If you're injured at work or become sick because of your job, you may be entitled to benefits through New Jersey's workers' compensation system. To get those benefits, however, you need to follow certain procedural steps and show that you're eligible. Below, we've outlined the state's rules for starting the claims process.
If you're an employee (not an independent contractor), workers’ compensation will cover injuries that happen because of your job and while you're working. Most injuries that occur at the workplace, or while you're performing work-related tasks, are covered. For example, if you hurt your back carrying boxes at work, or you slip and fall while running a work errand off-site, your injury will likely be covered.
Workers’ comp is a no-fault system, meaning that you can usually collect benefits regardless of who was at fault for the injury. However, New Jersey law does rule out coverage for certain injuries that result from an employee's misconduct, such as being intoxicated at work, participating in horseplay, or not using safety equipment that your employer provided and told you was necessary. Learn more about the general rules for determining whether injuries or illnesses are work related.
If you're eligible for workers' comp, you're usually limited to the benefits provided under that system. There are rare exceptions, however; for details, see When Your Employer's Actions Allow You to Sue Outside of Workers' Comp.
The first step in the workers' comp claim process is to report your injury to your employer. You should do this as soon as possible. You could lose your right to benefits if you don't give notice within 14 days after the injury, unless your employer actually knows about it. However, if you had a good excuse for missing the 14-day deadline, you have up to 90 days to provide notice before losing out on benefits.
If you need emergency medical treatment, you can go to the nearest emergency room or urgent care. Before getting any non-emergency treatment, however, you will need to check with your employer. In New Jersey, your employer is allowed to choose your treating doctor for work-related injuries.
Once you give your employer notice of your injury, it should notify its insurance company. (Some large and financially stable employers can get state approval to insure themselves, but they usually use outside claims adjusters to handle workers' comp claims.) The insurance company will file a report of injury with the New Jersey Department of Labor and Workforce Development (DLWD). A claims adjuster will then review your claim and decide whether to accept it.
If your claim is accepted, the insurance company should cover all necessary and authorized medical treatment related to the injury. It should also begin paying wage-loss benefits if you have to miss at least seven days of work because of the injury. Learn more about workers' comp benefits in New Jersey.
If the insurance company denies your claim or turns you down for some benefits you expected, you can appeal the decision through the New Jersey DLWD. However, if you want a formal hearing on your appeal, you must file a petition within two years after your were injured or learned that your occupational illness was related to your job. For details on how to file a petition, how the dispute resolution process works, and common reasons for denying claims, see What to Do If Your Workers' Comp Claim Is Denied in New Jersey.
Most workers can handle the initial part of the workers’ comp claim process on their own. If the insurance company readily accepts your claim and pays your benefits, you probably won't need to hire a lawyer. However, if the insurance company denies your claim or disputes the amount of benefits you are entitled to, you should consider hiring an experienced workers' comp lawyer. This is especially true if you need to attend a workers’ comp hearing, which involves complex procedural rules. For more information, see Should I Hire a Workers’ Comp Attorney or Can I Handle My Own Case?