Permanent Partial Disability Benefits under New Jersey’s Workers’ Compensation System

Partial Disability

If you’ve sustained an injury on the job and company authorized medical professionals have determined that you will either be unable to ever work again, or will carry a partial disability with you for the rest of your life, you may be eligible for either permanent partial benefits or permanent total benefits under New Jersey’s workers’ compensation laws.

Permanent Partial Disability Benefits

If you’ve suffered an injury that doesn’t preclude you from working, but limits your ability to perform your job or leads to a permanent change in your health, you can pursue what are known as permanent partial disability benefits, also called “scheduled or non-scheduled” losses. A scheduled loss is a permanent injury to appendages, such as arms, legs, hands, feet, fingers and toes, as well as eyes, ears or teeth. An unscheduled loss is a permanent injury to any other part of the body, such as your neck, back, lungs or heart.

Permanent partial disability payments customarily start immediately after any temporary disability payments are terminated. The amount of your payment and the number of weeks you receive payments are based on the percentage of disability, as established by the Department of Workers’ Compensation and the schedule of disabilities.

According to the 2016 schedule, the New Jersey statewide average weekly wage is $1,161.04, so the maximum rate that can be paid on a permanent disability claim is $871, though an additional 30% will be added for any amputation. Some examples of the duration of payments include:

  • Disability involving hand—245 weeks
  • Disability involving arm—330 weeks
  • Disability involving fingers—anywhere from 20 weeks to 75 weeks
  • Disability involving leg—315 weeks
  • Disability involving foot—230 weeks
  • Disability involving eye—200 weeks

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

Temporary Total Disability Benefits in a New Jersey Workers’ Compensation Claim

Disability Benefits

When you’ve been hurt on the job in New Jersey, your first course of action will likely be to file for workers’ compensation to cover lost wages. Technically, New Jersey is not a “wage loss” claim state for workers’ compensation purposes. Instead, injured workers are entitled to disability benefits, which can be partial or total, or temporary or permanent, based on the nature of the injury.

Temporary Total Disability Benefits

If you are unable to work at all because of your injury, you may be entitled to “total disability” payments for a specified period of time. You cannot start to recover total disability benefits, though, until you have been unable to work for a period of at least seven days. Once you meet that threshold, you may be eligible for payments, typically at a rate of 70% of your average weekly wage (AWW) for the 26 week period immediately prior to your injury. There’s both a minimum and a maximum that can be paid, though. Your benefits cannot exceed 75% of the New Jersey state average weekly wage, and must be at least 20% of the that amount.

Temporary total disability payments are only available if you are unable to work at all because of your injury. If your doctor clears you to return to work, your benefit payments will typically be discontinued. In addition, if you have reached what is known as “maximum medical improvement (MMI), where your doctor determines that you won’t get any better, the temporary benefits will be terminated and you may be eligible for some level of permanent benefits.

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.

What Medical Benefits Are Available in a New Jersey Workers’ Compensation Claim?

Medical Benefits

If you have been hurt on the job in New Jersey, one of your first steps after an injury will be to seek medical care. You’ll also want to ensure that your workers’ compensation benefits pay for any treatment you need. But are there any limits to the medical care you can pursue? Will workers’ compensation cover any “alternative” forms of treatment, such as chiropractic care? What about any medications you might need?

Under New Jersey law, the workers’ compensation coverage provided by your employer must pay for all “necessary and reasonable” medical treatment, prescriptions and hospitalization required because of the injury (provided the injury was suffered at work or because of your work). Though the law does not specifically define “necessary and reasonable,” if a dispute arises, the workers’ compensation judge will likely gather testimony from medical professionals to determine whether the treatment, care or other medical services you requested meet the test.

It’s important to understand that, under the New Jersey workers’ compensation system, your employer has the discretion to determine who will be your authorized treating physician for all injuries suffered on the job. There are limited exceptions to this rule—for example, if you need emergency care and there’s no time to obtain authorization from your employer, or if your employer wrongfully refuses to authorize any medical treatment at all, you may choose your own caregiver. However, you must notify your employer as soon as practicable if you seek unauthorized medical treatment.

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.

What Happens if Your Employer Has No Workers’ Compensation Coverage

Whistleblower

Under New Jersey law, all employers are required to either carry a valid policy of workers’ compensation insurance or qualify to be self-insured, which means they will pay any benefits directly out of company income. Unfortunately, one of the corners that employers often cut is paying for workers’ compensation coverage. So what happens if you are hurt at work and your employer is neither self-insured nor carrying a policy of workers’ compensation

Fortunately, the New Jersey legislature established the Uninsured Employer’s Fund (UEF) to cover such contingencies. The UEF provides temporary medical and disability benefits to workers whose employers cannot make workers’ compensation benefits payments and don’t have workers’ compensation insurance.

To recover benefits from the UEF, you must file a workers’ compensation petition, just as you would in any other circumstance. The formal claim petition asks for the name of your employer’s workers’ compensation insurance provider or for certification that your employer is self-insured. If neither of those conditions are indicated on the claim petition, the New Jersey workers’ compensation division will conduct a search through the state’s Compensation Rating and Inspection Bureau to verify your employer’s workers’ compensation insurance status.

If the search indicates there is no coverage, a hearing is scheduled to determine the actual status of your employer’s workers’ compensation benefits. If your employer is found to have violated New Jersey law, a financial penalty will be imposed and the workers’ compensation judge will enter an order allowing the UEF to make all disability and reasonable and necessary payments for medical 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 is an Employee for Purposes of a Workers’ Compensation Claim?

Compensation Claim

The workers’ compensation system in New Jersey is designed to provide benefits when someone is hurt on the job. Often, there’s no real issue as to whether the injured person was an employee. If you are on the company’s payroll, have submitted a W-4 and receive a W-2, then you’ll be considered an employee. But what if the employer alleges that you’re an independent contractor? Can you file a workers’ compensation claim against the company to whom you were providing services?

In New Jersey, the assumption is that anyone providing services to an employer is an employee for workers’ compensation purposes unless all of the following conditions can be shown:

  • The worker has been and will be free from direction or control of the performance of duties, both as agreed upon in any contract, and in fact,
  • The services provided are outside the usual course of business, or are performed outside all the places of business where such services are performed, and
  • The worker customarily performs these duties in an independently established trade, occupation, profession or business

If a dispute arises regarding whether a worker is an employee or an independent contractor, the New Jersey Department of Labor and Workforce Development will customarily complete a “worker classification questionnaire,” based on an interview with the worker. Among the questions asked to determine status are:

  • Type of business you operate—is it a sole proprietorship, partnership or other legal entity?
  • Are you required to work fixed hours?
  • Did you have other clients at the time you provided the services?
  • Approximately what percentage of your income was from the employer during the period you worked for them?

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.

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.

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.

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.

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