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Are you reluctant to file a workers’ compensation claim? Here’s why you don’t really have any other choice.

• April 01, 2022

Many employees are reluctant to file a workers’ compensation claim. Some feel it would be disloyal to a good employer who has treated them well over the years. Others fear retaliation from a bad employer. Either way, an injured worker really doesn’t have any choice other than to file a workers’ compensation claim. Here’s why:

NJ Workers’ Compensation Law in a Nutshell:

When you begin your employment, you surrender your right to sue that employer for negligence. This occurs automatically, by operation of law, whether you are aware of it or not. In exchange for having that very fundamental, common law right to a jury trial taken away, you are absolutely entitled to receive a more limited set of workers compensation benefits whenever you are injured on the job. Therefore, you are not “suing your employer” when you file a workers’ compensation claim. You are merely claiming all of the benefits to which you are entitled in exchange for NOT suing your employer.

Your employer is required by law to purchase workers’ compensation insurance every year, whether you file a claim or not. Your benefits are paid by the workers’ compensation insurance company, not by your employer.

The benefits that an injured worker is entitled to receive from the employer’s workers’ compensation insurance company are limited to medical benefits; temporary disability benefits; and permanent disability benefits.

Medical Benefits:

If you require medical attention because of a work-related injury, it is your employer’s workers’ compensation insurance company that is responsible for paying your medical bills. Your health insurance and your auto insurance can and will deny the payment of medical bills that are related to a work injury. Therefore, if you choose not to pursue a workers’ compensation claim, your only other choice is to pay the bills yourself. Submitting medical bills that you know are work-related to your health or automobile insurance carrier could be construed as insurance fraud.

Temporary Disability Benefits:

Similarly, if you are temporarily disabled because of a work injury, it is the employer’s workers’ compensation insurance company that is responsible for paying you temporary disability benefits, not the State of NJ or some other private disability insurance that you may have. If there is a question as to whether or not your injury is work-related, the State of NJ will pay you benefits, but only after you file a workers’ compensation claim upon which they will then place a lien. Therefore, if you are under the care of a doctor who says that you are unable to work due to a work-related injury, you will not be able to collect temporary disability benefits for the lost time from work unless you file a workers’ compensation claim. 

Permanent Disability Benefits:

In workers’ compensation, permanent disability does not necessarily mean that you are totally disabled and now forever incapable of working anymore. After the medical treatment for your work-related injury has been concluded, you may be left with a partial, but permanent disability to that injured body part. You are entitled to be compensated for the partial, permanent loss of function caused by your work injury. For example, if after a shoulder injury, you retain 80% of the use of your shoulder, you are entitled to receive 20% disability benefits as compensation for the permanent loss of function that the doctor could not restore to your shoulder. Receiving this money does not prohibit you from continuing to work in the future, in fact, your continued employment in the workforce is actually encouraged.

Some workers’ compensation insurance companies will voluntarily pay your medical and temporary disability benefits, but not permanent disability benefits. If the insurance company does pay you some money for permanent disability, it will most likely be for an amount far less than what your injury is actually worth.

Each state in the U.S. has its own workers’ compensation laws. Here in New Jersey, we have an adversarial system. This means that if you wish to obtain all of the workers’ compensation benefits to which you are entitled, it is necessary to be represented by an attorney and file a formal claim petition with the Division of Workers’ Compensation.