Protections for Injured Workers
Workers' Compensation provides medical treatment, wage replacement, and permanent disability compensation to employees who suffer job-related injuries or illnesses, as well as death benefits to dependents of workers who have died as a result of their employment.
Workers' compensation is a “no fault” insurance program that provides the following benefits to employees who suffer job-related injuries or illnesses.
- Medical Benefits
- Temporary Total Benefits
- Permanent Partial Benefits
- Permanent Total Benefits
It also provides death benefits to dependents of workers who have died as a result of their employment.
An injured employee will receive benefits regardless of who was at fault. In exchange for these benefits, the worker cannot bring a civil action against the employer for pain and suffering or other damages, except in cases of intentional acts.
You should notify your employer as soon as possible. The notice may be given to your supervisor, personnel office, or anyone in authority at your place of business. Notice does not have to be in writing. If you need medical treatment, a request should be made to your employer as soon as possible. Under the NJ workers' compensation law, the employer and/or their insurance carrier can select the physician(s) to treat injured workers for work related injuries.
Once an accident is reported to an employer, the employer’s workers’ compensation insurance carrier will file a First Report of Injury electronically with the State.
The employer's Workers’ Compensation insurance carrier will evaluate the claim and determine if it's compensable under the Workers’ Compensation law. They will contact the injured worker, the employer, and the medical provider to make this assessment. If the claim is accepted, they will direct the injured worker to an authorized medical provider for treatment. If time out of work extends beyond 7 days, they will also provide the injured worker temporary disability benefits during the period of rehabilitation.
Within 26 weeks after the worker returns to work or reaches maximum medical improvement, the insurance carrier is required to submit another form to the Division called the Subsequent Report of Injury. A copy of this form is sent to the worker for their review.
In cases of dispute between an injured worker and the employer and/or insurance carrier over entitlement to benefits, the worker may file either a formal Claim Petition or an Application for an Informal Hearing with the Division of Workers' Compensation.
Disputed issues may include whether the injury/illness was considered work-related, the type and extent of medical treatment, and/or the payment of temporary disability benefits.
Upon filing, the case will be assigned to a judge and a district office based upon the county of residence of the injured worker, or, if the worker lives out of state, the county where the employer is located.
Workers are generally represented by an attorney, but they may file a claim petition on their own (pro se).
To learn more, click here.
The Uninsured Employer's Fund (UEF) was established within the NJ Workers' Compensation Law to provide for temporary disability benefits and medical expenses to workers suffering from compensable injuries while working for employers who fail to provide the required Workers' Compensation insurance coverage and who fail to make such benefit payments as awarded by the Division of Workers' Compensation.
The process by which the UEF gets involved in a Workers' Compensation case is with the filing of a formal claim petition. If no insurance carrier or indication of approved self-insurance is indicated on the Claim Petition, a search is requested through the New Jersey Compensation Rating & Inspection Bureau to determine the insurance status of the employer.
If no insurance is found to be in place for the employer when a case is scheduled to be heard in a selected court vicinage, an attorney representing the Uninsured Employer's Fund is assigned. Certain documentation must be provided by the injured worker/their attorney to the Uninsured Employers Fund and the court. If the employer is found to have failed in providing the required insurance coverage, a Judge of Compensation will order benefits to be paid against the employer. If the employer will not or cannot make the ordered payments to the injured worker, the order of the Judge of Compensation is then docketed in Superior Court against the employer.
Upon application by the worker's attorney, the Uninsured Employers Fund makes payment of all temporary disability and reasonable and customary medical expenses included in the Judge's Order.
To learn more about the Uninsured Employer's Fund, click here.
The law requires that all New Jersey employers, not covered by Federal programs, have workers’ compensation coverage or be approved for self-insurance.
If you're aware of an uninsured employer, you may provide this information to the Office of Special Compensation Funds via email at firstname.lastname@example.org or by completing a Report of Non-Compliance form.
You don't have to identify yourself, but you should provide the name and address of the employer, and, if possible, the names of the principle operators of the business.
It is against the law for an employer to discharge or discriminate against an employee because the employee claimed or attempted to claim Workers' Compensation benefits or because the employee testified or is about to testify in a Workers' Compensation matter.
As the primary remedy is reinstatement to employment, it is necessary that the complainant is ready, willing, and able to perform the duties of such employment. The employee may seek either civil or administrative courses to effect remedies for such discrimination. Where the civil course is selected by the employee, a complaint against the employer would be filed by the employee against the employer in the Civil Part of the Superior Court. Where the administrative course is selected by the employee, the Office of Special Compensation Funds is responsible for investigating such claims.
If the employer's actions are not believed to be based upon the efforts of an employee to secure Workers' Compensation benefits for themselves or others, but because of the disabling condition, the employee would not have a claim for discrimination in Workers' Compensation; they may have a claim for violation of the Americans with Disabilities Act (ADA). Information concerning the ADA or the filing of complaints under the act may be obtained by writing or calling the Equal Employment Opportunity Commission at 1801 L. Street. NW., Washington, D.C. 20507; (202) 663-4900 (phone); (202) 663-4912 (fax).
If you would like to file a discrimination complaint through the administrative course of action as mentioned above, download and complete the form here.
An employee or their dependents can receive workers' compensation benefits for an injury or death arising out of and in the course of employment. The employer or their insurance carrier pays for necessary and reasonable medical treatment, loss of wages during the period of rehabilitation, and, when documented, benefits for permanent disability.
In the event that a worker is injured while working for an uninsured employer, application for medical and temporary benefits can be made to the Division's Uninsured Employers Fund (UEF).
All necessary and reasonable medical treatment, prescriptions, and hospitalization services related to the work injury are paid by the employer's insurance carrier or directly by the employer if they are self-insured.
The employer, and/or the insurance carrier, has the right to designate the authorized treating physician for all work-related injuries. Only in situations where the employer inappropriately refuses to provide medical treatment or if an emergency exists may the injured worker choose the treating physician. In the case of an emergency, the injured worker should notify the employer as soon as possible concerning the treatment being received.
If an injured worker is disabled for a period of more than seven days, he or she will be eligible to receive temporary total benefits at a rate of 70% their average weekly wage, not to exceed 75% of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20% of the SAWW. These benefits are provided during the period when a worker is unable to work and is under active medical care.
Benefits are usually terminated when the worker is released to return to work in some capacity 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. The worker, in some cases, may be left with either partial permanent injuries or total permanent injuries.
For benefit rates, click here.
When a job-related injury or illness results in a partial permanent disability, benefits are based upon a percentage of certain "scheduled" or "non-scheduled" losses. A "scheduled" loss is one involving arms, hands, fingers, legs, feet, toes, eyes, ears, or teeth. A "non-scheduled" loss is one involving any area or system of the body not specifically identified in the schedule, such as the back, the heart, or the lungs. These benefits are paid weekly and are due after the date temporary disability ends.
For benefit rates, click here.
For schedule of disabilities and maximum benefits, click here.
Sometimes when a work injury or illness prevents a worker from returning to any type of gainful employment, he or she may be entitled to receive permanent total disability benefits. Permanent Total Disability is also presumed when the worker has lost two major members, or a combination of members, of the body such as eyes, arms, hands, legs or feet. However, permanent total disability can also result from a combination of injuries that render the worker unemployable.
These weekly benefits are provided initially for a period of 450 weeks and continue beyond the initial 450 weeks, provided that the injured worker is able to show that he or she remains unable to earn wages. Wages earned after 450 weeks offset the weekly computation in proportion to the income at the time of the injury. Permanent Total benefits are paid weekly and are based upon 70% of the average weekly wage, not to exceed 75% of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20% of the SAWW.
The Second Injury Fund (SIF), which is administered by the Division of Workers’ Compensation, makes benefit payments to injured workers who are totally and permanently disabled as a result of their last work-related injury combined with the workers’ pre-existing disabilities.
The Second Injury Fund was established to encourage employers to hire disabled workers. The employer only pays for the work-related aspect of the total disability award.
To access more information about the Second Injury Fund, click here.
Dependents of a worker who dies because of a work-related injury or illness may be eligible to receive death benefits. The weekly benefits payments are 70% of the weekly wage of the deceased worker, not to exceed the maximum benefit amount established annually by the Commissioner of Labor. The benefit amount is divided by the surviving dependents as determined by a judge of compensation after a hearing on extent of dependency.
A surviving spouse and natural children who were a part of decedent's household at the time of death are conclusively presumed to be dependents.
A surviving spouse and natural children who were not a part of the decedent's household at the time of death and all other alleged dependents (parents, grandparents, grandchildren, brothers, sisters, etc.) must prove actual dependency.
Children who are deemed to be dependents remain so until the age of 18 years or, if a full-time student, until the age of 23 years. If a child is physically or mentally disabled, he/she may be eligible for further benefits.
The employer or its insurance carrier is responsible to pay up to $3,500 in funeral expenses for a job-related death. These funds are payable to whomever is liable for the funeral bill, be it the estate or an individual.
For more information, refer to N.J.S.A. 34:15-13 of the workers' compensation statute.
Attorneys will not charge a fee for an initial consultation. Attorney’s fees are determined by a Judge of Compensation if and when workers’ compensation benefits are awarded in a case. Fees are deducted from the award and cannot exceed 20% of the awarded amount.
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