NJ WORKER’S COMPENSATION AND MEDICARE: WHAT CAN HAPPEN

NJ Worker’s Compensation benefits were created to help those who are injured on the job to have quick access to medical treatment and set aside funds to help those workers who may lose future function permanently. To help speed up the process, employers are allowed to choose what doctors an injured employee will see for treatment. While the system was supposed to streamline problems with providing quick medical treatment, issues often arise, especially when an injured worker sees other doctors outside of the employer’s doctor.

Further complicating these situations is when the injured employee receives Medicare benefits. Of course, injured workers have other medical needs other than those from the injuries that happen at work. When on Medicare, an injured worker will sometimes be treated for both related or non-related medical issues, which is paid for by their Medicare benefits. While the injured worker often does not think twice about who is paying for their treatment, as long as they are able to get it.

When Medicare becomes involved, they must be notified of any worker’s compensation claim made, because Medicare will be entitled to be paid back for paying for treatment deemed to be a result of a workplace injury. If a permanent injury award is given, Medicare can and will hold the injured worker liable to reimburse Medicare for those payments. Further complicating the picture is how Medicare attributes what needs to be paid back. As mentioned earlier, often an injured worker on Medicare is also treating for other ailments. An underfunded and financially strapped program like Medicare will sometimes seek reimbursement for as much treatment as possible, sometimes even reaching into unrelated treatment.

Because of the Medicare issue, it is highly important that you speak with a NJ Workers' Compensation Lawyer with knowledge of the worker’s compensation system such as Simon Law Group and inform them if you receive Medicare benefits or will receive Medicare benefits in the future. An experienced workers' compensation lawyer will know how to ensure that minimal worker’s compensation benefits are used to reimburse Medicare for those treatments.

If you have been injured on the job, contact Simon Law Group and speak with a NJ Workers' Compensation Attorney at 800-709-1131 or complete the form on the left of this page.

NJ WORKERS' COMPENSATION - REPORT YOUR INJURY TO YOUR EMPLOYER

The importance of reporting your workplace injury

When you are injured while on the job, it is extremely important to notify your employer of the accident in order to protect the rights you may have in making a worker’s compensation claim. Although the rules in New Jersey allow a period of up to 90 days to inform your employer, it is recommended that you report the accident as soon as possibly. Often, an injured employee may not realize the severity of the injuries until after 90 days have passed and may be blocked from making a claim for Worker’s Compensation benefits.

 Injured? Contact Us Now!

Such was the situation in Alvarez v. Continental Airlines, A-3039-12T3 (App. Div. October 18, 2013). In this case, an International Service Manager for Continental Airlines slipped and fell inside an airplane on October 21, 2001, striking his head, shoulders and neck on the airplane’s floor. Instead of reporting the injury to his employer, he instead self-treated his injuries.

For unrelated reasons, the injured worker took a leave of absence and returned to work 6 months later, however by this time the pain from his injury was too great for him to continue working. At this time, he sought treatment from his Employer’s approved medical provider and could not return to work for an entire year.

After that year, the injured worker attempted to file a claim for worker’s compensation benefits. The employer denied that claim for failure to timely report an injury. After several years in court, a Judge of Compensation dismissed the case for failure to provide timely notice. Ultimately, the injured worker lost out on any permanency claims of worker’s compensation benefits, as the court found he did not report the injury and the employer had no way of knowing about the injury within the 90 days.

If you have been injured on the job, contact Simon Law Group and speak with a NJ Workers' Compensation Attorney at 800-709-1131 or complete the form on the left of this page.