Is Your Employer Required to Have Workers’ Compensation Insurance?

Image of a young man having a back pain while sitting at the working desk

If you suffer an injury on the job in New Jersey, one of your first steps to protect your rights will be to file a workers’ compensation claim. Under New Jersey law, all employers in the state who are not covered by federal programs must either have a valid policy of workers’ compensation insurance or be approved to be self-insured. The workers’ compensation must provide coverage for all qualified workers, whether they are residents of the state of New Jersey or not.

As a general rule, there are only two ways that a business in New Jersey can meet its workers’ compensation obligations: through a policy of insurance or by qualifying to be self-insured. Employers who opt to purchase workers’ compensation insurance must obtain their coverage from a mutual or stock insurance company that is licensed to do business in the state. The premiums paid for such insurance will be based on a number of factors, including the type of work being done, the wages being earned, and the number of claims filed by employees over the past few years.

In lieu of purchasing a policy of workers’ compensation insurance, your employer may apply to be self-insured. The Commissioner of the Department of Banking and Insurance will review the application, as well as financial information, to determine whether the employer has the resources to cover potential claims. The state may require that a bond be posted. A self-insured employer may administer the workers’ compensation program or may contract that responsibility out.

Limited Exceptions to the Rule

There are only a few exceptions to the rule requiring workers’ compensation insurance or self-insurance. Partners or members of a limited liability company need not be insured, but other employees of a partnership/LLC must be covered. The principal owner of a sole proprietorship is not required to have workers’ compensation coverage, but all other employees must.

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To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all workers’ compensation cases on a contingency basis. There will be no attorney fees unless we get compensation for your losses.

The Benefits Available in a Workers’ Compensation Claim

Benefits

You’ve never filed a workers’ compensation claim before, but you’ve just been hurt on the job and your injury makes it impossible for you to work. What types of benefits can you expect when you file a workers’ compensation claim?

The Basic Benefits

Under the New Jersey laws, your employer is responsible for all reasonable and necessary medical care necessitated by your injury. New Jersey is not a wage loss state, so technically, workers’ compensation benefits do not include a component to cover lost income. However, New Jersey does require payment for temporary disability, essentially providing a replacement for income. In addition, if your injuries are permanent, you may be entitled to permanent disability compensation.

Determining the Amount of Your Disability Payments

If your injury determined to be temporary (and you were off work for at least seven calendar days), the amount of your temporary disability payments will be calculated by taking 70% of your average weekly wage—the average you earned over the last 52 calendar weeks. There are, however, maximum and minimum rates that may be paid weekly. You must remain under regular medical care to qualify for these payments. You will only be eligible to receive temporary disability payments until you go back to work or until you have reached maximum medical improvement (MMI).

If your disability is determined to be permanent, it will be categorized as either permanent partial disability or permanent total disability. With a permanent partial disability, you can return to work, but receive payment based on your percentage of disability. With a permanent total disability, you won’t return to work , but will be entitled to payment of 70% of your average weekly wage (subject to a cap rate set by law) for up to 450 weeks. At the conclusion of the 450 weeks, you will be required to demonstrate that you remain totally disabled in order for the weekly payments to continue.

Contact Us

To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all personal injury cases on a contingency basis. There will be no attorney fees unless we get compensation for your losses.

Death Benefits under New Jersey’s Workers’ Compensation Laws

Death-Benefits

It’s more common to think of workers’ compensation benefits in the context of a temporary or permanent partial or total disability. But the New Jersey workers’ compensation laws also provide for payments to be made to surviving family members, should a breadwinner die of an occupational disease or in a workplace accident. Here are the benefits available for the wrongful death of a worker.

If your loved one died because of a work-related accident or as the result of an occupational illness, you have the right to recover up to 70% of the deceased’s average weekly wage for the 26 weeks immediately prior to their death. There are some statutory limits to the amount that can be paid.

For purposes of the workers’ compensation laws, a surviving spouse and any biological children who lived with the deceased at the time of death are considered to be dependents and eligible to receive workers’ compensation payments. All other potential dependents must demonstrate to the workers’ compensation judge that they were actual dependents at the time of death in order to obtain eligibility. In addition, a surviving spouse or natural child who was not part of the household at the time of death must also provide proof of dependency. A child is a dependent until age 18, or, if in school, until age 23. Offspring with physical or mental disabilities may be entitled to additional benefits.

The workers’ compensation insurance company has liability for up to $3,500 in funeral and burial expenses for a work-related death, payable to whoever has legal responsibility to pay the funeral expenses.

Contact Us

To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all personal injury cases on a contingency basis. There will be no attorney fees unless we get compensation for your losses.

What Should You Do If Your Employer Won’t Submit Your Workers’ Compensation Claim to the Insurance Company?

Insurance

In the aftermath of a workplace injury, you must notify your employer as soon as possible. Your employer should then submit your claim for benefits to the workers’ compensation insurance provider, so that you can start receiving benefits. But what are your options if your employer refuses to report the accident, injury or illness?

The first step you can take is to contact the workers’ compensation insurance company directly. Make certain you have all medical records, as well as any other statements by witnesses. The best approach is to send a package with copies of all relevant documents (keep the originals) to the insurance company, and pay the additional amount to ensure that the company must sign to acknowledge receipt.

If you don’t want to deal directly with the workers’ compensation insurance company, you can file a complaint with the New Jersey Division of Workers’ Compensation. You’ll need proof of insurance coverage by your employer, which should be posted in a prominent location in the workplace. However, if you cannot locate that information, you can contact the Compensation Rating and Inspection Bureau to confirm that your employer had the workers’ compensation required by law.

If you have not already done so, though, you should hire an experienced workers’ compensation attorney at this point. Your lawyer will have a comprehensive understanding of the process, and will be able to initiate the process to have your workers’ compensation properly considered.

Contact Our Office

To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all personal injury cases on a contingency basis. There will be no attorney fees unless we get compensation for your losses.

The Tax Consequences of Workers’ Compensation Benefits

Consequences

You’ve suffered an injury in an accident at work, you’ve developed carpal tunnel syndrome or some other condition because of repetitive stress or motion on the job, or you’ve contracted an illness because of exposure to certain substances in the workplace. You file a workers’ compensation claim, it’s approved and you start receiving benefits, but you notice there’s nothing being taken out for taxes. What’s that all about? Are you responsible for paying your own taxes? Is this even considered income?

As an employee in New Jersey receiving workers’ compensation benefits, you can relax as your benefits are not considered taxable income by either the state of New Jersey or the federal government, provided they are paid through or in accordance with state workers’ compensation laws. This also applies to any survivor benefits paid to your loved ones if you are killed in a workplace accident or die from an occupational disease. Be careful, though, as the exemption does not apply to any payments you receive from company sponsored retirement plans, even if you retired from your job due to a work-related injury or illness.

Note also that there may be a limited situation where workers’ compensation benefits are taxable if you are simultaneously receiving Social Security disability benefits. If you are eligible for Social Security disability benefits and you file for and receive workers’ compensation benefits, you may be required to pay taxes on the monetary benefits received.

Contact Us

To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all personal injury cases on a contingency basis. There will be no attorney fees unless we get compensation for your losses.

When Will You Start to Collect Workers’ Compensation Benefits?

Collect

One of the stated objectives of the workers’ compensation laws is to help injured workers start collecting benefits more swiftly than would be possible in a civil suit in court. But how long will it be before you actually start to receive benefits?

When You Are Eligible for Benefits

It’s important to understand that, while you can’t actually file a claim for workers’ compensation benefits until you have been out of work for a least one calendar week, your compensation actually starts on the date of your injury. If you are out a week, file a claim and your claim is approved, your payments will be retroactive to the first day you were unable to earn your compensation. Note that this only applies to compensation for lost wages—there is no similar provision requiring that you wait seven days to seek payment for medical treatment.

When Will Payments Actually Start?

Even under the best of circumstances, it will likely be at least two weeks before you receive your first payment, as there’s a certain amount of time required to process your claim.

Furthermore, if your claim is challenged, you won’t see any payments until the any disputes are resolved. However, your employer and the workers’ compensation insurance company cannot engage in unreasonable delays. Under the law, a delay of more than 30 days can be considered unreasonable (provided there are no legitimate challenges to your claim) and the insurance provider may be subject to an additional 25% penalty for wrongful delays.

Contact Us

To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all workers’ compensation cases on a contingency basis. There will be no attorney fees unless we get compensation for your losses.

When Will You Start to Collect Workers’ Compensation Benefits?

workplace-injury

If you have been in an accident at work, or you’ve developed an occupational disease or are suffering from some type of repetitive stress or motion injury caused by your job, the first thing you need to do is take care of your health. Once you’ve received necessary emergency medical treatment, though, the next important step is to advise your employer of your injury. Don’t undergo any elective medical care until you’ve notified your employer of your injury.

Typically, you’ll want to notify your employer of your injury within 14 days, but there’s usually no reason to wait more than a day or two, unless you are uncertain of the extent of your injury, or your injury takes a week or more to fully manifest. The longer you wait, though, the more reluctant your employer and the workers’ compensation insurance company will be to honor your claim, and the greater risk that some intervening event will give the insurance company the opportunity to argue that your injuries are not work-related. If you don’t provide notice within 90 days, you may forfeit all right to obtain workers’ compensation benefits.

Under New Jersey law, you must be out of work for at least seven calendar days before you are eligible for workers’ compensation benefits, though you will receive compensation retroactive to your date of injury, if your claim is approved. There is, however, no waiting period to obtain reimbursement or payment for medical care for work-related injuries.

That does not mean, however, that you have to wait seven days before notifying your employer. In most instances, you are best-served by notifying your employer as soon as practicable.

Contact Us

To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all workers’ compensation cases on a contingency basis. There will be no attorney fees unless we get compensation for your losses.

How Do I Report My Workplace Injury in New Jersey?

workplace-injury

If you have been in an accident at work, or you’ve developed an occupational disease or are suffering from some type of repetitive stress or motion injury caused by your job, the first thing you need to do is take care of your health. Once you’ve received necessary emergency medical treatment, though, the next important step is to advise your employer of your injury. Don’t undergo any elective medical care until you’ve notified your employer of your injury.

Typically, you’ll want to notify your employer of your injury within 14 days, but there’s usually no reason to wait more than a day or two, unless you are uncertain of the extent of your injury, or your injury takes a week or more to fully manifest. The longer you wait, though, the more reluctant your employer and the workers’ compensation insurance company will be to honor your claim, and the greater risk that some intervening event will give the insurance company the opportunity to argue that your injuries are not work-related. If you don’t provide notice within 90 days, you may forfeit all right to obtain workers’ compensation benefits.

Under New Jersey law, you must be out of work for at least seven calendar days before you are eligible for workers’ compensation benefits, though you will receive compensation retroactive to your date of injury, if your claim is approved. There is, however, no waiting period to obtain reimbursement or payment for medical care for work-related injuries.

That does not mean, however, that you have to wait seven days before notifying your employer. In most instances, you are best-served by notifying your employer as soon as practicable.

Contact Us

To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all workers’ compensation cases on a contingency basis. There will be no attorney fees unless we get compensation for your losses.

Are You Limited to the Benefits Available under a Workers’ Compensation Claim?

workinjury

When you’ve been hurt on the job, your first course of action is typically to notify your employer and initiate the process to receive workers’ compensation benefits. But is that your only legal option? That depends.

Under the workers’ compensation laws, workers’ compensation benefits are intended to cover any injuries caused by the carelessness or negligence of your employer or a co-employee. They do not limit your rights to recover for losses caused by other parties. Accordingly, if you suffer injuries caused in part or in whole by someone other than your employer or a fellow employee, you can file a separate legal action to recover for those losses. Some common situations where a worker may seek damages in addition or instead of through a workers’ compensation claim include:

  • Injuries caused in a work-related motor vehicle accident, if the at-fault driver was neither your employer nor a co-employee
  • Injuries caused when a product, machine, tool or piece of equipment breaks down or malfunctions, causing an injury
  • Injuries caused by a vendor, customer or other person not working for your employer

These types of lawsuits, known as “third party actions,” are outside of the workers’ compensation process and essentially take the form of civil lawsuits. Accordingly, with a third party action, you’ll have to go through discovery, file a complaint, and take your case to trial, if necessary. You may also have to wait months or years before you see any compensation. However, if your injuries were caused in part by your employer and in part by a third party, you can actually seek damages simultaneously through a workers’ compensation claim and a lawsuit.

Contact Our Office

To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all workers’ compensation cases on a contingency basis. There will be no attorney fees unless we get compensation for your losses.

How to File a Workers’ Compensation Claim in New Jersey

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In New Jersey, as in all other states, when you have sustained an injury in the workplace, you generally have a right to pursue benefits through the state’s workers’ compensation system. The workers’ compensation laws were set up to provide benefits to both employers and employees. Legislators intended that employees benefit from the streamlined process, so that payment of benefits would start much sooner than if a lawsuit had make its way through the courts. Legislators also established guidelines for payouts, so that employees don’t have to worry about unreasonable jury verdicts.

To pursue workers’ compensation benefits in New Jersey, you must first qualify. There are only two requirements—you must have been working at the time of the injury, and you must have been hurt. After you have sought any required medical attention, you must notify your employer as soon as possible, but no later than 30 days after the injury. Your employer may require that you undergo a physical examination, and has the right to choose the examining physician. That does not mean, however, that you cannot receive treatment from your own physician.

When you notify your employer of your injury, your employer will notify the company’s workers’ compensation insurance provider. Based on the finding of the examining physician, or upon other evidence, the workers’ compensation will either approve or deny your application for benefits. If your petition is denied, you have the right to file either a formal claim petition or an application for an informal hearing with the New Jersey Division of Workers’ Compensation. A workers’ compensation judge will then be assigned to your case and the hearing will be scheduled. Based on testimony at the hearing, the judge will either approve or reject your claim.

Contact Us

To arrange a private meeting, contact us by e-mail or call our office at 908-200-2297. Evening and weekend meetings are available upon request. We take all major credit cards.

We handle all workers’ compensation cases on a contingency basis. There will be no attorney fees unless we get compensation for your losses.

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