would certainly lose your right to workers’ compensation. You might also lose your claim if you are injured or if you had the intent to injure someone else while you were under the influence of alcohol or drugs.

When the insurance carrier and/or employer believe that the injury is work-related, the claim is paid off. If the employer refuses the claim, the worker may contact workers’ compensation attorney, and the judge has to intervene and award the final decision. The claimant is entitled to disability benefits until the final decision comes.

A workers’ compensation attorney may also be contacted if the worker is dissatisfied with the settlement amount. Hearings related to workers’ compensation are administrative proceedings which take place in a separate court.

Since every state may have its own workers’ compensation policy, some states allow employees to sue the third party if the injury occurred due to defective machinery or materials provided by the third party vendor.

Workers’ compensation coverage is made mandatory for every employee by the state. However, the state law allows certain exemptions for small companies with five or lesser employees, independent contractors, farm hands and domestic workers.

While processing the workers’ compensation, it is important to determine whether the injury is work-related or not; any injury that occurs during the course of employment is a work-related injury. This does not imply that the worker has to be physically present at the office premises at the time of the accident. If he/she was traveling as was required by the employer, it also constitutes the work-related injury.

Most importantly, no employer shall be held liable for any compensation until the notice of work-related injury has been given to the employer. Workers’ Compensation Statute requires the employee or someone on his/her behalf to report any work-related injury to the employer within fourteen days from the time of occurrence of such incident.

If you or your loved ones have been in an accident at work, understandably you’re going through a lot. An experienced workers’ compensation attorney at Goldberg & Wolf can help you navigate through the complex process of filing a claim and make sure that you get the benefits that are rightly deserved. Contact our legal team at (856)-651-1600 regarding your case.