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New Jersey provides review options for disputed workers’ comp claims

On Behalf of | Dec 13, 2021 | Workers' Compensation |

Filing a workers’ compensation claim in New Jersey involves a formal process, but the steps seem straightforward. Any employee hurt on the job could seek and collect benefits, with the understanding receiving benefits reduces the ability to sue an employer dramatically. Lawsuits typically involve negligence, and New Jersey remains a no-fault workers’ comp state. Such employee-friendly elements notwithstanding, there are times when the claim may face disputes. Rules exist for employees to challenge those disputes.

Disputing a workers’ compensation claim in New Jersey

A common dispute surrounding a claim asks the question, “Was the injury work-related?” The employer might doubt that the injury happened at work, leaving the employer dealing with a complicated situation. Similarly, the employer or insurance carrier may question how hurt the worker is. An insurance carrier could dispute the level of medical care necessary to treat the problem.

Often, the Workers’ Compensation Board will review disputed claims. The board may arrive at an administrative decision based on the evidence associated with the case. An employee may find the board agrees with his or her initial claim. However, this outcome does not always occur, leaving the employee to explore other possible solutions.

Further actions regarding workers’ compensation disputes

When the board cannot provide an administrative decision, the workers’ compensation claim may enter into the conciliation process. The conciliation process involves a review by the board’s attorney. The attorney’s recommendation and the subsequent proposal could solve the dispute.

Objections to the conciliation process would likely lead to a hearing in front of a workers’ compensation law judge. The judge’s decision may end the dispute in a fair manner.

Whether dealing with a review board, a conciliator, or a judge, the employee might need to present a strong case that overcomes the dispute. The effective presentation of solid evidence could lead to a conclusion that upholds the claim.



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