The New Jersey Workers’ Compensation Claims Process: An Overview
Filing and pursuing a workers’ compensation claim typically involves a number of steps. Understanding these steps and how claims usually proceed can be helpful to:
- Setting realistic expectations
- Alleviating anxieties and concerns about the process
- Clarifying workers’ rights and options when valid claims are mishandled or wrongfully denied.
While the following presents a general overview of the workers’ compensation claims process in New Jersey, please contact Middlesex County Workers Compensation Attorney James A. Hicks whenever you are ready for further insights and helpful advice regarding your potential claim.
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How the New Jersey Workers’ Compensation Claims Process Typically Works
Here is a simplified overview of how a workers’ compensation claim starts and is generally resolved in New Jersey:
- A work accident, injury and/or illness is reported to the employer – This report is usually the first step in initiating a workers’ compensation claim. It’s typically in workers’ best interests to make these reports as soon as possible after an incident or injury. By law, workers have 90 days to file this report (verbally or in writing) to a supervisor or another authority at their workplace.1
- The worker makes a request for medical treatment – After submitting the work accident or injury report to the employer, the next step will be for workers to request medical treatment from the employer. While this step can be skipped in emergency situations, in non-emergency situations, injured workers should make this request so employers can refer them to a physician or health care provider. If injured workers see a doctor of their own choosing for non-emergency treatment, this treatment may not be covered by the employer or its insurer.
- The employer notifies the insurer of the incident or injury – After being notified of the work injury or illness, the employer should inform its insurer of the injury so the insurer can submit a First Report of Injury to the New Jersey Department of Workers’ Compensation (DWC). Self-insured employers are responsible for filing this report to the DWC.
- The claim is evaluated – Once the DWC has been notified, the insurer (or self-insured employer) will investigate the claim, likely contacting the injured worker, the medical provider(s) and/or the employer as part of this process. The insurer (or employer) may also request various documentation, such accident reports, medical records and/or earnings statements. After investigating the claim, the insurer (or employer) will issue a finding, either approving or denying the claim.
What occurs next will depend on various factors, including the nature and severity of the injuries a worker has sustained. Please note, however, that at any point in the workers’ compensation claims process:
- Making mistakes or missing deadlines can lead to delays and additional challenges with claims.
- Employers and/or insurers may dispute injured workers’ injuries, possibly complicating claims and presenting an uphill battle to getting benefits.
- The guidance of an experienced attorney – like Middlesex County Workers Compensation Attorney James A. Hicks – can be pivotal to avoiding mistakes and successfully navigating every phase of the claims process.
For more specifics about the process associated with workers’ compensation claims in New Jersey, don’t hesitate to contact the Law Office of James A. Hicks, LLC.
Get Experienced Help Navigating the Claims Process: Contact Middlesex County Workers Compensation Lawyer James A. Hicks
If you or a loved one has been hurt on the job, you don’t have to face insurers – or navigate the claims process – alone. You can rely on Middlesex County Workers Compensation Lawyer James A. Hicks for experienced help, extraordinary advocacy and the highest quality representation at every point during the workers’ compensation claim process.
Call (732) 767-1300 or email us for more information about your case and how Attorney James A. Hicks can help you.
For more than 15 years, Attorney James A. Hicks has been certified by the Supreme Court of New Jersey as a workers’ compensation law attorney (a designation only held by about 2 percent of attorneys in the state). This means that Mr. Hicks has the experience, knowledge and skills to effectively represent injured New Jersey workers in any type of workers’ compensation case.
Let Mr. Hicks explain how he can help you obtain the benefits you likely deserve.
From offices in Middlesex County, Attorney James A. Hicks is proud to represent injured workers and families from across the state of New Jersey.
1: According to information from the New Jersey Department of Workers’ Compensation (DWC)