All You Need to Know About Compensation Claims

compensation claims

According to a 2021 report by the Bureau of Labor Statistics (BLS), there were 2.7 million non-fatal workplace illnesses and injuries reported among private sector employees in 2020.

These numbers clearly show that injuries can, and do happen regularly in many workplaces. Therefore, you should be familiar with the laws and regulations governing your state and company concerning worker place injuries.

This will help you claim worker’s compensation and other benefits should you get injured, suffer an illness from work-related incidences, or face unfair treatment.

Although your workplace may seem like a calm place to be, there are hidden dangers that can cause injuries or ailments.

Some examples are electrically-powered machines such as power saws, slippery work floors, and dangerous chemicals. Other injuries may be invisible such as depression and anxiety caused by bullying, racial or gender discrimination, and other toxic work culture.

Suffering from an injury at work or a debilitating sickness can lead to the loss of income and mental trauma. You should be compensated for these losses if your employer is responsible for your injuries. 

Whether that happens depends on how much you know about your rights in the workplace. 

What is worker’s compensation?

A worker’s compensation claim is a request forwarded to an employer by an employee who is disabled, injured, or made unwell due to work-related accidents or illness.

Worker’s compensation is used to pay for rehabilitation services, lost wages, or medical costs.

You should apply for worker’s compensation immediately after you suffer a work-related injury or ailment to increase your chances of getting it.

Employers are required by law to pay for legitimate compensation claims from their workers. 

Many employers have worker’s compensation coverage to protect themselves against liabilities arising from requests by their employees.

Don’t be afraid to ask for compensation if you suffer an injury at work.

How to apply for a compensation claim

You can apply for workers’ compensation by filling out a compensation claims form. If you are in New Jersey, these forms are usually forwarded to the Division of workers compensation for approval or denial. 

 

The board members scrutinize the claims form and look for any signs of fraud or indiscipline, such as a failure to go for rehabilitation treatment or keep doctor’s appointments.

Report a work-related injury or ailment to the human resource manager in your company within 30 days.

Any injury or illness you report must coincide with work-related duties, such as suffering an accident while delivering company goods in a faulty company vehicle.

You have a limited time to report and file a claim and if that window passes, you may lose your right to ask for compensation.

Reporting in a timely manner means that your injury or illness is still fresh, which gives company officials a chance to gather evidence concerning your claim. 

Some examples are video clips of the incident, physical evidence of injuries, and witness accounts of any occurrences concerning the injury or ailment in question. 

Keep such evidence up-to-date because it will help you to get your compensation quickly and easily.

Expect your employer to refer you to a company doctor for a medical check-up to verify the injuries you specify in the compensation claim. 

Insurance investigators may also question you about the events leading to the work-related injury or ailment.

You can also expect HR to give you some paperwork to fill, in which you should outline all the details of your injury or illness. Some of the details to include are;

  • The date and time on which the work-related injury happened.
  • The place where the work injury occurred 
  • A list of witnesses to the incident 

Employers are also expected to fill out a report of injury form, which is sent to the Division of Workers’ Compensation Board.

If your compensation claim is satisfactorily investigated and found to be accurate, you will be eligible for;

  • Payment/reimbursement of medical expenses
  • Leave time for recuperation
  • Re-training when you get back to work
  • Modified duties if you are incapacitated 
  • Temporary or permanent disability benefits

Laws affecting compensation claims in New Jersey

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According to New Jersey workers compensation laws, you are required to receive benefits such as payment for medical care when you suffer an occupational illness or a workplace injury.

Disputes surrounding compensation are usually administrative, but some laws govern them.

For example, New Jersey employees are required to file a work-related compensation notice with their employer 14 – 90 days after the injury. They are then given 2 years to file a compensation claim.

Employers are expected to forward information on compensation claims to the New Jersey Division of Workers’ Compensation board within 21 days of receiving notice of them.

You can expect your lawyer to investigate your injury claims during this period. 

Investigating and paying for legitimate compensation claims frees an employer from any possible legal action. 

However, that should not stop you from pursuing compensation from third parties who have contributed to your injuries or illnesses. For example, if a worker was negligent with a chemical, injuring you in the process.

You should know your rights concerning workers’ compensation from the day you start working in a company. This will help you avoid accidents or incidents that may lead to expensive compensation lawsuits or tedious procedures concerning an insurance claim.

What happens after you claim worker’s compensation?

Once you file a worker’s compensation claim, you will have to wait until it is approved. If all goes well, the insurance company will give your employer payment details concerning your claim.

You could get an offer to cover your medical bills or lost wages resulting from the incident.

Some insurers give you a chance to get your compensation as a lump – sum, while others pay it in installments. 

It’s also important to note that not all compensation claims are successful. 

Some reasons for a rejected worker’s compensation claim are;

  • Insufficient evidence showing the connection between an employee’s injury and their work.
  • Contradicting accounts from witnesses concerning injuries suffered at the workplace
  • Lack of cooperation from the employer and other people required to approve compensation claims

 

The first thing to do if your worker’s compensation claim is rejected is to check the reasons for the denial. That may help you create a strategy to reclaim the benefits you’ve lost.

Once you know why your compensation claim was rejected, try to fix the errors, for example, by finding more evidence.

Many workers also benefit from asking for legal advice in NJ. An experienced attorney is invaluable to the process.

You can also ask the insurer to reconsider your compensation claim after giving them any new evidence you’ve gathered. 

If your negotiations with the insurer fail, You may appeal the decision to deny you worker’s compensation at the New Jersey Division of Workers’.

Final thoughts on compensation claims

The above information about compensation claims can help you to get reimbursed for workplace injuries.

Here’s a recap of what to do when filing a compensation claim.

  1. Immediately get treatment for your work-related injury.
  2. Gather evidence concerning your work injury, such as medical records.
  3. Report details on the work-related injury to your employer, file a worker’ compensation claim, and forward the evidence in your favor.
  4. Co-operate with any investigations concerning your work injury as you await a verdict.
  5. Lodge an appeal with the insurance provider, New Jersey Division of Workers’, or the courts, if your worker’s compensation claim is rejected.
  6. Negotiate how to get reimbursed for work-related injuries if your compensation claim is accepted, for example, through installment benefits.

Author: Kelly Hanks

Published
Categorized as Insurance