Workers’ compensation is a lifeline for anyone injured on the job. But from the moment you’re injured, you have to navigate a highly confusing and often frustrating system, all while trying to heal. If you do anything wrong, it can set your case back and impact your ability to receive compensation.
In New Jersey, you’ll be facing a maze of fast-approaching deadlines, medical rules, employer pressure, and shady insurance tactics that won’t lean in your favor.
Here’s what you need to know about protecting your rights to benefits.
Understand how New Jersey workers’ compensation works
New Jersey’s workers’ comp system is structured to provide injured parties with medical care, wage replacement, and long-term disability benefits after a job-related injury. But it’s not an easy process. Everything is tightly controlled by the workers’ comp insurance company, which means you need to follow their rules to the letter. Even when you fully qualify for benefits, you’re still subject to delays and lowball offers. That’s why many people work with an attorney early in the process.
Insurance companies have entire teams trained to scrutinize every detail of your claim. Adjusters are not on your side and will try to downplay your injury. A workers’ comp attorney will handle all communications, ensure paperwork is submitted correctly, and fight back when adjusters try to minimize your benefits.
Working with a knowledgeable attorney ensures deadlines are met and documentation is solid.
How an attorney protects your medical rights
In New Jersey, employers and insurers typically choose the doctors who treat injured employees. That’s fine for simple injuries, but for anything serious, you’ll want a specialist to treat you. Adjusters have every reason to downplay injuries. The less injured they can make you appear on paper, the less compensation they need to pay you. An attorney will notice if the insurer is limiting your treatment, delaying referrals, or sending you back to work too soon.
If your claim is unfairly denied or your employer retaliates, a workers’ comp attorney will step in and do everything possible to get you paid fairly. For example, they’ll request hearings and bring in medical experts to support your appeal, and file a lawsuit against your employer if necessary.
Know what medical treatment is covered
Since your employer or the insurer has the right to choose the doctors who treat you, the quality and speed of your treatment will vary. While the law promises “all necessary and reasonable medical treatment,” the insurance company will attempt to define “necessary” in the cheapest terms possible. You might need to push for a second opinion or have a lawyer intervene to obtain care from a specialist.
Workers’ comp must pay for all medically necessary treatment, including surgeries, physical therapy, injections, diagnostics, and medications. But insurers often try to end treatment too soon by claiming you’ve reached “maximum medical improvement” (MMI). You might need a lawyer to help you fight if this determination is made too soon.
In New Jersey, workers’ comp covers more than just medical appointments and treatment. It can also pay for devices like braces, medical supplies, and sometimes travel expenses. These smaller costs are often reimbursable, so keep all of your receipts and mileage records.
How wage replacement works in New Jersey
When you’re unable to work, temporary disability benefits can help. But New Jersey only pays 70% of your average weekly wage up to a state-mandated cap. And to get wage replacement, you need to get authorization for being out of work from the workers’ comp doctor, and benefits only begin after you’ve missed seven days. That means your regular doctor can’t take you off work. Only the employer-authorized doctor can control your work status for the purposes of getting compensation.
After your medical treatment is complete, the state will evaluate your injury to see if it caused any lasting damage. If so, you’ll be eligible for permanent disability benefits to compensate for functional loss, pain, and reduced work capacity. New Jersey uses a percentage-based system to calculate these benefits.
Protect your rights from the start
Workers’ compensation in New Jersey will cover medical care, partial wage replacement, and disability support, but it won’t happen automatically. You need to have thorough documentation and be aware when the insurance company is trying to minimize your payout. While the system is designed to support injured workers, it’s still tilted in the insurer’s favor.
The insurance company will look for inconsistencies and anything they can twist into evidence that your injury isn’t as serious as you claim. Being aware of these shady tactics can save your claim. If anything feels off, don’t hesitate to contact a lawyer. The system isn’t perfect, but a lawyer will ensure you get fairly compensated.
