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 beentitled 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 initialworkers’ 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 an 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: Workers’ Compensation Disability Benefits