Closed Period of Disability

If you have been disabled for a period of time and return to work you still may qualify for Social Security Disability Benefits.  The Social Security Administration defines a closed period of disability as “the period of disability with a definite beginning date and a definite ending date. . . . ”  Program Operations Manual System (POMS) DI 25510.001.

Many people return to work following a period of disability because their health or injuries improve.  Some have no choice because they need an income to survive.  Generally if a person is unable to work for a period of 12 months or more and meets the medical requirements he or she may be eligible to receive Social Security Disability Benefits.

If I get hurt at work can I go to my own doctor?

When you get injured at work it can be very stressful.   Unsettling questions may run though your mind:

“Do I have a serious injury?”

Is my injury permanent?”

“Will I be out of work?”

 Often, the last thing you want to think about is dealing with your employer’s workers’ compensation insurance company in order to schedule your treatment. One of the most common questions I get as a certified Workers’ Compensation Law attorney is:

“I’ve gotten hurt at work, can I go to my own doctor?”

In New Jersey, NJSA 34:15.15 allows you to see your own doctor if it is an emergency.  You can also go to the emergency room.  However, as soon as possible after your emergency medical visit you are required to let your employer’s workers’ compensation insurance company know about your injury.  

Did you know that by law the insurance company has the right to control your treatment?  This means the insurance company gets to pick the medical providers and specialists you are allowed to see.  The insurance company does not always have your best interest in mind, but rather is more interested in saving money.

An important fact to remember is the workers’ compensation law does not assign fault to a work injury.  In other words, even if you get hurt at work and it is your own fault, you are still covered by workers’ compensation.  However, one of the trade-offs for you being covered regardless of who caused your injury is that your employer, through their insurance company, gets to pick your doctors.  As long as the insurance is providing you medical care it is difficult for you to switch or change doctors.  However, if the insurance company refuses to provide you with treatment or abruptly terminates your treatment a Motion can be filed with the Court seeking an order to compel the insurance company to provide medical treatment or to reinstate your treatment.

What is a Certified Workers Compensation Law Attorney?

A Certified Workers Compensation Law Attorney is a designation granted by the New Jersey Supreme Court to attorneys who are able to demonstrate sufficient levels of experience, education, knowledge, and skill in workers’ compensation law practice. The Supreme Court, through its Board on Attorney Certification, designates only those lawyers who are able to meet the standards set by the Board and approved by the Court.
A certified attorney is more than just an attorney who specializes in a particular area of law.

A New Jersey attorney who is certified by the Supreme Court must have:

• Been a member in good standing of the New Jersey bar for over 5 years
• Fulfilled ongoing continuing legal education requirements
• Demonstrated a substantial level of experience in workers compensation law
• Been favorably evaluated by other attorneys and judges familiar with his or her work
• Taken and passed a written examination in workers compensation law

Source: Board on Attorney Certification

If Medicare pays for my treatment will it affect my workers compensation claim?

A Medicare beneficiary with a pending workers compensation claim may be required to reimburse Medicare some or all of their workers compensation benefits. The Centers for Medicare and Medicaid services “CMS” administers all Medicare payments to medical providers. Payments for medical conditions, which are the result of work related injuries or exposures, are considered “conditional payments”. These payments by Medicare are made on the condition that if an injured worker receives workers compensation benefits Medicare is entitled to make a claim for reimbursement. Therefore, it is very important to consider your legal rights and obligations when seeking medical treatment through Medicare while you have a pending workers compensation claim. Your employer or their insurance company must be put on proper notice before seeking treatment through Medicare. This is so even if your workers compensation claim is denied or any further treatment has been denied.

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