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An employee or his/her dependents can receive Workers' Compensation benefits for an injury or death arising out of and in the course of employment. The employer or its insurance carrier pays for the necessary and reasonable medical treatment, temporary disability benefits in place of wages lost during the period of disability and when documented, benefits for permanent disability.

If an injured worker is disabled for a period of more than seven days, he or she will be eligible to receive temporary disability benefits at a rate of 70% their average weekly wage, not to exceed the maximum rate or fall below the minimum rate set by statute in effect during the year of accident. These benefits are provided during the period when a worker is unable to work and is under active medical care. Click here to obtain temporary benefit maximum and minimum rates in effect for the past several years.

Benefits are usually terminated when the worker is released to return to work in some capacity and/or if he or she has reached maximum medical improvement (MMI). MMI is a term that is used when additional treatment will no longer improve the medical condition of the injured worker.

There is nothing in the New Jersey Workers’ Compensation law that prevents an employer from discontinuing an employee’s health benefits coverage while they are unable to work as a result of a job-related injury. However, some protections are available under the Federal Family Medical Leave Act. These laws do not come within the jurisdiction of the Workers’ Compensation court and a judge of compensation does not have the authority to enforce them.

For further information in this regard, you may wish to contact the US Department of Labor, Employment Standards Administration at 1-866-4-USA-DOL or visit their web site at http://www.dol.gov/.

The statute allows that only totally and permanently disabled workers and dependents of deceased workers whose date of injury or death occurred prior to January 1, 1980 may be eligible for supplemental benefits or cost of living increases. Dependents of deceased workers may, in some cases, be eligible where the death of the worker occurred after 1979 but was directly and causally attributable to the injury resulting in total and permanent disability prior to 1980.

However, for those receiving temporary total or partial total disability benefits, there is no provision in the statute for cost of living adjustments.

Work-related injuries or illnesses are not compensable under the NJ Temporary Disability Benefits Law. However, if an individual claims Workers' Compensation benefits and the claim is contested by the Workers' Compensation insurance carrier, temporary disability benefits may be paid by TDI pending resolution of a formal WC claim petition. A lien is filed by the Disability Insurance Service to protect its subrogation rights against any subsequent WC award. For more information, you can visit the Division of Temporary Disability Insurance's website or call them directly at (609) 292-7060.

By law, you must be unable to work for seven days (including weekends and holidays) before you are eligible for temporary disability benefits. Benefits are retroactive to the first day. The seven days need not be consecutive.

Please note that there is no similar waiting period to receive medical benefits or permanent disability benefits. Those benefits are due, if warranted, regardless of the number of lost workdays.

There is two-year statute of limitations that applies to Workers' Compensation cases. A formal claim petition must be filed within two years of the date of injury or the date of last payment of compensation, whichever is later. Medical treatment authorized by the employer is considered a payment of compensation. In cases of occupational illness, for example - asbestosis, lead poisoning or hearing loss, the claim petition must be filed within two years from the date the worker first became aware of the condition and its relationship to employment. Please note that the filing of an application for an informal hearing does not stop the two-year statute of limitations from running.

Generally, you can expect to wait two weeks before receiving temporary disability benefits. If your employer or their insurance carrier unreasonably and negligently delays denial of a claim, they may be liable to you for an additional amount of 25% of the amounts due plus any reasonable legal fees incurred in relation to the delay. A delay of 30 days or more is presumed to be unreasonable.

The Workers’ Compensation Insurance carrier has, by law, 60 days in which to process the payment after which time you may be entitled to receive simple interest on the delayed payments. However, it is more realistic to expect receipt of your initial payment within 6 to 8 weeks from the date of the execution of the judge’s order.

The statute N.J.S.A. 34:15-15 does give the employer the authority to select the health service professionals to provide care to an injured worker. However, if the employer refuses or neglects to provide services reasonable and necessary to cure and relieve the worker of the effect of the injury or restore function where possible, the employee may take action by filing a Motion for Medical and/or Temporary Disability Benefits. The filing procedures are outlined in the Rules of the Division of Workers’ Compensation, N.J.A.C. 12:235-3.2. These proceedings are given a very high priority and are scheduled before a judge within 30 days of the proper filing of the motion.

You should contact your attorney to determine the tentative date of your next Workers’ Compensation hearing. If you are representing yourself, the Division will provide written notice through the mail approximately two (2) weeks before the scheduled hearing.

First established in the 1920's, the Second Injury Fund is intended to promote the hiring of disabled individuals and to reduce the potential costs of WC awards for employers for injuries or conditions pre-existing the last compensable work-related accident. This is done by the Fund assuming payment of permanent disability benefits after an initial period during which the employer or his insurance carrier makes these payments.

To be eligible for Fund benefits, an individual must be totally and permanently disabled as the direct result of a work-related injury in combination with a pre-existing permanent partial disability. It is not necessary that the pre-existing permanent partial disability be work-related.

No. Fund benefits are in the same amount as those received from the employer or the employer’s insurance carrier and begin when the employer’s obligation to make benefit payments cease.

Fund benefits are potentially paid during the lifetime of the injured worker so long as the injured worker remains totally and permanently disabled and unemployed. Benefits cease upon the death of the worker. Death, funeral and dependents’ benefits are not payable from the Fund.

In very limited circumstances you may earn wages while collecting Second Injury Fund benefits. However, any wages from employment will be used to reduce your benefit amount. This reduction is based upon the percentage that your current earnings bear to those at the time of your being declared permanently and totally disabled. Please note that benefits after the first 450 weeks are payable only if you (1) had submitted to the physical and/or educational rehabilitation as may be prescribed by the Division of Vocational Rehabilitation Services, and (2) can show, that because of your continuing disability, you are unable to earn wages equal to those earned at the time of your permanent and total disability.

Please be aware that you are responsible for notifying the Office of Special Compensation Funds immediately when you begin earning wages. Failure to do so may result in reductions or removal of benefits to recover some or all benefits paid during employment.

You should also note that employment which calls into question your continuing permanent and total disability may give rise to a reevaluation of your medical condition and possible removal of benefits.

Supplemental benefits are amounts paid in addition to the basic awarded weekly Workers’ Compensation benefit rate to address changes in the cost of living. Calculated annually, these benefits are based upon the current maximum weekly Workers’ Compensation rate in relation to the percentage of your basic benefit rate to the maximum rate in effect at the time of your injury. Supplemental benefits are reduced for receipt of Social Security, Black Lung, and/or employer disability pension benefits and are also subject to reduction for employment in cases of total and permanent disability.

The statute allows that only totally and permanently disabled workers and dependents of deceased workers whose date of injury or, as the case may be, death occurred prior to January 1, 1980 may be eligible for supplemental benefits. Dependents of deceased workers may, in some cases, be eligible where the death of the worker occurred after 1979 but was directly and causally attributable to the injury resulting in total and permanent disability prior to 1980.

As a result of recent legislation, dependents of public safety workers and essential workers whose death is attributable to COVID-19, may receive supplemental benefits.

The Uninsured Employers Fund was established to make payments of medical expenses and temporary disability benefits to injured workers whose employers failed to provide the required Workers’ Compensation insurance coverage and who fail or refuse to make Workers’ Compensation benefit payments as awarded. Payments for permanent disability are not made by the Fund.

When a formal Workers’ Compensation claim is filed with the Division of Workers’ Compensation and the employer is found to be uninsured, a motion to join the Uninsured Employers Fund is submitted by the worker or his/her attorney. If an award is made for temporary disability benefits and/or medical expenses, the Uninsured Employers Fund will make payment of the temporary disability benefits and reasonable and customary medical expenses included in the Judge's Order.

Before any payments are made from the Fund, liens in the amounts of any payments that may be made from the Fund are docketed against the employer in the Superior Court. Although not payable by the Fund, any permanent disability benefits awarded and unpaid by the employer are also docketed on behalf of the injured worker. In addition, the employer is subject to a penalty of up to $6,000 after an award has been unpaid. This amount is also docketed against the employer in the Superior Court.

While the Fund does not pay permanent disability benefits, any such award is docketed with the Superior Court as a lien against the employer. This lien may be prosecuted by the injured worker or his/her attorney for collection should the employer assets be located.

In general, it takes 90 to 120 days after the date of an award for payments to be made from the Fund. This is necessary and includes docketing of liens in the Superior Court, as well as the approval and payment voucher process required to make payments. No payments may be made prior to an award by the courts of the Division of Workers’ Compensation and the docketing of amounts owed.

While the greatest time is required by the statute or regulation, the worker and his/her attorney can ensure the quickest payment if complete documentation of medical expenses are included in the case file forwarded to the Office of Special Compensation Funds. Copies of all itemized bills and receipts should be forwarded to UEF counsel as soon as possible. The originals of all itemized billing statements should be provided to UEF counsel at trial.

With the exception of public employers, the law requires that employers operating in New Jersey provide for the payment of Workers’ Compensation benefits through an insurance policy or an approved plan of self-insurance. If you suspect that your employer is in violation of this requirement, you should immediately notify the Office of Special Compensation Funds at (609) 292-0165 or at P.O. Box 399, Trenton, NJ 08625-0399 of your suspicion. You may also provide this information to us by completing an online Report of Non-Compliance form. You need not identify yourself but you should be prepared to provide the name and exact address of the employer and, if possible, the names of the principle operators of the business.

Additionally, proof of coverage should be displayed in a prominent location at the place of business. If you would like to verify the coverage status of an employer, you can obtain this information by writing to the Compensation Rating & Inspection Bureau at 60 Park Place, Newark, NJ 07102 or by visiting their website at www.njcrib.com.

Domestic employees must be covered by the residential employment provisions of homeowner policies.

Failure to provide the required insurance is a disorderly persons offense and, if the failure was willful, a crime of the fourth degree. In addition, penalties for failure are assessed at up to $5,000 for the first twenty days and up to $5,000 for each ten-day period thereafter. Penalties are docketed as liens against the employer in the Superior Court and collection action is taken to prosecute those liens through seizure of property.

Our sources of noncompliance with the compulsory insurance requirements of the law include reports from employees, other employers, community and union organizations, other governmental agencies, and, unfortunately, claims filed by injured workers. We also perform a periodic cross-match of employer data maintained by the Department of Labor and Workforce Development and the Department of Banking and Insurance to identify employers appearing to have failed to provide the required insurance. To obtain coverage information, please write to the Compensation Rating & Inspection Bureau at 60 Park Place, Newark N.J. 07102 or visit their web-site at www.njcrib.com.

The Compensation Rating & Inspection Bureau of the Department of Banking & Insurance is responsible for rate setting matters for workers’ compensation. They can be reached by calling (973) 622-6014 or by visiting their web-site at www.njcrib.com.