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Can One Word Affect New Jersey Workers’ Compensation?

Can One Word Affect New Jersey Workers’ Compensation?According to experts, there are two main reasons that New Jersey Workers’ Compensation costs are frequently overpaid. The first is the failure to take a detailed past medical history. The second is a general lack of understanding of the legal implication of the term “aggravation” as it pertains to work induced injuries. When it comes to paying out workers’ compensation claims, the term “aggravated” can be problematic and costly when an authorized workers’ compensation physician determines that a worker’s preexisting injury or condition was worsened by their work activities.

Take for example, a worker with a previously known and documented shoulder condition which would eventually require surgical attention. One day while this worker was lifting heavy materials in the performance if their job duties they suddenly felt a strong pain in their shoulder. They reported the pain to their supervisor who instructed them to seek care through the employers workers’ compensation physician who orders an MRI, which shows extensive muscle tissue damage that would require corrective surgery. If the treating doctor says that the work incident “aggravated a prior condition,” most New Jersey Judges of Compensation will require the employer to pay for surgery and for any resulting loss of use.

Experts say that in many cases employers are having to wrongfully pay for costly medical procedures, surgeries and other treatment that the employee would have otherwise had to undergo eventually regardless of their work activities. This is largely because physicians have a different understanding and use for the phrase “aggravated” when describing injuries. In some cases, a physician truly means that the work act exacerbated an existing condition or injury to a new level. Yet in many cases, the authorized doctor means that the work activity simply caused “more pain” on a temporary basis with no real change in the underlying condition. When the added strain from the work activity is temporary, employers should not necessarily be held accountable for paying for surgery or permanency. Especially when the surgery was imminent.

While obtaining a thorough and detailed medical history for each employee would be preferable, The Americans with Disabilities Act places restrictions on employers when it comes to asking job applicants to answer medical questions, take a medical exam, or identify a disability. For example, an employer may not ask a job applicant to answer medical questions or take a medical exam before making a job offer. However, the law does allow employers to condition a job offer on the applicant answering certain medical questions or successfully passing a medical exam, but only if all new employees in the same job have to answer the questions or take the exam.

At Associated Specialty Insurance Agency (ASIA), we understand your clients likely have many questions about their New Jersey Workers’ Compensation coverage. Our focus over the past two decades has been exclusively in Workers’ Compensation, providing insurance agents and brokers with access to markets and programs for their clients throughout our target states of New Jersey, Pennsylvania, New York, Connecticut, Delaware, Maryland, Virginia, North Carolina, and Florida. For more information about our services and what industries we target, please contact us today at (866) 679-7457.

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