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  1. #1
    Join Date
    Feb 2009
    Posts
    4

    Default Jurisdiction? Live/Work Mostly in NJ. Hurt Working in NY

    I work for a large global company. I live in New Jersey and most of my work is in NJ. I travel to various locations in NJ depending on customer demand for service.
    My regional office is in NY but rarely go there. I was hurt while moving and installing some heavy equipment in NEW YORK. I reported it to my mgr (NJ) and employee health nurse (west coast.) I was told that Gallagher Bassett in NJ was the office handling my claim. After finally getting through and a response they said my company wasn't handled by their office but I had to get in touch with a Pennsylvania office.

    I had been hurt (2 different occasions) on the job several years ago (same company) both times in NY. I was then directed to deal with Gallahger Bassett in NY (syracuse.) I'm not sure why but it seemed the rationale was that the accident happened in NY.
    There was no excess loss of worktime except for a few days handled as sick time. Medical bills and prescriptions seemed to be settled without much fuss.

    My question is this time who has jurisdiction and how does it work?

    This time the injury is more serious (back injury and severe pain.) There will be lost time from work on my doctors orders. I have passed the sick time limit of a few days and now am on short term disability.
    I saw my physician, got meds, had an MRI, saw my physician again, different meds, and the DR. wants me to visit an ortho dr.

    Any ideas on how jurisdiction is established. Should the claim go through the NY workmans comp? Or should it be NJ? Why am I dealing with an office in PA?

    To add to things It is over 10 days since I reported this and the insurance co. (PA office) has not issued a claim number. The case mgr says they are having coding problems.


    They have also selected the ortho dr for me to visit. Not one suggested by my physician and not particularly nearby. But in their network.

    I asked today for a list of ortho doctors in their network so that I might find one more convenient. No response yet.
    I will check their website.

    Any ideas or suggestions.

    Thanks
    Last edited by pogobird; 02-20-2009 at 02:22 PM. Reason: grammar spelling

  2. #2
    Join Date
    Oct 2006
    Posts
    9,108

    Default Re: Jurisdiction? Live/Work Mostly in NJ. Hurt Working in NY

    oftentimes there is multiple jurisdictions available -
    generally based on residence or where injury occurred. you may get your choice if you want to file litigation. i suspect the employer have may already filed with one or the other.

    how and where the claims administrator assigns caseloads and claims is up to them and not covered by comp law.

  3. #3
    Join Date
    Jan 2007
    Location
    PA, but worked in NJ
    Posts
    667

    Default Re: Jurisdiction? Live/Work Mostly in NJ. Hurt Working in NY

    Hey Pogobird, At your work breakroom you will see next to wage an hour statement under the right to know law if in NJ the company responsible for work injuries

    You may be hurting self by taking short term disability as this is for non occupational injuries for which you claim this is???

    Honestly if I know why you reported this to a NJ MGR I may have a better clue as to who should hold jurisdiction. In considering you had a similar situation and it was NY jurisdiction I would imagine it would be NY again???

    In any case you must report this as a work injury to protect your rights under what ever jurisdiction is covering.

    Once jurisdiction is established and should it be NJ please come back as then I can help you. PA -NJ-NY WC are different as night from day.

    BUG

  4. #4
    Join Date
    Jan 2007
    Location
    PA, but worked in NJ
    Posts
    667

    Default Re: Jurisdiction? Live/Work Mostly in NJ. Hurt Working in NY

    I may have mis wrote above as I should have put "Typically employer sponsored Short/Long term disability plans usually are for non occupational injuries" and all work injuries fall under the WC law of the jurisdiction in which applies.

  5. #5
    Join Date
    Feb 2009
    Posts
    4

    Default Re: Jurisdiction? Live/Work Mostly in NJ. Hurt Working in NY

    bugman, thanks for your reply.

    At your work breakroom you will see next to wage an hour statement under the right to know law if in NJ the company responsible for work injuries

    Breakroom is probably in my regional office in NY (Westchester area) that I rarely (once a year maybe) go to. Would that wage hour statement be in that office in NY?

    "Typically employer sponsored Short/Long term disability plans usually are for non occupational injuries" and all work injuries fall under the WC law of the jurisdiction in which applies.

    After reporting the injury to the company occupational nurse (west coast) she indicated the need to apply to the Claims Management Service Group that handles the Short Term DisabilityBenefit for my company. There is a salary continuance program that I think is combined with the STD benefit that provides for full salary while out from work, short term.
    If I apply to the state for benefits those payments would be turned over to the company since they would cause my benefit to be over my regular salary.

    As per company policy I reported the injury to the occupational nurse (west coast) and my regular manager who is in New Jersey. I work 95% or more in NJ; live in NJ; but was helping on a job in NY when the injury occured.

    Prior times I regularly worked in NY and reported to a mgr in Connecticut but I always lived in NJ. His area covered CT and some of NY. (complex huh?)



    In any case you must report this as a work injury to protect your rights under what ever jurisdiction is covering.

    Report to whom? My employer and their agents or the State I live in.



    Thanks alot for your time and info. You seem knowledgeable and helpful on this site.

  6. #6
    Join Date
    Feb 2009
    Posts
    4

    Default Re: Jurisdiction? Live/Work Mostly in NJ. Hurt Working in NY

    .SH,

    I don't clearly understand your post.

    Jurisdiction based on residence, NJ, vs place of injury, NY, is my question. Complicated by the fact that the insurance company office I am dealing with is in PA.

    Litigation?? I'm not sure. If things get messy and insurance co refused to pay then its a possibility. I hope that my time out is short and recovery swift, physical therapy already scheduled and meds are continued, and I will be back at work.


    Even the company occupational nurse thought the claim would be handled in NJ or NY. Why PA?? She has sent an inquiry the the insurance co as tho why PA but no answer yet.
    I doubt she will get one.

    Thanks.

  7. #7
    Join Date
    Jan 2007
    Location
    PA, but worked in NJ
    Posts
    667

    Default Re: Jurisdiction? Live/Work Mostly in NJ. Hurt Working in NY

    Hi Pogo,

    I must be honest with you, your situation is very unique, and the post from SH may have much merit as to
    his statement "oftentimes there is multiple jurisdictions available " and it just may be the option of your employer to chose the jurisdiction.

    As for finding the WC carrier info this, is the NJ law and will only apply to NJ. It would be next to the wage an hr info in ANY NJ office. So if your break room is in NY. I cant be sure if that will apply??

    Yes I understand what you are saying that occ. nurse said to report this to STD, and for sure you will do much better there in the short term, as you most likely will get higher pay while out. As long as you make it clear to the STD that you were hurt at work, then I see no issue with going this route. however if this should turn out to be something totally disabling that's where the red tape becomes HEAVY??

    It does appear to me that this would be considered under NJ WC. With that said, if your company will be OK with your injury falling under STD as well as LTD if needed, then that's a benefit most do not have in NJ, GOOD FOR YOU!!!

    Report to whom to any who ask. Im sure there is paper work involved with STD/LTD this is where you must be clear where the origin of the injury was. As you said you have reported this to your employer, and may even have filed an incident/accident report to them. Its ALWAYS a good ideas to make copies of these documents and to whom you submitted it to. Its not unheard of from NJ employers to become absent minded when/if this should turn out to be a huge liability .

    A great source of information should be in your employee handbook or better yet work agreement or Union contract if you have one. I am unaware of any law in NJ that would forbid you to get eligible for STD as long as the employer sponsored plan allows this.

    Definitely get back with the Pa office to see if they have "decoded" the coding issue. I'm sure they did have a difficult time coding this!!!!! My concern is you dont want their coding problems become your legal problems, as far as your rights under WC are concerned. I hope for your sake this is a PA claim as Pa is more worker friendly as far as WC is concerned, but each state has its pros and cons, and pa seems to have more pro worker than NJ. To me NJ is the worst place to be hurt and their WC is much more difficult as well as political.

    You cant collect WC along with STD or any other disability plan that supplements your income, as that's called double dipping and is a NO No.You can use any insurance that covers stuff like house/car payments You cant get more than your reg salary. I think NJ is 60% of reg salary but if you have an employer plan that offers better you can opt for that, as its a benefit that you have earned while being employed there. in any case its your responsibility to make sure you are protected. Its no surprise to me to hear one tell me that their employer is flat out lying to cover their butt when an injury at work is concerned.

    So I would say getting to the bottom of the coding issue and getting your claim # is priority 1. If your employer says you are eligible for STD while out from work injury as I said Good for you. Just make sure you are authorized to receive medical treatments as well for this injury, this is where jurisdiction becomes more relevant, save any and all documents related to this as you never know whats important until you needed it??

    Thanks for your confidence, and I do take these issues very seriously, as they can be life altering. I hope you will come back and share with us what the decoding issue really is?? That's what I am most curious about.

    BUG

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