The New Jersey workers’ compensation system is in place to help employees who have been injured on the job or become ill due to their work exposures obtain medical treatment and other benefits. The benefits of workers’ compensation include medical expenses, income replacement, permanent disability benefits, and death benefits for a worker’s dependents.
As an injured worker, you might be wondering: how do I maximize my workers’ comp settlement?
In order to make the most of your workers’ compensation claim, it’s important to be aware of all of the benefits at your disposal and the different ways employers, insurance companies, and adjusters may try to deny or reduce the benefits workers are entitled to following a work injury. Here are some tips on how to maximize your workers’ comp settlement.
How to Maximize Your Workers’ Comp Settlement
There are a number of things you can do to make the most of your workers’ compensation claim in New Jersey, including the following:
1. File for Benefits for Your Work Injury
2. Beware of Common Workers’ Compensation Insurance Company and Adjuster Tricks
3. Appeal Denied Workers’ Compensation Claims
4. Hire an Experienced New Jersey Workers’ Compensation Attorney
1. File for Disability Benefits for Your Work Injury
When you’re injured at work, you may be eligible for temporary disability benefits, permanent disability benefits, or both. These benefits are meant to replace a portion of your lost wages while you are unable to work and compensate you for permanent injuries. The amount of benefits you receive will depend on your income and the severity of your disability.
Temporary Disability
Temporary disability benefits are paid by the workers’ comp insurance company and are based on your average weekly wage. These benefits are paid at 70 % of your average weekly wage. You may be entitled to temporary disability benefits if a doctor confirms you are unable to work due to your workplace injury, or you are placed on work restrictions and your employer is unable to accommodate those restrictions.
Permanent Disability
Permanent disability benefits are paid by the workers’ compensation insurance company and are based on your average weekly wage and the percentage of disability for the affected body part as outlined by the disability chart for the year of your injury. You may be entitled to permanent disability benefits if it is determined your injury will affect you for the rest of your life.
Total vs. Partial Permanent Disability
There are two types of permanent disability benefits: total and partial. Total disability benefits are paid when an employee is deemed permanently and totally disabled due to a work accident, in which you are unable to obtain gainful employment due to your injuries. Partial disability benefits are paid when an employee is able to work but suffers from a permanent disability that makes it harder to do their job than prior to the work injury.
2. Beware of Common Workers’ Compensation Insurance Company and Adjuster Tricks
Workers’ compensation insurance companies are in the business of making money. As a claimant, it is important to be aware of some of the tactics that these companies may use in an effort to reduce or deny your benefits. Regardless of whether you know how to maximize your workers’ comp settlement or not, these parties can act as a real obstacle between you and your deserved benefits.
Delaying Benefits
One common trick is to delay paying benefits. The insurance company may claim that it needs more time to investigate your claim when in reality it is just trying to buy time so that you will give up and go away. You can combat this by keeping a detailed record of all conversations and correspondence with the insurance company. You should also keep any medical bills or other documentation related to your injury.
Coverage disputes
Another common trick is to argue that your injury is not covered by workers’ compensation. Your adjuster may claim that your injury did not occur at work or that it was not caused by work-related activities. This is where proper reporting and documentation of your workplace accident and injury can be critical to filing your claim.
Injury Severity Disputes
Finally, the insurance company may deny your claim based on the severity of your injury. Insurance companies hire their own doctors, who are often more likely to deny a claim than the claimant’s doctor. On top of any potential inherent bias, these companies often pressure their doctors to deny claims due to injury severity and try to prove it with the following methods:
- The insurance company insists that you are able to work other jobs.
- The insurance company insists that the injury is not serious enough to warrant benefits.
- The insurance company insists that you are fabricating or exaggerating their injury in order to receive benefits.
- The insurance company insists that your injuries are due to a pre-existing condition and not related to the work accident.
If your workers’ compensation doctor denies your claim, it is important to get a second opinion from another doctor to make sure that your claim is not denied unjustly.
3. Appeal Denied Workers’ Compensation Claims
If your New Jersey workers’ compensation claim is denied, it’s important to take action right away. With the help of a qualified workers’ compensation attorney, you have the right to appeal the decision on multiple levels:
Request a Workers’ Compensation Denied Claim Hearing
The first step in appealing a denied claim is for your attorney to file a Claim Petition with New Jersey Division of Workers’ Compensation. This will schedule your claim to be heard by a New Jersey Workers’ Compensation Judge.
At the hearing, your attorney and an attorney for your employer/insurance company will have the opportunity to present evidence and argue your respective positions. After the hearing, the Judge will make recommendations and if a trial is necessary will provide a written decision as to their findings.
Appeal to the New Jersey Superior Court, Appellate Division
If you are still not satisfied with the Judge’s decision, you can appeal to the New Jersey Superior Court, Appellate Division. You must file your Notice of Appeal within 45 days of the date of the Judge’s decision.
Filing for workers’ compensation benefits can be a complicated process, but it is important to make sure that you are getting the full benefits you are entitled to and to know how to maximize your workers’ comp settlement. If your claim is denied, don’t give up – appeal the decision and keep fighting for what you deserve.
4. Hire an Experienced New Jersey Workers’ Compensation Attorney
As you can see, the New Jersey workers’ compensation system can be complicated, and there are many obstacles along the way between you and your compensation. Hiring a workers’ compensation lawyer is not required, but it will give you the best chance of making sure you receive the benefits that you are entitled pursuant to New Jersey Workers’ Compensation Laws and Court Decisions.
A workers’ compensation lawyer can help you in a number of ways, including:
- Educating you on how to maximize your workers’ comp settlement
- Filing and appealing your workers’ compensation claim
- Filing and appealing your disability claim
- Gathering evidence to support your claims
- Questioning witnesses and expert witnesses
- Cross-examining insurance company doctors and other expert witnesses
- Negotiating with the insurance company on your behalf
- Representing you at hearings and appeals
- Advising you for your best interests
If you have been injured at work in the state of New Jersey, it is important to know how to maximize your workers’ comp settlement. An experienced workers’ comp attorney can help you get the benefits you deserve. He or she will be able to guide you through the process and help you negotiate a fair settlement.
By following these four tips, you can improve your chances of getting a fair and timely settlement from your workers’ comp claim.
How to Maximize Your Workers’ Comp Settlement: Kotlar, Hernandez & Cohen – New Jersey Workers’ Compensation Lawyers
Kotlar, Hernandez & Cohen – The People First Lawyers have been helping injured workers with their New Jersey workers’ comp claims since 1995. We work tirelessly for our clients to ensure you receive medical care, financial compensation, and justice, regardless of an adjuster or insurance carrier’s claim denials. With four Board Certified Workers’ Compensation Law attorneys on our team, we are well-equipped to handle your work injury or illness claim.
If you’ve been the victim of a work-related injury or occupational disease, if your job has caused you ongoing physical pain in any way, or if you’re looking for help with how to maximize your workers’ comp settlement, contact our law firm to schedule a free consultation or call us 24/7 at (856) 751-7676.
Adam Kotlar, Esq.
Adam Kotlar is an aggressive and diligent trial attorney and the founder of Kotlar, Hernandez & Cohen. He is one of only four attorneys in the state of New Jersey to be Certified by the Supreme Court of New Jersey as both a Civil Trial and a Workers’ Compensation Law Attorney among other accolades.
