New Jersey Workers’ Compensation Claim Denials, Disputes, and Claims Petitions

The procedure for filing a workers’ compensation claim can be complicated. Workers’ compensation benefits may be denied or disputed for any number of reasons, and this can be frustrating for employees with legitimate work-related injuries. However, this does not have to be the end of the process. Under New Jersey law, employees have the right to file a workers’ compensation claim petition or informal dispute application under several circumstances when the worker is unhappy with the initial application results.

The circumstances for disputing a workers’ compensation filing include the following:

  1. To appeal a workers’ compensation claim that has been denied;
  2. To dispute the medical treatments that are required for a worker’s injury;
  3. To challenge the amount of the workers’ compensation benefit payment;
  4. To file for permanent disability benefits.

Under New Jersey workers’ compensation law, a Claim Petition is a formal submission that must be filed within the statutory time limit of two years from the date of the accident that caused the underlying injury or the date of last payment of compensation. The information included in the petition must comply with the requirements of N.J.S.A. 34:15-51, which states:

A paper copy of the petition shall state the respective addresses of the petitioner and of the defendant, the facts relating to employment at the time of injury, the injury in its extent and character, the amount of wages received at the time of injury, the knowledge of the employer or notice of the occurrence of the accident, and such other facts as may be necessary and proper for the information of the division and shall state the matter or matters in dispute and the contention of the petitioner with reference thereto.

Within six months from the date of filing, a hearing before a judge of compensation will take place. A Claim Petition may then be settled by agreement of the parties with regard to the amount of benefits and extent of disability, or, if a settlement cannot be reached, the claim will proceed to trial where the injured worker will have the opportunity to prove his or her injury through medical evidence and witness testimony.   At the conclusion of trial, the judge will reach a decision on the case. This decision is binding and only appealable to the Appellate Division of the Superior Court of New Jersey.

Instead of filing a Claim Petition, an injured employee may also choose to file an Application for Informal Hearing. This application is generally only used for less complicated disputes with an employer or insurance carrier, such as with regards to the amount of temporary benefits, medical treatment and permanency benefits. The results of such a hearing are not binding, and an injured worker still has the right to file a formal Claim Petition if he or she is not satisfied with the decision reached at the Informal Hearing.

 

Although an injured worker does not need to be represented by an attorney, the State of New Jersey highly recommends it, in order to protect injured workers’ rights and ensure that claims are properly filed with supporting evidence within the time limits provided by law.

New Jersey Workers’ Compensation Lawyers at Shebell & Shebell Can Help You File, Appeal, or Dispute a Workers’ Compensation Claim

If you or someone you love receives an on-the-job injury or illness, you may be entitled to compensation or other related benefits or you may need to challenge the award you have already received. The experienced Workers’ Compensation lawyers at Shebell & Shebell can help. We represent clients throughout New Jersey, including Monmouth County, Middlesex County, and Ocean County, including Howell, Freehold, Middletown, Shrewsbury, Wall, Union Beach and Neptune. For a free consultation, call us at 866-957-5237 or contact us online today.

 

Practice Areas of Shebell & Shebell LLC – Personal Injury Lawyers