The Importance of Being Honest in NJ Workers’ Compensation Cases

Workers’ Compensation Attorneys Serving Clients in Princeton, Ewing, Hamilton, Pennington and across Mercer County, NJ

The Importance of Being Honest in NJ Workers' Compensation CasesThe concept of insurance fraud continues to find its way into the New Jersey Workers’ Compensation claims. Insurance carriers are now directing their lawyers to pursue fraud claims against injured employees as a means to terminate medical and monetary benefits. However, the nature of this fraud does not always lie in acts that could be recognized as “obvious.” An obvious example would be when an employee exaggerates the severity of their medical condition and is later found engaging in activities inconsistent with the nature of their complaints. Another obvious example is when an injured employee is found collecting money while engaged in a work-related activity which is more strenuous than the work they performed for their employer.

Legitimate Claims and Disabled Employees

Unfortunately, there are allegations of fraud being made against disabled employees with legitimate claims. These employees are complying with the instructions of their treating physicians and adhering to the directions of their insurance adjusters. Nonetheless, the insurance carriers are attempting to terminate their obligation to provide benefits by invoking N.J.S.A. 34:15-57.4. This is a New Jersey law holding that an employee is guilty of fraud if they file a workers’ compensation claim for medical or temporary disability benefits when they know that the claim contains false or misleading information. A violation of this statute under the New Jersey Criminal Code is a crime of the fourth degree, which could subject the person to a sentence of up to 18 months in county jail. The penalty in workers’ compensation court is the termination of all benefits and an order to repay back the benefits already received.

Insurances Carries and Fraudulent Actions performed by employees

Insurance carriers in New Jersey are bringing fraud actions when they believe they can prove that an employee knowingly failed to reveal prior injuries, accidents, or other claims. This is because the employee filing the claim has an obligation to notify either the treating physician, the evaluating physician, or the insurance carrier insuring their employer of these other factors.

The success or failure of the insurance carrier’s approach in these cases is almost completely in the hands of the workers’ compensation judge who is assigned to the case.

However, there is some guidance for judges when confronted with a fraud claim.

  • First, the alleged infraction must be more than an inaccurate or inconsistent statement made during the course of treatment. Many people cannot recall the names or dates of physicians who treated them for injuries in the past – especially those individuals with a lengthy personal injury history.
  • Second, the alleged infraction must be more than an omission of prior diagnoses to their treating physician. Many people cannot recall all of the tests performed or their test results. It is enough that the injured employee informs his treating doctor that they had a prior injury to the area of the body which they are alleging arose out of the work-related accident.

Keep in mind that major treatment, such as surgery or the recommendation for surgery, is also information that should be shared with your physician. This is common sense, as you want your doctor to know your complete history so that you can receive the very best treatment available to you.

As a general rule, if you are injured at work, you need to be honest with your doctors. Follow their directions and restrictions at all times.

Contact our Trenton Personal Injury Staff of Attorneys

If you have any questions about your obligations when injured, please contract Kamensky, Cohen & Riechelson we have experienced attorneys in Princeton, Ewing, Hamilton, Pennington and across Mercer County, New Jersey.

Don´t hesitate to schedule an initial consultation by calling (609) 528-2596 or visiting our website and fill out an online form.

Man Gets 15 Years for Aggravated Manslaughter in Trenton, NJ

A Burlington NJ man was recently sentenced to serve 15 years in New Jersey State Prison for killing a man.

The 22-year-old defendant shot the 20-year-old victim to death in 2011. The incident took place in Trenton, New Jersey.

Police said that the defendant shot the victim while the victim sat in a car near the intersection of Hart Avenue and Hurley Street in Trenton. After the shooting, the victim was taken to nearby Capital Health Regional Medical Center; he was pronounced dead a short time later.

The homicide reportedly stemmed from an argument between the defendant and the victim. According to authorities, the argument occurred one day before the shooting.

The defendant was arrested and charged with murder. He later pleaded guilty to aggravated manslaughter charges.

During the sentencing hearing, the defendant apologized to the victim’s family. Several members of the victim’s family were present in the courtroom when the defendant told them that he understands the pain they are going through.

Part of the plea deal also calls for the defendant to receive mental health treatment while he is incarcerated. The defendant has reportedly been diagnosed as a paranoid schizophrenic. The judge acknowledged the defendant’s mental state during sentencing; he observed that the defendant stopped taking much-needed medication sometime after childhood.

Remarkably, while the victim was awaiting trial, he reportedly assaulted a fellow inmate at the Mercer County Jail. As a result, the defendant has also been sentenced to 5 years in prison for aggravated assault. However, the sentence will run concurrently with his 15-year sentence for the aggravated manslaughter conviction.

For additional information about this case, read the NJ.com article entitled “Burlington Man Gets 15 Years in Prison for 2011 Trenton Slaying.”

Charges Filed in Princeton NJ School Bus Crash

The driver of a vehicle involved in a serious school bus crash in Princeton NJ has been charged with multiple traffic violations.

According to authorities, the 26-year-old Morris Plains resident was driving a 2011 BMW 328i north on Route 26 when he rounded a curve and struck a school bus.

Police believe that the driver crossed a double-yellow line while rounding a curve on the highway just past Hutchinson Drive. The driver reportedly lost control of the vehicle and struck the left front bumper of the bus, which was traveling south on Route 26. The bus was reportedly heading to Ewing, New Jersey.

Authorities said that the collision caused the bus to flip on its side. Meanwhile, the BMW spun out of control before coming to a stop.

Four people were injured in the accident: the driver of the BMW and three people who were on the bus. One of the people injured was a 16-year-old student at Rock Brook School. Everyone who suffered injuries was taken to Capital Health Regional Medical Center in Trenton, where they received medical treatment. Thankfully, no one suffered life-threatening injuries.

Princeton police and the Mercer County Prosecutor’s Office conducted a thorough investigation to determine the cause of the crash. It was eventually decided that the driver of the BMW should be charged with careless driving and failure to keep right.

At this time, police still do not know if excessive speeding played a factor in the accident.

For more information, access the NJ.com article entitled “Charges Filed in School Bus Crash in Princeton.”

Authorities Investigating House Fire in Hopewell Township, NJ

Hopewell Township authorities are investigating a fire at an unoccupied house.

Hopewell NJ police received a report of a structure fire at a house on Elm Ridge Road. Hopewell police officers and Pennington firefighters then responded to the scene.

When police and firefighters got to the house, they found flames in the kitchen and the living room. The firefighters worked quickly to extinguish the flames.

Several firefighting units assisted with the effort to put out the fire. The other units included crews from Pennington Fire Company, Hopewell Fire Department, Lawrenceville Fire Company, Union Fire Company, and Lawrence Road Fire Company.

The Pennington First Aid Squad also went to the scene to assist in the event of any injuries. Thankfully, there were no reports of injuries to any of the firefighters. However, police did reveal that the house sustained significant damage due to the fire.

Authorities from several departments are actively investigating the incident to determine whether arson was involved in the fire. Among the investigating agencies are the Hopewell Township Police Department, Hopewell Valley Emergency Services, the Mercer County Fire Marshal’s Office, and the Mercer County Prosecutor’s Office.

For additional information, check out the NJ.com article entitled “Authorities Investigating Unoccupied House Fire in Hopewell Township.”

Princeton Woman Injured in Single-Vehicle Car Accident

Police in Princeton NJ are investigating a traffic accident that resulted in a local woman being hospitalized.

According to authorities, the 56-year-old victim was driving her 1997 Ford Expedition on Mercer Street near Hale Drive when she lost control of the vehicle and skidded off the road.

The SUV ultimately came to a stop when it struck a large, uprooted tree on the side of the road.

Sometime later, emergency responders arrived at the scene and found that the woman was trapped inside the vehicle. The emergency responders eventually removed the woman from the SUV.

Police said that the driver suffered minor injuries in the accident. After the driver was extricated from the vehicle, she was transported to University Medical Center of Princeton at Plainsboro, where she received medical treatment for her injuries.

In addition to causing bodily injuries to the driver, the accident also resulted in extensive damage to the front end of the SUV.

Police had to shut down Mercer Street for roughly one hour after the accident. Once the woman was taken to the hospital and the debris was removed from the street, police reopened the road for traffic.

Princeton police indicated that the accident is currently under investigation. At this time, the driver has not been charged with reckless driving or careless driving.

To learn more, check out the NJ.com article entitled “Princeton Woman Hospitalized After Crashing into Tree.”