Worker’s Compensation, in the state of New Jersey, is a statutory method of providing benefits to an employee or his/her dependent who suffers injuries or death by accident or occupational disease out of or in the course of employment. New Jersey utilizes the “whole man” or “medical impairment” in order to establish disability. The main benefits accruing to an employee are: hospital, medical and rehabilitation expenses; and after a seven-day waiting period, temporary or total disability. Weekly benefits are based on 70% of the employee’s Weekly Wage subject to a 75% of the State Average Weekly Wage. After discharge from active curative medical treatment or upon the Claimant’s return to work, temporary total disability is discontinued and the employer or the insurance carrier is required to pay temporary disability or total permanent disability. If the injuries or occupational disease result in death of the employee, his/her dependent(s) may bring an action for a dependency benefits.
Payment of compensation benefits for temporary or permanent disability is controlled by the definition of the term “disability” which is in turn defined by statute. The term is defined as a permanent impairment caused by a compensable action or a compensable occupational disease, based upon demonstrable objective medical evidence, which restricts the function of the body or of its members or of its organs. Included in the criteria which shall be considered, shall be whether there has been a lessening to a material degree of an employee’s working ability.
Permanent disability may be awarded when the Petitioner has a medical disability which constitutes 100% disability or when the Petitioner qualifies for total permanent disability by statutory provision. For instance where there is a loss of both hands, both arms, both feet, both legs, both eyes, or any two thereof as a result of any one (1) accident payment is made pursuant permanent disability statute.
Likewise is the worker has a pre-existing disability upon which a compensable disability is superimposed, and the combination of the pre-existing disability and the superimposed compensable disability causes permanent total disability, the petitioner will be entitled to benefits from the Second Injury. The amount of the Petitioner’s wage determines the amount of the Petitioner’s compensation rate. The number of dependents the petitioner has is also a variable used to compute the compensation rate. For one (1) dependent, 50% of the wage is payable. The rate increases by 5% for each additional dependent up to a maximum of 70% of the wage for five (5) or more dependents. Payment to the surviving spouse for a period of 450 weeks and continues thereafter until death or remarriage.
In order to institute a claim, a Claim Petition must be filed with the Division of Worker’s Compensation. This is now done through E-filing. Thereafter the employer or its insurance company has 30 days to file an answer. The respondent is further required to indicate whether the information regarding Employer and/or insurance carrier, supplied by the Petitioner, has been corrected. The respondent must further indicate whether the Petitioner was in its employ on the dates stated in the Claim Petition and the correct date of the subject accident. Finally, the Respondent must admit or deny whether the injuries sustained occurred out of or in the course of employment and whether it is covered by the Worker’s Compensation Statute.
Benefits payable for temporary disability are payable to the employee during the time that he or she is out of work and in active curative medical treatment. Should the respondent fail or neglect to make payment of temporary disability or furnish the injured employee with medical treatment, the injured employee can proceed by way of Motion, a formal application with the Worker’s Compensation Court to procure it.
For uninsured employers, any accident occurring on or after May 27, 1988, the Uninsured Employer’s Fund controls. This fund covers reasonable medical expenses and temporary disability, but does not pay death benefits or extra benefits for unlawful employment of minors.
The Division of Worker’s Compensation is required to direct the parties to appear at a conference before a Judge, at which time the parties are required to exchange medical reports, limit issues and execute a Pre-Trial Memorandum.
The insurance carrier’s attorney has the right to demand medical information in cases where treatment was rendered by the Petitioner’s private physician. Following the exchange of each party’s information, each side must evaluate the case to determine the nature of the medical examinations to be performed as may be appropriate and each side will order examinations to be performed by a doctor.
After completion of all medical examinations, the case is ready for a Pre-Trial Conference. If the case is one that may be preferably settled by Pre-Trial Conference, the Petitioner’s attorney should have his or her client available in court. If the parties agree on a quantum of disability to be paid, they can submit the matter to a Judge of Compensation on an Order Approving Settlement. The Judge of Compensation, after considering sworn testimony of the Petitioner and any other witnesses presented along with the stipulation of the parties and the consent of the Petitioner, may enter the Order Approving Settlement. This Order includes a finding that the terms of settlement are fair and just and have the same effect as a determination or rule of Judgment.
Over the last 25 years I have been representing individuals in effectuating Worker’s Compensation claims for injuries sustained at the workplace. In order to navigate through the sometimes daunting waters of worker’s compensation, the experience of a skilled practitioner is required.At the Law Office of E. Gregory M. Cannarozzi, Counsellor at Law, L.L.C. in Oradell, New Jersey, our workers’ compensation staff is committed to providing clients with responsive and effective legal services. If you have been injured in a workplace accident, it is important to have a lawyer review your claim in order to see that you are being treated fairly.