By:
Attorney Jeffrey S. Monaghan
Under the New Jersey Workers'
Compensation Statutes, an injured worker who has received either a settlement
or judgment entitling them to an award of permanent partial total disability
for injuries sustained in a compensable work related accident maintains two
important additional rights for a specific period of time, after their initial
claim has been resolved.
Our Workers' Compensation Statutes
recognizes the fact that certain medical conditions may worsen over time, and
the law therefore allows the injured worker the following two rights that
extend beyond the settlement or judgment date on their original claim.
The need for additional medical
treatment
One of the rights that an injured
worker maintains after receiving their initial workers' compensation judgment,
is the right to make a request through the workers' compensation insurance
carrier defending the claim for additional necessary and related medical
treatment if the injured worker believes that the particular medical treatment
covered in their initial judgment has significantly worsened since the judgment
was received.
In order to be entitled to additional
medical treatment the injured worker must be able to establish that the
particular injury involved has significantly worsened since receiving their
initial settlement or judgment. For instance, if the work related accident
involved an injury to the low back, and at that time of the initial settlement
the worker was experiencing mid to low back pain, but they are now experiencing
pain radiating from their low back into their left and/or right legs, or if the
low back pain itself has significantly worsened the injured worker may be
entitled to a course of additional medical treatment.
Similarly, if the initial injury
involved in an injury to a shoulder and the injured worker is now experiencing
a greater reduction in their range of motion of the shoulder or is under
increased restrictions in their ability to lift or carry certain items in their
day to day job duties at work, these additional limitations and complaints
might possibly entitle the worker to further treatment. If the initial accident involved an injury to
a left or right knee, and the individual is experiencing increased swelling in
their knee or perhaps a buckling or
giving away of the knee that was different from the symptoms they were
experiencing at the time of their initial settlement, the injured worker may be
entitled to further medical treatment in view of these increased problems and
limitations.
In order to receive such additional
medical treatment, the injured worker or their attorney, must make a request
for this additional medical treatment to the workers' compensation insurance
carrier that defended the claim on behalf of the employer in the initial case. Injured workers are not entitled to receive
additional medical treatment on their own without first making a proper request
to the workers' compensation insurance carrier.
The right to reopen an initial
workers' compensation claim
The second important right that an
injured worker who has received a workers' compensation judgment maintains is
the right to file an application to reopen their initial settlement or judgment
and to attempt to prove that the particular injury sustained in the initial
accident has substantially worsened since the time the initial resolution
thereby possibly entitling the injured worker to a new award of permanent
partial total disability. In order to be entitled to a new and increased
permanent partial total award, the injured worker has the burden of proof in
establishing by objective medical evidence that the original injury or injuries
sustained in their initial accident have in fact worsened to a material degree.
Time limitations for requesting
additional medical treatment and/or filing an application to reopen an initial
award
The time frame for attempting to prove
their entitlement to either or both of the above benefits is governed by what
the law refers to as the Statute of Limitations. Under the statute of
limitations, an injured worker has a two-year period of time to either request
additional medical treatment from their original judgment and/or to file an
application to reopen their case. The
two year time frame to exercise either or both of these possible future rights
begins to run from the date the injured worker receives their final settlement
payment on their initial workers' compensation judgment. Often times the injured worker receives their
initial award in one lump sum payment. If this is the case, then the time frame to request additional medical
treatment and/or file an application to reopen the case is two years from the
date that payment has been received in the mail. If the entire settlement is not due and owing
in one lump sum, then the two year period of time to either request additional
treatment or file an application to reopen the case is two years from the date
that the final settlement check has been received.
Injuries caused by work related
accidents often times worsen and the limitations and disabilities caused by the
work related injury can in certain circumstances substantially increase with
the passage of time. Therefore, the potential rights to additional medical
treatment, the payment of which would be the responsibility of the workers' compensation
insurance carrier, and the worker's entitlement to an increased partial
permanent disability award can be extremely important and valuable parts of a
workers' compensation settlement.
Individuals who have previously
received a workers' compensation award who believe they may be in need of
additional medical treatment for the work related injury are best served by
contacting the attorney who represented them in their initial workers' compensation
claim, or another attorney who practices in the area of New Jersey Workers'
Compensation Law so that a proper and timely request can be made to the
workers' compensation insurance carrier on behalf of the injured worker and
their entitlement to possible additional benefits can be protected.
Learn more about our New Jersey Workers’ Compensation practice