If you were injured while working at your job in New Jersey, you can file a claim with your employer’s workers’ compensation insurance carrier. Employers are required to carry workers’ compensation insurance to protect employees who are injured at work or develop occupational diseases as a result of their working conditions. Here is some information about what workers’ compensation covers and what you might expect in a settlement from the attorneys at Swartz Swidler.
What Worker’s Compensation Covers Following the Approval of a Claim
After the insurance company approves your workers’ comp claim, it will pay for all of your medical expenses that relate to your injuries. If you can’t return to work because of your injuries, workers’ compensation will also provide benefits to pay a portion of your wages each week until you can return. These temporary total disability benefits should continue while you are off from work recovering. They end once you go back to your job even if your claim remains open. For example, if you are returned to work but continue to attend physical therapy appointments, your worker’s compensation claim might remain open, but your temporary disability benefits will end.
Understanding Workers’ Compensation Settlements
Once you have completed treatment and have returned to work, your workers’ compensation claim will be closed. In some cases, however, closing a claim will involve a negotiated settlement between the injured worker and the insurance company with the help of a worker’s compensation attorney. If an agreement can’t be reached, the claim will be decided by an administrative law judge.
A settlement negotiation might begin when the insurance company makes an offer. This might include an offer to pay unpaid medical bills and benefits together with money to pay for the future costs of treatment. If you were left with permanent disabilities, you might be entitled to additional funds.
Your workers’ compensation settlement might either be paid as a lump sum or through a structured payment plan. If you receive a lump sum settlement, you will receive a single payment for all of your claim’s benefits and medical costs. If it is a structured payment plan, you will receive payments over a set duration and might also have a separate account to pay for your future medical treatment costs.
What Is Included in a Settlement?
During the settlement negotiations, your attorney and the insurance company will both calculate the value of the claim. Your lawyer will try to include enough compensation to cover all of your previous care and any future treatment you will need. A settlement should include all of the following things:
- Unpaid medical bills
- Future anticipated medical costs
- Past lost wages
- Future lost wages
- Permanent or temporary disability benefits
- Attorney’s fees
Once your attorney has completed their calculations, they will negotiate on your behalf with the insurance company. The final settlement will likely be a compromise between your attorney and the insurance company. Once your settlement agreement is finalized, the administrative law judge will review it and determine whether it’s fair to you. To protect your interests, it is a good idea for you to have a lawyer help you through the settlement negotiations process to ensure you receive adequate compensation for your injuries. Your attorney should keep in contact with you during the negotiations to keep you informed about what’s happening with your claim.
It can take some time to work out a settlement. If a settlement can’t be reached, your claim will likely need to go to court for a hearing before an administrative law judge. It’s important to understand that a workers’ compensation trial comes with risks for both you and the insurance company. The judge might order an award that is either much lower or higher than your settlement offer. Having an attorney represent you can improve your chances of success.
Why a Claim Might Go to Trial
Your claim might go to trial for one of two reasons, including if your claim is denied or when your settlement offer is unreasonably low. If your claim is denied, you have a right to file an appeal and a hearing before a judge. If your settlement offer is unreasonably low, and the insurance company won’t budge, you might also need to take your claim to trial and let the court decide. The workers’ compensation hearing allows both you and the insurance company to present evidence and argue your positions. The judge will evaluate the evidence presented by both sides and will determine an appropriate settlement amount when the settlement offer is at issue.
If the claim was denied, the court will determine whether it should have been approved. If you are successful, the insurance company must comply with the court’s order to pay a settlement or reverse a denied claim. However, if the court decides in favor of the insurance company or orders a lower amount than what you were offered, you will also have to comply or file an appeal of the court’s decision.
Get Help From a Workers’ Comp Attorney
If you were injured at work, you might want to speak with a workers’ compensation attorney to understand your rights to recover benefits. The attorneys at Swartz Swidler can review your case and explain the types of benefits you should be entitled to receive and can help you with negotiating a settlement. Call us today for a free consultation at (856) 685 7420.