Tag Archives: workers compensation

Personal Injury, Workers Compensation

Reasonable and Necessary

New Jersey law provides protections for you as an employee. The workers compensation system in New Jersey allows that, if you’re injured at work or while working, you are owed reasonable and necessary medical treatment. In other words, if you’re injured on the job, the law protects you from having to pay your medical expenses out of pocket.

Limitations 

While these protections sound easy enough, there are limitations. The first is that workers compensation is responsible only for those medical treatments that are directly related to the injury you incurred at work. The second is that workers comp is responsible only for those medical treatments that are reasonable and necessary. These limitations provide insurance companies with ample opportunities to contest workers compensation claims.

Reasonable and Necessary

Reasonable and necessary sounds straightforward enough, but wiggle room is built into the process. Once your workers’ comp claim is allowed, there are some categories of treatment that are generally accepted as reasonable and necessary:

  • Diagnostic testing – including x-rays, MRIs, ultrasounds – when determined medically necessary to accurately diagnose the nature of your injury;
  • Designated hospital services;
  • The prescription and administration of designated medications;
  • Doctor and specialist appointments;
  • Designated surgeries;
  • Physical therapy for a designated interval; and
  • Designated medical devices, including wheelchairs, splints, and crutches.

What about Unnecessary and Unreasonable?

Insurance companies are in the business of turning a profit, and there are certain medical treatments that they routinely determine to be both unnecessary and unreasonable:

  • Any treatments related to your injury that your doctor finds unnecessary;
  • Alternative medical therapies – such as acupuncture and chiropractic care;
  • Prescription drugs and treatments that are new, experimental, or cost prohibitive;
  • Treatment that isn’t consistent with the injury you’ve incurred or with your diagnosis;
  • Treatments that duplicate themselves – such as the same treatment ordered by more than one doctor;
  • Designated treatments ordered by non-specialists;
  • Ongoing treatment for a minor or subjective injury; and
  • Any medical treatment of more than three weeks for a soft-tissue injury.

Medical professionals naturally prioritize improving your health. Insurance companies, however, are invested in keeping medical expenses down. This clash can lead to complications for workers compensation claims.

Your Workers Compensation Claim

If you’ve been injured on the job, you know just how difficult that can be. If the insurance company is contesting payment for the medical treatment that you need, it can be more difficult still. Your health is too important to leave to chance. An experienced workers compensation lawyer will guide your claim toward the just compensation to which you’re entitled.

If You Have a Workers Comp Claim, Call 201-498-9768 Today for More Information 

If you were injured on the job, make full recovery your priority. Don’t let workers compensation insurance dictate the kind of medical care you receive. A skilled New Jersey workers comp attorney will advocate for your rights and for your rightful compensation. At John L. Schettino law, we’re here to help. For a free phone consultation, contact or call me at (201) 498-9768 today.

Workers Compensation

How to File a Successful Workers Comp Claim

If you have a New Jersey Workers Comp claim, you know how stressful that can be. Your claim, however, matters, so it’s important to understand how you can help ensure that your claim will successfully cover the injury and damages you’ve incurred. Toward this end, there are some important factors for you to consider.

The Workers Compensation Judge

You are going to bring your claim in front of a Workers Compensation Judge, and it is in your best interest to present yourself as honestly and credibly as you can. Honestly answer the judge’s questions with straightforward clarity. Don’t embellish, exaggerate, or draw undue attention to your incurred injury or disability; instead be forthright in your presentation. An experienced workers comp attorney will make sure that you are well prepared to accurately and effectively present your claim to the Workers Compensation Judge.

Your Expert Witnesses

The same qualities that are important for you to possess when you go before the judge also apply to your expert witnesses and your testifying medical provider. Your workers’ comp lawyer will also work with these witnesses to ensure they are well prepared, credible, and focused on the elements that are most important to your claim.

Your Workers Comp Claim

If you were injured on the job, it’s likely not your finest hour, but the success of your workers’ comp claim can depend upon the strength of your presentation to the workers’ compensation judge. It’s your workers’ comp attorney’s job to prepare you for this elemental task. This includes explaining what you should expect, teaching you how to comport yourself before the judge, and carefully going over your case with you so that you understand its important elements and how to effectively communicate these elements in your own words. Your attorney is also tasked with ensuring that you are comfortable with what lies ahead, including accurately and convincingly communicating how your work injury has adversely affected your life.

If You Were Injured on the Job, Call 201-498-9768 Today for More Information

If you suffered an injury while on the job, don’t leave your claim or recovery to chance – you need a skilled New Jersey workers’ comp lawyer who will help guide your claim toward the resolution you’re entitled to. At John L. Schettino law, we’re here to help. We have the experience, knowledge, and dedication to helping prepare you to successfully and confidently present your claim before the workers’ comp judge. For a free phone consultation, contact or call me at (201) 498-9768.

Workers Compensation

A Look at Treatment under a Workers’ Comp Claim

If you’re injured on the job in New Jersey, the NJ workers’ compensation system ensures that your employer or your employer’s workers’ compensation insurance company must pay for your reasonable and necessary medical treatment. In other words, if you are injured at work, the law provides that you don’t have to pay for the associated medical expenses. As with most legal provisions, however, a workers’ comp claim is not without its limitations.

Reasonable and Necessary Medical Treatment

It seems easy enough – if you are injured at work, workers’ comp has got you covered. It’s not, however, quite that simple. Workers’ comp insurance companies are only responsible for paying for those medical treatments shown to be directly related to the injury you sustained at work. Further, these companies need only pay for those medical treatments that are directly related and that are reasonable and necessary.

What’s Reasonable and What’s Necessary?

 It probably goes without saying that you and your workers’ compensation insurance provider may not always see eye-to-eye when it comes to what is reasonable and necessary regarding your medical treatment. There are some basics, however, that most insurance companies – once they’ve accepted your workers’ comp claim– will cover:

 

  • Medical appointments;
  • Diagnostic testing, including x-rays, MRIs, ultrasounds, and the like – but only if such tests are medically necessary to diagnose the exact nature of your work-related injury;
  • Some hospital services;
  • Some surgeries;
  • The administration and purchase of some prescription medications;
  • Some medical devices, including things like wheelchairs, splints, crutches, and hearing aids; and
  • Some physical therapy (for a prescribed period).

As this list reveals, workers’ compensation insurance companies are not only cynical but also have plenty of wiggle room when it comes to finding medical expenses unnecessary and unreasonable.

Unnecessary and Unreasonable

While reputable doctors rarely order treatments that they don’t believe are both medically necessary and reasonable, workers compensation insurance companies are in the business of making money and are not averse to taking on a few battles. For instance, these insurance companies have been known to deny experimental or cost-prohibitive treatments and drugs; alternative therapies like chiropractic and acupuncture (that many people find offer significant relief); more than three weeks of treatment for soft-tissue injuries; and specialized treatments ordered by non-specialized medical professionals.

 

Don’t despair; experienced workers’ compensation attorneys understand how important your claim is to you and know how to fight for the resolution you are entitled to.

 

If You Were Injured on the Job, Call 201-498-9768 Today for More Information

 

If you were injured on the job, don’t leave your recovery to chance or to your employer’s workers’ compensation insurance. Contact a skilled New Jersey workers’ comp lawyer who will help guide your claim toward the resolution you’re entitled to. At John L. Schettino law, we’re here to help. For a free phone consultation, contact or call me at (201) 498-9768.

Personal Injury

Workers Compensation: What To Do

If you have been the victim of a workplace-related injury, you will most likely be eligible for workers compensation that will take care of your medical bill and other injury-related expenses. Knowing your rights is vital to navigating the often complex process of filing for and receiving workers compensation benefits and you may need to enlist the help of an experienced lawyer to do so. At the Law Office of John L. Schettino, we have helped thousands of individuals like yourself receive their full workers compensation rights. Here is a brief run-down of what you should know in situations of workers compensation for a work-related injury or illness.

Preventative Steps:

If you’ve ever suffered a major illness or injury, chances are there were some warning signs that you missed as it was beginning. Every time there is an accident at work, you should be sure to report it and include your involvement in the incident, even if you don’t believe at the time that you’ve been injured. This is a necessary precaution to make sure that you’ll have a substantial paper trail for receiving your workers compensation benefits, as well as providing necessary updates to any safety concerns in the workplace for yourself and your co-workers.

Immediately After:

After any kind of accident in which you sustain injuries, you should immediately get checked out by a doctor, as well as filling out your accident report. If you have a serious injury that requires immediate care, go to the emergency room. If it’s a different type of injury and not as critical, you should still talk to your employer about going to another doctor. You could use a doctor chosen by your employer, but if you aren’t satisfied by the level of care, you can also go to another as well.

What Workers Comp Provides:

With workers compensation, you should be eligible to receive medical benefits, temporary total benefits, permanent partial benefits, or permanent total benefits, depending on your injury and its effect on your abilities to remain at work. Under NJ law, dependents can also receive benefits if the worker who was supporting them died as a result of their employment. Unlike many other insurance issues, injured employees are entitled to their workers compensation benefits even if they were at fault. Receiving these benefits does mean that the worker will not be able to press civil action against the company regarding to the incident, unless it was intentionally done. Benefits will be explained in length in a following post.

When Facing Difficulties:

If your supervisor is not complying with workers compensation rights, or giving you a hard time about seeking medical care, it may be in your best interests to hire a workers compensation attorney. At John L. Schettino law, we can provide a free phone consultation and work with you to receive your full benefits that you are entitled to for your individual case. Contact me at (201) 498-9768 for a free consultation on your rights how I can best represent you.