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WHAT MEDICAL BENEFITS ARE AVAILABLE IN NJ COMP?

New Jersey Workers Comp provides that an employer shall furnish medical benefits. This includes surgical and hospital services as is necessary. That is, necessary to cure and relieve the effects of an injury. And to restore the functions of the impaired member or organ where restoration is possible.

This is a fundamental responsibility of the employer. The provision for medical treatment should be quickly forthcoming. But the law allows for the employer to deny coverage, if appropriate, even after providing medical treatment. This offsets the concern of employers that providing medical treatment to an injured worker will represent an acceptance of coverage for the entire matter.
 
 
An injured worker in New Jersey should receive all reasonable and necessary medical treatment. This treatment should cure and relieve the worker from the impact of the injury. Medical treatment can include a broad array of options recommended by the authorized health care provider. These options are inclusive of, for example, physical therapy and chiropractic sessions.
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The employer or the insurance carrier pays all the medical cost. They are direct payments that go to the health care provider. This is a full benefit with no out of pocket cost to the employee. That is, no copay or deductible.
 
Each case is unique. The nature and amount of medical treatment necessary is also unique. That is, treatment must reflect the individual facts and circumstances of the case.

Who Chooses The Treating Physician?

Simply stated, the employer selects the treating physician. The injured worker does not have the right to select the treating doctor in NJ workers compensation. As such, an injured worker needs to see what is commonly referred to as an “authorized” health care provider.

There are two major exceptions. First, if there is an emergency need for medical treatment. Second, there has been a request for medical treatment that has been wrongfully denied. That is, there is a wrongful refusal to authorize treatment.

What is Reasonable and Necessary Medical Treatment?

The employer must provide reasonable and necessary medical treatment to the injured worker. While the medical benefit in NJ Comp is simple to state there are often difficulties in the interpretation. For example, what medical treatment does the injured worker need and why needed.

An experienced workers compensation attorney knows how to negotiate with the insurance company (or employer if self-insured) to get treatment authorized or how to take the matter before a Judge of Compensation for a judicial determination if necessary. Last but not least, our contact number is (856) 596-8000.

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Disclaimer

The information contained on this website is for general information purposes only. Any examples used in this website are hypothetical situations only and are included for educational purposes. Nothing on this site should be taken as legal advice or legal opinion on any specific facts or circumstances. Every case is unique. The information contained on this website is not intended to create, and receipt or viewing does not constitute an attorney-client relationship nor is it intended to substitute for the advice of an attorney. Any references to New Jersey Law may not be the most current version. Check official sites for the most current version.

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