Overview of New Jersey’s Worker’s Compensation Benefits

 BY:

C. Gregory Schultz, Esquire

            There are three basic types of benefits that the injured worker is entitled to under the New Jersey System of Compensation.  These include medical benefits, temporary disability, and permanent disability benefits.  These will be described in more detail below:

A.        Medical Benefits

            The injured worker is entitled to receive appropriate medical treatment for all work related injuries.  The worker’s compensation carrier is responsible for providing and paying for all medical treatment that is necessary, reasonable and connected to the work injury.  The New Jersey system of compensation does allow the worker’s compensation carrier to control medical benefits.  This means that the carrier can dictate which health care providers will provide treatment to the injured worker. 

B.         Temporary Disability Benefits

            The injured worker may also be entitled to receive temporary disability from the worker’s compensation carrier.  New Jersey provides for a 7 day grace period, meaning that injured employee must be out of work for at least 8 days before he/she is entitled to receive temporary disability benefits.  Once the injured worker qualifies for temporary disability benefits they get paid retroactive to the first day the injured worker was out of work.  Temporary disability benefits are paid at the rate of 70% of the worker’s average gross weekly pay.  Temporary disability benefits are paid to the injured worker for the period of time that the treating physician certifies that the worker is unable to perform his regular work duties as a direct result of injuries sustained on the job.

C.        Permanent Disability Benefits

            When the injured worker has completed medical treatment and/or has reached maximum medical improvement, the worker may also be entitled to a permanency award.  New Jersey uses a system of schedules and percentages.  The permanency award is based upon a standard of objective evidence of any restrictions or loss of function of the body or body member.  After a claim petition is filed with the Division of Worker’s Compensation, the injured worker will eventually be sent for permanency evaluations by his/her attorney as well as the attorney for the employer.  The examining physicians who examine the injured worker, review all medical records and prepare a detailed report setting forth their opinions as to the nature and extent of any permanent disabilities sustained by the worker as a result of the work related injury.  Those reports will be used by the attorneys and the judge to decide the appropriate percentage of permanent disability that the worker should receive.  In most cases the attorney for the injured worker and the employer arrive at a settlement figure.  In the event a settlement can not be reached, the case is tried before the worker’s compensation judge who will fix the degree of permanent disability at the conclusion of the trial.

D.        Re-Opening Permanency Claim

            New Jersey Worker’s Compensation Act provides that even after an injured worker receives a permanency award he/she has the right to re-open the case at a later date and receive an increase in permanency benefits if he/she can prove that the condition has measurably worsened since the time of the first award.  The injured worker has a period of two years from the date he/she last received a permanency check within which to re-open the case.

E.         Recognized Classes of Claims

            In New Jersey there are two classifications of claims entitling a worker to compensation benefits.  First category is traumatic injury claims.  These claims involve a one time trauma which can be either physical or psychiatric in nature (i.e. worker falling off a ladder and breaking his arm).  The second class is the occupational disease claim.  These claims involve injuries caused by repetitive activity or exposure over a period of days, months, or even years.  Examples of these types of claims would include carpal tunnel syndrome developed by grocery store check out clerk who repetitively scans merchandise, or a  worker who develops lung disease as a result of exposure to asbestos in the work place.  In occupational cases the worker must prove the disease is due from the causes and conditions characteristic of the particular work or occupation that the worker was performing, and that the disease was caused in “material degree” by the work activity. 

F.         Conclusion

            Laws governing worker’s compensation in New Jersey are quite complex and the above presentation only provides a general overview of the basics.  It is always recommended that an individual who is injured at work seek the advice and counsel of an attorney who specializes in worker’s compensation claims.