ELIGIBLE – Workers’ Compensation Statute: In 1917 New Jersey passed its workers' compensation statute. That law has been amended and modified over the years but still provides valuable benefits for workers who have injuries resulting from accidents on the job, which "arise out of and during the course of" their employment.
BENEFITS: There are three benefits available to injured workers. They include:
- Authorized medical treatment - includes testing, necessary appliances, prosthesis, drugs, physical therapy, surgery, pain management, psychiatric counseling, as well as all other treatment that is necessary to cure and relieve the petitioner of the residuals of the injuries".
- Temporary Disability – constitutes wage replacement and is paid at the rate of 70% of the worker's salary (not to exceed the statutory maximum) for every week that the worker is out of work, remains under active medical treatment; and, the medical condition continues to improve. Such benefits stop when the worker "plateaus" medically or returns to employment whichever occurs first in time.
- Permanent Disability – is payable after temporary disability stops. The worker then becomes entitled to a determination as to the extent of permanent disability. A special medical evaluation (one on behalf of the worker and another on behalf of the employer) will determine the extent to which the work injuries have limited the efficiency of the worker’s activity in the "ordinary pursuits of life". That determination is reduced to a percentage of disability (e.g. 25% of total or 10% of the left hand or 15% of the right leg). Whatever the percentage of disability, it translates according to a statutory formula to a specific number of weeks of benefits that the worker can receive even though the individual may return to work at the same or another job. In other words such permanent disability benefits can be received while working.
AUTHORIZED TREATMENT: While medical treatment is paid fully by the employer (there being no co-pay or deductible) – it must be “authorized” by the employer. In other words, as is commonly expressed, the employer has the right to “control” or designate the actual treating physician. If you obtain medical treatment on your own you run the risk of getting stuck with having to pay those medical bills, personally.
WHEN YOU MUST FILE: There is a two year statute of limitations which requires the worker to file a Claim Petition with the Division of Workers' Compensation within two years of the date of accident. There are exceptions to the two-year rule, which apply if the worker has received authorized medical treatment or temporary disability or permanent disability payments. In such instances the two-year period starts to run on the date of the last payment of such benefits.
FAULT: Under workers' compensation the law does not concern itself with the question whether the worker was at "fault" (negligent) in causing the accident or injuries. Fault only is considered where it is believed that the worker intentionally injured himself or, where the accident was the exclusive result of the workers' intoxication.
GOING AND COMING: Under normal circumstances traveling to and from your work place is not considered being in the scope of your employment. So if you have an accident on the way it is not covered under workers' compensation.
Exceptions: However, there are exceptions to that rule. Suppose your boss asked you to take some work home with you for completion and bring it back in the morning so that a deadline could be met. Under those circumstances it may be considered that you took your work home with you and traveling to work the next workday if an accident happens – it may be covered. Another example is referred to as "special errand" or "special mission". In that instance it may be a critical part of your job to stop somewhere on the way to work to pick up something necessary for your employer and necessary to carry out your job responsibilities. In that event should an accident occur on the way to or from the special errand location it may be considered compensable. A third example pertains to workers who are "traveling" out of state or out of country on work assignment. Accidents occurring out of such circumstances are often times covered as well. [This list is not intended to describe all of the possibilities - there are many more].
DEATH BENEFITS: Should a worker die as the result of a work related accident, that worker's spouse, dependent children (as well as dependent individuals) may be entitled to as much as 70 percent of the worker's salary at the time of death for lifetime (of the spouse) or during the period of dependency (as it pertains to children and other dependent individuals).
TAXES: All workers' compensation benefits are tax-free.
ADMINISTRATION: Workers' compensation cases are handled through the Division of Workers' Compensation, which is an administrative agency of the State of New Jersey under the Department of Labor and Work Force Development. There are several vicinages (or Courts) throughout the state. The handling of a workers' compensation claim is somewhat similar to the processing of a Social Security disability claim (except Social Security is a federal, and not state, benefit). A small percentage of compensation claims to go "trial" before a workers' compensation judge; however, the vast majority of cases are "settled" without a trial.
FAQ: For answers to common questions click here.
ILLEGAL ALIENS: Are covered under workers' compensation.
THIRD PARTY CLAIMS: Often times a work accident also results in a claim against a negligent third party. For example, while traveling on work assignment if a worker is involved in a motor vehicle accident he may have two claims – a workers' compensation claim and a claim against the negligent driver that struck him. In such event and where recovery is obtained from both cases the law calls for a partial payback.
OTHER BENEFITS: There is another, quite valuable, area of compensation benefits that this site discusses under "HIDDEN" BENEFITS.