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.

WORKERS' COMPENSATION - HEAD INJURY - NJ Workers' Comp Attorney

Head Injury - According to Wikipedia

Any injury that results in trauma to the scalp, skull, or brain can be classified as a head injury. The terms traumatic brain injury and head injury are often used interchangeably in medical literature.[1] This broad classification includes neuronal injuries, hemorrhages, vascular injuries, cranial nerve injuries, and subdural hygromas, among many others.[2] These classifications can be further categorized as open (penetrating) or closed head injuries. This depends on if the skull was broken or not.[3] Because head injuries cover such a broad scope of injuries, there are many causes—including accidents, falls, physical assault, or traffic accidents—that can cause head injuries. Many of these are minor, but some can be severe enough to require hospitalization.[4]

The incidence (number of new cases) of head injury is 1.7 million people in the United States alone each year. About 3% of these incidences lead to death. Adults suffer head injuries more frequently than any age group. Their injuries tend to be due to falls, motor vehicle crashes, colliding or being struck by an object, and assaults. Children, however, tend to experience head injuries due to accidental falls and intentional causes (such as being struck or shaken). Head injury usually occurs in toddlers as they learn to walk. Head trauma is a common cause of childhood hospitalization.[5]

Unlike a broken bone where trauma to the body is obvious, head trauma can sometimes be obvious or discrete. In the case of an open head injury, the skull is cracked and broken by an object that makes contact with the brain. This leads to bleeding. Other obvious symptoms can be neurological in nature. The person may become sleepy, behave abnormally, lose consciousness, vomit, develop a severe headache, have mismatched pupil sizes, and/or be unable to move certain parts of the body.[3] While these symptoms happen right after head injury occurs, many problems can develop later in life. Alzheimer’s disease, for example, is much more likely to develop in a person who has experienced a head injury.[6]

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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.

WORKERS' COMPENSATION - WOUNDS AND LACERATIONS

Wounds & Lacerations - According to Wikipedia

A wound is a type of injury in which skin is torn, cut, or punctured (an open wound), or where blunt force trauma causes a contusion (a closed wound). In pathology, it specifically refers to a sharp injury which damages the dermis of the skin.

Classification

According to level of contamination a wound can be classified as

§  clean wound , a wound made under sterile conditions where there are no organisms present in the wound and the wound is likely to heal without complications.

§  contaminated wound , where the wound is as a result of accidental injury where there are pathogenic organisms and foreign bodies in the wound.

§  infected wound , where the wound has pathogenic organisms present and multiplying showing clinical signs of infection, where it looks yellow, oozing pus, having pain and redness.

§  colonized wound , where the wound is a chronic one and there are a number of organisms present and very difficult to heal as in a bedsore.

Open

Open wounds can be classified according to the object that caused the wound. The types of open wound are:

§  Incisions or incised wounds, caused by a clean, sharp-edged object such as a knife, razor, or glass splinter.

§  Lacerations, irregular tear-like wounds caused by some blunt trauma. Lacerations and incisions may appear linear (regular) or stellate (irregular). The term laceration is commonly misused in reference to incisions.

§  Abrasions (grazes), superficial wounds in which the topmost layer of the skin (the epidermis) is scraped off. Abrasions are often caused by a sliding fall onto a rough surface.

§  Avulsions, injuries in which a body structure is forcibly detached from its normal point of insertion. A type of amputation where the extremity is pulled off rather than cut off.

§  Puncture wounds, caused by an object puncturing the skin, such as a splinter, nail or needle.

§  Penetration wounds, caused by an object such as a knife entering and coming out from the skin.

§  Gunshot wounds, caused by a bullet or similar projectile driving into or through the body. There may be two wounds, one at the site of entry and one at the site of exit, generally referred to as a "through-and-through."

Closed

Closed wounds have fewer categories, but are just as dangerous as open wounds. The types of closed wounds are:

§  Contusions, more commonly known as bruises, caused by a blunt force trauma that damages tissue under the skin.

§  Hematomas, also called a blood tumor, caused by damage to a blood vessel that in turn causes blood to collect under the skin.

§  Crush injury, caused by a great or extreme amount of force applied over a long period of time.

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.

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