When a New Jersey worker suffers a work-related injury, the employer is generally required to furnish that worker with relevant medical care that is “necessary to cure and relieve the worker of the effects of the injury” [see N.J. Stat. § 34:15-15]. Some insurance companies (and self-insured employers) are reluctant, however, to pay for medical treatment, such as long-term pain management, on the grounds that such care is merely “palliative.” Within most medical circles, palliative care is ordinarily understood as treatment that provides relief for the injured worker, but which does not cure the underlying condition itself. What is the employer’s responsibility when it comes to providing such medical treatment?
Workers’ Compensation is Not Supposed to be “a Word Game”
Contrary to what claims representatives at some insurance companies want you to believe, workers’ compensation law doesn’t play “word games.” It isn’t the label that controls the situation, as the employer in the landmark New Jersey case of Hanrahan v. Township of Sparta discovered. In that case, a police officer was injured in an automobile accident during the course of his employment. The employer subsequently objected to continued medical treatment, arguing that it would not result in a cure. The court said the issue wasn’t whether the treatment was “palliative,” that as long as there was a showing by competent medical testimony that the treatment was “reasonably necessary to cure or relieve the effects of the officer’s injury,” it should be provided [emphasis added].
Provision for Pain Management is not the Same as Paying Damages for “Pain and Suffering”
Another tactic taken by some insurance claims representatives relates to the long-standing rule within workers’ compensation law that there can be no recovery for “pain and suffering.” The insurance representative may accordingly argue that it cannot pay for pain management treatment because of that prohibition. Such a position ignores the fact, of course, that providing such care to an injured worker is not at all the same thing as compensating a worker for his or her pain and suffering. The payment is made to the health care provider, not directly to the injured worker.
Absolute Cures Often Are Not Possible
Workers’ compensation benefits are never linked to absolute cures. There are many situations in which an absolute cure for the injured worker’s injury or condition can never be achieved. That does not, of course, mean that the insurance company can refuse medical care that is reasonably necessary to treat the worker. It sometimes means that the employer or insurer must provide special benefits for permanent impairment. Unfortunately, many injured workers can find themselves arguing with a brick wall.
Break Through the Brick Wall With Expert Legal Representation
Have you sustained a work-related injury? Do you have a chronic pain issue? Have you been denied medical treatment on the grounds that it is merely palliative? Do you feel like you are arguing with a brick wall?
At Petro Cohen Petro Matarazzo, we have been active breaking down such walls for many years. We specialize in helping hard-working folks just like you. Call or contact us for a free consultation. Talk to an experienced lawyer who can help you sort out your rights. Remember that there are time limits within which work-related injury claims must be filed. We can be reached by phone at 888-675-7607, or you can complete our online form. We look forward to discussing your situation with you.