Recent reports indicate that as many as half of Americans younger than 65 suffer from a preexisting condition that insurance companies cite to either deny or limit health benefits. Indeed, some workers compensation carriers have a pattern of denying claims on the ground that the injured worker suffers a preexisting problem. Injured workers should not accept such denials. While prior health conditions can complicate your claim for benefits, they do not necessarily prevent coverage.

A workers compensation preexisting injury is different

The meaning of “preexisting” under New Jersey workers compensation law is quite different than in other insurance contexts. Typically, preexisting means something that existed before the event at issue. For example, if you suffered back pain prior to a work-related accident in which you injured your back, then your medical insurance might preclude you from receiving full medical benefits. For purposes of a workers compensation claim, however, preexisting conditions are those in which a new work injury aggravates a prior work injury involving the same body part or parts.

Preexisting work injury condition aggravated by the current injury

If your new injury aggravates an injury from a previous work place accident, then your benefits can be reduced slightly to account for the prior claim. Your employer should pay for your medical treatment related to this new work-related injury and for temporary disability benefits if you are unable to work.

Preexisting condition unrelated to prior work injury

Some preexisting conditions stem from people’s natural aging processes or a prior injury unrelated to work. If your current work injury aggravates a non-job-related preexisting condition, workers compensation may still cover you to the extent that your worsened condition can be attributed to the new work-related injury.

Preexisting condition unaffected by current work injury

If your current work injury does not affect your preexisting condition, then it should have little or no impact on your claim for benefits. Your private insurance should continue coverage for your treatment of your preexisting condition, and your employer should cover your medical bills related to your work injury.

A New Jersey workers compensation attorney can help you determine whether you should complete a claim for an aggravated condition or a new workers compensation claim.

You probably have given many years of hard work and loyalty to your employer. Yet when you suffer an injury on the job and seek workers compensation, your employer may not show you the same loyalty. Instead, some employers and their insurers try to avoid paying you the workers comp benefits you deserve. To ensure that you get the benefits you need and deserve, seek the advice of an experienced attorney to help you with your workers compensation claim. Here are some of the ways a lawyer can assist you:

Denial of claim

Once you file a workers compensation claim, your employer may contest the basis of your injury, contending either that you were not injured or that your injury was not job-related. An experienced attorney knows how to investigate the accident or injury and establish the connection to your work. In addition, it is important to report an injury within the legal time frame. Attorneys know that the New Jersey workers compensation laws give you only two years to report the injury or you may lose your right to benefits.

Problem with treating physician

New Jersey law requires that you get treatment from an employer-approved doctor. In some cases, these doctors may clear you to return to work before you have fully healed from your injury. Your attorney can help you find an alternative health provider who has your best interests in mind.

Delay or denial of certain benefits

If your benefits are delayed, your attorney can investigate the cause and accelerate the process. You should not accept a denial of any benefits without consulting with an experienced attorney. Your attorney may discover that the denial was unjustified, and can initiate an appeal on your behalf.

Retaliation

The law prohibits employers from firing or demoting an employee for filing a workers compensation claim. An attorney can uncover the true reasons for your dismissal or demotion and file a lawsuit against your employer, if necessary.

Third-party claim

If a defective product or someone other than your employer caused your workplace injury, a workers compensation attorney can help you recover damages in addition to your workers comp benefits.

Contact a New Jersey workers compensation attorney to file your claim or to appeal a denial so you receive all the benefits you deserve.

Bergen County attorneys help disabled workers claim permanent benefits
One of the sad truths of life is that some injuries don’t heal. Even if you received excellent medical care, you may find that your work-related injury has not improved sufficiently for you to return to work. You may have to continue working at a less demanding job for lower wages, or you may be unable to return at all. Under these circumstances, you need experienced legal assistance to help you get the benefits you deserve. At the Law Offices of Richard S. Greenberg, our attorneys seek a disability settlement that reflects your true condition and compensates you for the full extent of your injury.

Preserving your right to claim permanent disability benefits
Once medical treatment for your work-related injury ends and you have achieved maximum medical improvement, you enter the permanent disability phase of your workers’ compensation claim. To assert your right to permanent disability benefits, you must submit a claim within two years of your last authorized medical visit or your last payment of workers’ comp benefits.

Managing the battle of the medical experts
After filing your claim, the Division of Workers’ Compensation schedules a hearing to decide your level of disability, which can be anywhere from 1 percent partial permanent disability to 100 percent or total permanent disability. The insurance company may schedule an independent medical examination prior to the hearing. Don’t be fooled by the word “independent.” The physician is paid by the insurance company, so you can expect to receive a low disability rating and a correspondingly low settlement offer from the insurer.

Your attorney must arrange an examination by another physician familiar with the disability rate schedule to seek a more favorable estimate. A hearing’s outcome usually hinges on the credibility of the victim’s medical experts versus those of the insurance company. Your final disability rating is likely to reflect a compromise between the two. Parties often settle before the hearing is complete, but if you don’t receive a satisfactory offer, you can take your case all the way to judgment.

Attorney fees for your workers’ compensation settlement
New Jersey workers’ compensation law does not allow attorneys to accept fees in advance. The Judge of Compensation sets attorney fees as a percentage of the settlement or judgment, up to a maximum of 20 percent. However, not all of that is taken from your award; the court may require the insurance company to pay more than half of your attorney’s fees.

Trust our Bergen County attorneys to get results in your disability settlement
The attorneys at the Law Offices of Richard S. Greenberg fight aggressively to maximize permanent disability settlements.