If you've been injured on the job in New Jersey, you might be wondering about the type of medical care you're entitled to under workers' compensation. New Jersey law ensures that injured workers receive medical treatment, including hospital care, to help them recover from work-related injuries or illnesses. In the following sections, JFM Law will explain your rights under New Jersey workers' compensation laws, the level of hospital care you can expect, and how our NJ workers' compensation lawyers can help you through the process.
New Jersey Workers' Compensation Lawyer
If you’ve been hurt on the job, getting the medical care you need shouldn’t be a battle. In New Jersey, workers’ compensation is there to help, but sometimes getting access to that care can be harder than it should be. If you’re facing delays or denials of the benefits you’re entitled to, you don’t have to handle it alone. Let JFM Law help you understand your rights and fight for the care you need. Call (732) 333-6621 or reach out online for a free consultation. Our workers’ comp attorneys have offices in Freehold, Toms River, and New Brunswick, and we’re here for injured workers across New Jersey.
Common Work Injuries Resulting in Hospital Stays
The most common work injuries requiring hospitalization include fractures, head injuries, and severe lacerations, often resulting from falls, slips, or machinery accidents. Workers in construction and manufacturing are particularly vulnerable to these incidents. Traumatic brain injuries from falling objects or machinery mishaps can lead to extended hospital stays. Burns from chemicals, fires, or electrical accidents also require immediate and intensive medical care. Crush injuries, caused by heavy equipment or falling materials, can result in significant damage to bones and tissues, necessitating surgery. Lastly, repetitive stress injuries, while often chronic, sometimes require surgical intervention, leading to hospitalization.
Introduction to Workers' Compensation in New Jersey
Workers' compensation in New Jersey provides benefits to workers who suffer injuries or illnesses while on the job. These benefits cover medical treatment, temporary disability payments, and compensation for permanent disability if your injury causes lasting harm. But one of the most critical benefits provided is access to medical care, which includes hospital services.
Under New Jersey law, your employer or their insurance company is responsible for covering all necessary and reasonable medical treatment related to your work injury. This includes hospital stays, surgeries, prescriptions, and follow-up treatments.
Who Pays for Your Hospital Care After a Work Injury?
NJ Statutes § 34:15-15 says that employers must provide medical treatment "necessary to cure and relieve the worker of the effects of the injury." If you're hospitalized as part of your treatment, your employer (or their insurance carrier) will pay for that hospital care.
You don’t have to worry about co-pays, deductibles, or other out-of-pocket expenses that would typically come with medical treatment. The goal of workers' compensation is to take care of your medical needs so you can focus on recovery and getting back to work if possible.
What Type of Hospital Room Are You Entitled to?
One of the key questions you might have is about the quality of care you can expect in the hospital. Under NJ Statutes § 34:15-15.2, you are entitled to "semi-private" room care at the hospital. This means that, at a minimum, you will be in a room shared with one other patient. If a semi-private or private room is available, the hospital cannot place you in a lesser-quality room.
In other words, you won’t be placed in a large ward or a crowded room just because you’re receiving care through workers' compensation. The law ensures that you get the same standard of care that any other patient would receive in similar circumstances.
What Happens if the Hospital Bills You?
You might be worried about getting bills from the hospital or medical providers, especially if they seem to be coming directly to you. However, under NJ Statutes § 34:15-15, medical providers are not allowed to bill you directly for services related to your work injury. All costs are supposed to be covered by your employer or their insurance company.
If a medical provider tries to collect unpaid bills from you, they could face penalties. NJ Statutes § 34:15-15 prohibits medical providers from reporting unpaid charges to credit agencies or sending those bills to collections until a judge has fully decided the matter. If you find yourself receiving bills for treatment covered by workers' compensation, you should notify your employer and their insurance carrier immediately. They are responsible for resolving any billing issues with the hospital or doctors.
Can You Choose Your Own Doctor or Hospital?
In New Jersey, your employer or their workers' compensation insurance carrier has the right to choose the doctor or hospital that will treat you after a work injury. This means that you cannot simply go to any hospital or doctor you prefer unless it’s an emergency.
However, if your employer refuses or neglects to provide medical treatment, or if the situation is urgent and they can’t be reached, you have the right to seek medical care on your own. In emergency situations, the law recognizes that you may not have the time to wait for employer approval. If you do go to a hospital or doctor without prior approval due to an emergency, you must notify your employer as soon as possible, according to NJ Statutes § 34:15-15.
Emergent Medical Care: What If You Need Immediate Help?
If you’re in a situation where you need immediate medical care and your employer isn’t providing it, New Jersey law allows you to take action. Under NJ Statutes § 34:15-15.3, if your doctor determines that you need emergency medical treatment and your employer or their insurance carrier isn’t authorizing it, you can file a motion for emergent medical treatment with the Division of Workers’ Compensation.
This motion can be filed at the same time as your initial claim or afterward, and it requires that your doctor provide medical documentation explaining the nature of the emergency and the risks of delaying treatment. The Division will then hold a hearing within five days to decide whether you should receive the treatment. If approved, your employer will be required to cover the costs.
Are There Limits on the Amount of Medical Care You Can Receive?
In some cases, employers might try to argue that certain treatments or hospital stays are not necessary. Under NJ Statutes § 34:15-15, medical treatments must be "necessary" and "reasonable" to cure or relieve the effects of your injury. If your doctor believes that you need additional care or treatment that exceeds a certain cost, they have to submit a petition to the Division of Workers' Compensation.
The Division will then investigate whether the additional care is required and make a decision. If they determine that the treatment is necessary, your employer will be required to cover the cost. This ensures that you aren’t cut off from necessary medical care, even if the costs are higher than expected.
What Happens if You Refuse Treatment?
Sometimes, injured workers may refuse certain medical treatments recommended by the employer's chosen doctor. Under NJ Statutes § 34:15-23, if you refuse treatment that is deemed necessary by the employer's doctor, the employer can file a petition with the Division of Workers' Compensation. If the Division determines that the treatment is necessary, they can order you to comply.
If you continue to refuse, the Division has the authority to reduce or modify your workers' compensation benefits based on the evidence. This is why it’s important to carefully consider the recommendations of the treating doctor and consult with a workers' compensation attorney if you have concerns about the treatment plan.
How a Workers' Compensation Lawyer Can Help You
Navigating the workers' compensation system in New Jersey can be overwhelming, especially when it comes to understanding your medical and hospital care rights. This is where a workers' compensation lawyer can be an invaluable resource.
Here’s how a lawyer can help you:
- Ensure You Receive Proper Care: A workers' compensation lawyer can help make sure that your employer is providing the necessary medical treatment, including hospital care. They can push back if your employer or their insurance carrier is refusing to cover treatments or hospital stays that your doctor says are necessary.
- File Motions for Emergent Care: If you need emergency medical treatment and your employer isn’t providing it, your lawyer can file a motion with the Division of Workers’ Compensation on your behalf. They will gather the necessary medical documentation and represent you at hearings to ensure you receive the care you need without unnecessary delays.
- Challenge Denied Treatments: If your employer’s insurance company denies medical treatments, a lawyer can help challenge these denials through the appropriate legal channels. They can argue before the Division of Workers' Compensation to prove that the treatments are necessary and reasonable.
- Resolve Billing Issues: If you’re being wrongfully billed by hospitals or doctors for treatments related to your work injury, your lawyer can step in to resolve these issues. They will make sure that you’re not held financially responsible for medical care that should be covered under workers’ compensation law.
- Protect Your Rights in Refusal Cases: If you disagree with a treatment plan recommended by the employer's chosen doctor, a workers' compensation lawyer can help protect your rights. They can argue your case before the Division of Workers’ Compensation to ensure you’re not penalized for refusing unnecessary or harmful treatments.
Frequently Asked Questions
Who pays for medical care if I'm injured at work?
Your employer or their workers' compensation insurance covers all necessary medical expenses, including hospital care.
Do I have to pay out-of-pocket for my hospital care?
No, workers' compensation covers all costs; you don’t pay co-pays or deductibles.
Can I choose my own doctor or hospital?
No, your employer or their insurance selects the medical provider unless it's an emergency.
What type of hospital room am I entitled to?
You are entitled to a semi-private room, not a lesser-quality one.
What happens if the hospital bills me directly?
Medical providers cannot bill you directly. Notify your employer and their insurer immediately.
What if I need emergency care and can't contact my employer?
You can seek emergency care and notify your employer as soon as possible.
Are there limits to the medical care I can receive?
Treatment must be necessary and reasonable, as determined by your doctor and the Workers' Compensation Division.
What if my employer's doctor recommends treatment I don't want?
Refusing recommended treatment could reduce your benefits, but consult with a doctor and the Workers' Compensation Division first.
How soon will I receive emergency medical treatment if needed?
You can file a motion for emergent treatment, and a hearing will occur within five days.
What happens if my employer denies my medical treatment?
You can challenge the denial through the Workers' Compensation Division to secure necessary treatment.
Workers' Comp Attorney in New Jersey
If an injury at work has left you struggling to get the medical care or benefits you deserve, it’s important to know that help is available. Sometimes, the system doesn’t work as it should, leaving injured workers with bills or delays in their treatment. You don’t have to deal with that on your own. JFM Law workers’ compensation lawyers understand what you’re going through and are ready to help you get the care and support you need. Whether you’re just starting your claim or facing a denial, reach out today at (732) 333-6621 or online to schedule a free consultation and take the first step toward securing the benefits you’re entitled to.