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NJ Workers’ Comp Benefits: Medical Bill Payment Rules

NJ Workers' Comp Benefits Medical Bill Payment RulesAs a New Jersey Workers’ Compensation Benefits professional, you likely already understand the three benefits that NJ Workers’ Comp recipients are entitled to when they get hurt at work; payment of temporary disability benefits or wage replacement, payment of an award of permanent disability, and payment of medical bills. This last factor is an important part of the New Jersey Workers’ Comp statute, and an important matter for your Workers’ Compensation clients to understand.

The New Jersey requirement for medical bill payments is that the employer provides medical treatment that is reasonable, necessary, related to the worker’s injury and is designed to cure the worker’s condition. Under New Jersey Workers’ Compensation law, the worker is not permitted to seek treatment with their primary care doctor or specialist without the prior consent and approval of their employer and the Workers’ Compensation carrier. As such, the employer is obligated to pay 100% of the bills.

It’s also important for New Jersey employers to understand that the state is a no-fault state for Workers’ Comp. This means that their workers can receive benefits regardless of who was at fault for their injury, even if it was the worker themselves that made a mistake that led to their injury. On the other hand though, the worker cannot sue for negligence if the employer is found to be at fault for the injury.

In the course of receiving their Workers’ Comp benefits, the employee will not have to pay any deductibles, co-pays, or out of pocket expenses. This includes prescription medications and any other medical devices prescribed by the authorized doctor. In the absence of broken bones or other severe medical conditions, the treatment for New Jersey Workers’ Comp claim injuries is typically conservative.

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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