Workplace Injuries

New Hampshire has enacted laws which require virtually every employer to provide workers' compensation benefits to injured employees. Such benefits are usually paid by insurance.

If you are injured at work, or if you have contracted an occupational disease, you should immediately report it to your employer. In most cases, written notice of injury must be provided within 2 years. Most employers have N.H. Department of Labor "notice" forms for injured employees to complete. In addition to the notice requirement, claims for benefits must usually be made within 3 years from the date of injury.

Once put on notice by the employee, employers then have 5 days to file a written report with the N.H. Department of Labor. The insurance company has 21 days from the date of notice to either accept the claim and begin paying benefits, or to deny the claim in writing. If a claim is denied, the employee has only 18 months from receiving notice of the denial to request a hearing on the case at the N.H. Department of Labor.

Some common grounds for denial by insurance companies include allegations that (1) the injury is not work-related, (2) the worker is not disabled as a result of his/her injury, (3) claimed medical bills are not reasonable, necessary, or causally related to a work injury, and (4) the injured worker is actually an independent contractor and not an employee.

Contested claims are resolved by a hearing at the Department of Labor. Hearings are presided over and decided by neutral hearing officers employed by the Department of Labor. Written decisions are issued within 30 days from the hearing date. The losing party may then appeal for a new hearing before a three-member Compensation Appeals Board. It takes several months for an appeal hearing to be scheduled. Appeal hearings are conducted much the same way as the initial Labor Department hearing; however, there are separate rules and procedures. The losing party following the Appeals Board hearing may then appeal claimed errors of law to the New Hampshire Supreme Court. Whether the case will be heard and considered by the N.H. Supreme Court is discretionary with that Court. It's very important to understand that injured workers have the right to legal representation at each step.

Workers' compensation benefits are payable for work-related injuries regardless of fault. Therefore, unless the employee was intoxicated at the time of injury or is guilty of serious and willful misconduct, workers' compensation benefits are payable even if the employee negligently causes his/her own injury.

Workers' compensation benefits under N.H. law include (1) payment of reasonable and necessary medical bills, (2) total disability benefits figured at 60% of the pre-injury average gross weekly wage, (3) a separate money award for permanent partial impairment to certain body parts, (4) vocational rehabilitation services if a return to your former occupation is not medically possible, (5) reinstatement to your job if your company has at least 5 employees and your treating physician approves a return to regular work within 18 months from the date of injury and you have not accepted another job elsewhere, (6) benefits to the spouse and dependent children of a worker who dies because of a work-related incident or conditions, (7) mileage reimbursement for travel to medical appointments.

If an injured worker is only partially disabled (e.g. he/she can only work part-time or otherwise in a lesser paying job), or has progressed from a state of total disability to one of partial disability, he/she may be eligible for partial disability benefits. Partial disability benefits are calculated at 60% of the difference between the injured worker's pre-injury gross average weekly wage and the actual wages earned each week while partially disabled. Eligibility for partial disability benefits ends once 5 years has elapsed from the date of injury.

Unless your employer is providing a managed care program approved in advance by the N.H. Department of Labor, injured workers have the right to choose their own physician. Reasonable and necessary medical, therapy and prescription bills should be submitted directly to the workers' compensation insurance carrier for payment. The insurance company does have the right to schedule, at their expense, "independent medical examinations" with a qualified doctor. Insurance companies are usually limited to 2 such examinations per year which must usually take place within a 50 mile radius of the injured employee's residence. If the employee refuses to submit to such an exam, the employee's right to weekly benefits shall be suspended.

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