Understanding Workers’ Compensation
Workers’ compensation benefits were designed to protect employees for injuries “arising out of and in the course of employment.” There are essentially three parts to every workers’ compensation claim as follows:
- Employer provides authorized medical care – Other than emergency care, the employer or its insurance company has the right to select medical providers. All authorized medical care is paid in full.
- Compensation for lost wages – If an authorized treating physician mandates an injured employee to stay home from work, temporary benefits are provided.
- Total Disability – In some cases, the injury may be severe enough to qualify for some portion of total disability. Partial total disability may be awarded when a person’s injuries have not totally disabled the worker. This determination comes after a person has received maximum medical benefit.
When does the Workday Start?
Earlier, we indicated that workers’ compensation benefits are available for work-related accidents. Does this mean that an accident that occurs during a person’s daily commute is compensable? When does the workday start? In pertinent part, NJSA 34:15-36 states:
Employment shall be deemed to commence when an employee arrives at the employer’s place of employment to report for work and shall terminate when the employee leaves the employer’s place of employment, excluding areas not under the control of the employer; provided however, when the employee is required by the employer to be away from the employer’s place of employment, the employee shall be deemed to be in the course of employment when the employee is engaged in the direct performance of duties assigned or directed by the employer; but the employment of employee paid travel time by an employer for time spent traveling to and from a job site or of any employee who utilizes an employer authorized vehicle shall commence and terminate with the time spent traveling to and from a job site or the authorized operation of a vehicle on business authorized by the employer.
Compensable or Non-Compensable?
Let’s look at two basic scenarios to illustrate whether or not a claim is eligible for workers compensation:
- Employee takes the bus to the company warehouse daily. Bus is in an accident and worker is injured. Although there may be a case against the bus company or another vehicle owner, there is no workers’ compensation claim.
- Outside sales representative leaves home to visit customer and is injured in an accident. There is a claim, although there may be some investigation to ensure employee did not make personal stops.
It is not always as easy as the above examples to determine if a claim is considered work-related. The Law Offices of Anthony Carbone has represented injured workers for many years. Contact us to discuss your case.