Filing a workers’ compensation claim in New Jersey can be a complex process. To secure the benefits you’re entitled to, it’s crucial to understand the steps that follow the initial filing, and to connect with our seasoned Hudson County Workers’ Compensation Lawyers.
What Happens Immediately After You File a Workers’ Compensation Claim in New Jersey?
Following a workplace injury, your employer is required to notify its insurance carrier. The insurance company will then establish a claim and begin investigating the merits of your case. It’s important to bear in mind that your initial actions can significantly impact the outcome of your case. While filing your claim formally kicks off the process, approval and benefits are not automatically recovered. The insurance company must first fully assess the unique circumstances.
The key stages of a workers’ compensation include:
- Initiating Medical Treatment: You will likely be directed to an authorized medical provider. Your employer must authorize the treatment for coverage. The treating physician will assess your injury, determine any work restrictions, and establish medical records.
- Claim Investigation: The insurance company will evaluate your claim to determine eligibility for benefits. Their primary objective is to determine if your injury is related to your job duties.
- Claim Approval or Denial: After reviewing your claim, the insurer will either accept or deny your claim. If your claim is approved, your medical care will be covered, and wage benefits may begin. If your claim is denied, you will receive a formal denial notice. The notice outlines the reasons for your claim being rejected. It should be noted that you have the right to appeal this decision.
- Temporary Disability Benefits: If your injuries prevent you from working, you may be eligible. These benefits replace a portion of your lost income. They typically begin after a specific waiting period and continue for the duration of your treatment and inability to return to work.
- Reaching Maximum Medical Improvement (MMI): This stage signifies an important transition in your workers’ compensation claim. MMI is reached when your condition stabilizes, and further treatment is not expected to result in significant improvement.
- Permanent Disability Evaluation: After reaching MMI, if you still have lasting physical impairments, you will be assessed for permanent disability. This determines your eligibility for either permanent partial disability (PPD) benefits or permanent total disability (PTD) benefits.
- Claim Resolution: The final stage is determining the severity of your injury and how it impacts your life. Workers’ compensation claims are typically concluded through a settlement agreement. Your options include a single lump sum payment or a structured agreement involving payments distributed over a set period. This agreement will formally conclude your case.
At Lerner, Piermont, Riverol & Lawlor, P.A., we are prepared to help guide you through this process and protect your rights. Connect with our firm today to schedule a consultation.
