How to dispute a new jersey workers compensation claim

Don’t Get Cheated: Disputing New Jersey Workers’ Comp Claims

When an on-the-job injury puts you out of work, you probably can’t afford to wait around for your employer’s insurance company to step in and help. And when the employer and/or insurance carrier questions or even denies your claim, it can be disastrous.

This is why the state of New Jersey’s Division of Workers’ Compensation provides an appeals system for injured workers. The worker can file an application for an informal hearing or submit a formal claim petition.

The workers’ compensation appeals division takes into consideration certain criteria during the review process, including:

  • Whether or not the claim is based on a work-related injury or illness.
  • The amount and types of medical services required.
  • Whether or not the worker requires temporary disability benefits.
  • Benefits for the dependents of a permanently disabled worker.
  • Benefits for the dependents of a worker who is deceased due to job-related causes.

While it is permissible to file an appeal on your own, most workers get an attorney to assist them in this process.

Informal Hearings

Workers can request informal hearings before a compensation judge. Generally, in this type of dispute the following is true:

  • The disputed claim is resolved in a simpler way than in a claim petition.
  • The issues include temporary benefit amounts, permanency benefits, and medical treatment decisions.
  • A judge makes suggestions during an informal hearing, but these are not binding, meaning that you still have the right to move ahead and file a formal claim petition if you are not satisfied. However, you do need to be aware that you have only two years from the date of the injury or the date of your last benefit payment to file.
  • The injured worker has the right to have legal counsel present at the hearing and if you are awarded any amount, the lawyer is limited to 10% of the amount, which you will pay.
  • Most informal claim hearings take place within a few weeks of the request and are resolved within one or two hearings.

Formal Claim Petitions

When an informal hearing doesn’t work, or the dispute is too complicated to handle in one or two sessions, many workers choose to file a formal claim. Once the claim petition is filled out and filed, you can expect:

  • Waiting up to six months for the first hearing with the judge.
  • To be heard in a district workers’ compensation office in the county where you reside or work.
  • A pretrial decision to be made when both parties mutually agree to the extent of the disability and the amount of benefits awarded without litigation. If this doesn’t happen, the case will go to trial where witness statements, your statement, and medical evidence will all be presented and considered.
  • When all the evidence is presented, the judge will make a decision that is binding; neither party can change it unless appealed in the state supreme court.
  • You will need an attorney to make sure your best interests are represented and that all evidence you need is available.

If you want to appeal a New Jersey workers’ compensation claim decision, your best bet is to consult an experienced lawyer. Call Gaylord Popp today toll free at 855-850-7856. Your initial consultation is free and we will work hard to get you the compensation you both need and deserve.