We haven’t spoken about the New Jersey Workers’ Compensation system in a little while and there is still a great amount of information regarding the available benefits that all public safety officers and first responders should be made aware of. With that being said, let’s talk a little about medical benefits under the New Jersey Workers Compensation Act.
Under the New Jersey Workers’ Compensation system, the injured employee is entitled to reasonable and necessary medical treatment to cure and relieve the effects of the injury, illness, or condition that occurred either on the job or as a result of the job. In New Jersey, due to the fact that the employer is responsible for payment of 100% of the injured worker’s medical treatment associated with the workplace injury, the employer has the right and ability to control treatment. What this means, is that the employer or the employer’s workers’ compensation insurance carrier will select the doctors that will treat the injured worker for his or her injury.
When the injured worker is treated by medical physicians that have been chosen by the employer or the employer’s insurance company, this treatment is commonly referred to as “Authorized Treatment”. However, if the injured employee receives treatment for his or her workplace injuries from physicians, doctors, or hospitals that have not been chosen or authorized by the employer or the employer’s insurance company, this particular treatment is referred to as “Unauthorized Treatment”.
The New Jersey Workers’ Compensation Act only requires employers to make payment for “authorized treatment” in a New Jersey workers’ compensation case. Therefore, should an injured employee obtain treatment from physicians or medical providers that have not been chosen by their employer or their employer’s insurance company, he or she may be responsible for paying these medical bills out of his or her own pocket.
It is important for an injured employee to understand that the only medical treatment that has to be provided under The New Jersey Workers’ Compensation Act is treatment that is medically necessary to cure and relieve the effects of the injury or condition. Palliative medical treatment does not have to be provided by the employer. Palliative medical care has been described as medical care or treatment that concentrates on reducing the severity of pain associated with the injury, rather than halting or delaying the progression of the injury itself. To clarify, palliative medical treatment is care that provides pain relief only. It is not medical care or treatment that will improve the medical condition of the injured worker.
Medical treatment under the New Jersey Workers Compensation Act must continue until one of two events occurs; the employee is returned to work, or in the alternative, a doctor declares that the employee has reached maximum medical improvement or “MMI”. When one of these two events occurs, medical benefits and temporary total disability benefits will cease, and the injured employee’s claim will move to the establishment of a permanent disability rating and thus the settlement of the case. We will discuss permanent disability and partial total disability in a later entry.