So far, 2019 has been a good year for first responders in New Jersey.
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Medicaid Liens and Workers’ Comp
In today’s economic climate many people do not have or cannot afford health insurance through their employer. In situations such as this, it is very often the case that the individual is covered by a state program involving Medicaid.
Medicaid is need-based, and in reality, it is a federal program administered by the state. Medicaid is intended to be used for non-work related conditions only. If a worker is injured on the job who happens to be covered by Medicaid, it is absolutely necessary to avoid using Medicaid for treatment.
Liens Attaching to Injured Workers’ Compensation Claims – The Veterans Administration
The Veterans Administration provides medical coverage in many instances to veterans of the United States Armed Forces. Like Medicare, it is a federal program, and like Medicare, has the ability to lien a Workers’ Compensation file and seek repayment for any amounts the V.A. feels have been made for a work-related condition.
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Medicare Liens Attached to a Workers’ Compensation Claim
The second lien type I will be discussing in this series of blogs is Medicare. Medicare is a benefit under federal law which, in most cases, is provided to an individual either by that individual reaching 65 years of age or by that individual being found to be eligible for Social Security Disability benefits.
Social Security Disability recipients are eligible for Medicare in most cases after a two-year waiting period. Medicare has the right under federal law to recover any money they pay for medical treatment which they feel is something which should have been paid by a workers’ compensation insurance carrier.
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ERISA Liens from Medical Treatment – Do I Have to Repay Them?
One of the things we try to warn clients about early in a case is being sure that they treat only with authorized physicians, that is, physicians who are appointed by your employer or your employer’s workers’ compensation insurance company.
Under New Jersey law an injured worker does not have the right to choose a treating physician when an injury is accepted as work related by his or her employer. Treatment must be provided by the employer, an important provision of our Workers’ Compensation Act originally enacted in 1911. That Act incorporated a compromise which allowed employers to choose the doctors as a cost saving measure, in return for the injured worker not having to prove that he or she was not negligent, and not having to prove that the injury was someone else’s fault.
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Is a Petitioner in a Workers’ Compensation Claim Able to Obtain Copies of His or Her Authorized Treating Records?
Many people who have filed a Worker’s Compensation claim in New Jersey ask whether they are entitled to copies of their treating medical records from the health providers authorized by their employer’s insurance carrier. The answer is yes. Under the Worker’s Compensation Act, specifically NJSA 34:15-128.4, it is unlawful for an employer, insurance carrier or
Can Your Employer’s Insurance Company Send You to an “Independent Medical Exam” While You Are Still Under Insurance Company Physician Care?
This issue arises more and more in our practice. Insurance companies and self-insured employers frequently schedule these “IME”s during the course of authorized treatment, often while the injured employee is still out of work and receiving temporary disability payments. Sometimes the reason for the exam is quite legitimate. If a worker has sustained a serious
Can an Injured Worker With an Underlying Degenerative Condition Collect?
Does the NJ Worker’s Compensation Act allow an injured worker with an underlying degenerative condition to collect worker’s compensation benefits if the condition is aggravated in an accident at work? The answer is yes. Under the Act and case law an injury can be compensable by original causation, aggravation, acceleration or exacerbation.
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Idiopathic Falls at Work -Are They Compensable?
A worker passed out at work. She was working on a copier when she passed out and fell due to a personal medical condition completely unrelated to work. When she passed out she struck her head and shoulder on the concrete floor, suffering a concussion and fractured collarbone.
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Workers’ Compensation for Cardiovascular and Cerebral Injuries
What are the factors a court will review in deciding if an on-the-job heart attack is compensable?
The New Jersey Workers’ Compensation Act has a specific provision addressing cardiovascular and cerebral vascular (stroke) injuries. Section 7.2 of the Act provides, “In any claim for compensation for injury or death from cardiovascular or cerebral vascular causes