What medical benefits as an injured worker am I entitled to?
The injured worker is entitled to all reasonable necessary and related medical expenses authorized and paid for by the Workers Compensation Carrier. In New Jersey, the insurance carrier must authorize (that is arrange and pay for) the medical treatment. You will also see the employer’s Workers Compensation Physician. In New Jersey, the employer directs and controls the medical treatment.
The Workers Compensation Insurance Carrier will direct and pay for all medical treatment. If the injured worker goes to see their own doctor without having authorization with the insurance company, the injured worker may be responsible for payment of any medical bills arising from seeing their own doctor. The insurance company must provide all reasonable and necessary medical treatment up until the point you reach maximum medical improvement. Maximum medical improvement is the term used by physicians when you arrive at a point, even with additional medical treatment, your injury will not become any better or any worse. At this time, the insurance carrier is allowed to stop the medical treatment and is allowed to stop your temporary benefits regardless of whether you are able to return to your prior employment or any employment.
It is important when you are treating with the Workers Compensation Physicians to fully explain to them the nature and extent of your injuries and their relation to the work accident. It is important, from the first day, that you accurately document everything with the employer and Workers Compensation Physician so your injuries are adequately addressed.
An injured worker may also be entitled to medical treatment after their case is over by filing an application to modify or review (re-open) their case. This is discussed later in the question and answer section.
What are temporary benefits, and is an injured worker entitled to them?
The temporary benefits are a wage replacement for the period of time you are out of work due to your work-related injury and under active medical treatment paid for by the Workers Compensation Carrier.
The Workers Compensation Insurance Carrier has to pay the injured worker 70 percent of his or her average weekly wage over the past 26 weeks. This payment is due after the insurance doctor keeps the injured worker out of work for more than seven (7) days. These checks are paid weekly or bi-weekly, depending on the insurance company.
The insurance company must pay the injured worker temporary benefits up until the point in time when the injured worker is released to return to work (and the employer has work available) and/or has reached maximum medical improvement.
Once an employee reaches maximum medical improvement, the employer may discontinue temporary benefits regardless of whether or not that employee is able to return to their prior job or any other gainful employment.
If are injured at work, you should immediately contact attorney Michael J. Dennin, Esquire in order to protect your rights to medical benefits, temporary benefits and secure permanent benefits on your behalf. Mr. Dennin represents individuals in Cherry Hill, Marlton, Audubon, Haddon Township, Medford, Haddonfield, Merchantville, Maple Shade, Pennsauken, Camden, Collingswood, Gloucester City, Haddon Heights, Mt. Holly, Barrington and all other cities and townships throughout the State of New Jersey. He provides aggressive and reliable representation at no cost unless he makes a recovery for you. Contact him at 856-577-9138 or on the web at www.denninlegal.com.