NJ Personal Injury Law Report

Dependents of a worker who dies because of a work related injury or illness may be eligible to receive death benefits. The weekly benefits payments are 70% of the weekly wage of the deceased worker, not to exceed the maximum benefit amount established annually by the Commissioner of Labor.  The benefit amount is divided by the surviving dependents as determined by a judge after a hearing on extent of dependency.

A surviving spouse and natural children who were a part of decedent’s household at the time of death are conclusively presumed to be dependents.

A surviving spouse and natural children who were not a part of the decedent’s household at the time of death and all other alleged dependents (parents, grandparents, grandchildren, brothers, sisters, etc.) must prove actual dependency.

Children who are deemed to be dependents remain so until the age of 18 years or if a full-time student, until the age of 23 years.

If a child is physically or mentally disabled, he/she may be eligible for further benefits.

The employer or its insurance carrier is responsible to pay up to $3,500 in funeral expenses for a job-related death. These funds are payable to whomever is liable for the funeral bill, be it the estate or an individual.

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Sometimes when a work injury or illness prevents a worker from returning to any type of gainful employment, he or she may be entitled to receive permanent total disability benefits. These weekly benefits are provided initially for a period of 450 weeks. These benefits continue beyond the initial 450 weeks provided that the injured worker is able to show that he or she remains unable to earn wages.

Wages earned after 450 weeks offset the weekly computation in proportion to the income at the time of the injury. Permanent Total benefits are paid weekly and are based upon 70% of the average weekly wage, not to exceed 75% of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20% of the SAWW.

Permanent Total Disability is also presumed when the worker has lost two major members or a combination of members of the body such as eyes, arms, hands, legs or feet. However, permanent total disability can also result from a combination of injuries that render the worker unemployable.

The Second Injury Fund (SIF), which is administered by the Division of Workers’ Compensation, makes benefit payments to injured workers who are totally and permanently disabled as a result of their last work-related injury combined with the workers’ pre-existing disabilities.

The Second Injury Fund was established to encourage employers to hire disabled workers. The employer only pays for the work related aspect of the total disability award.

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When a job related injury or illness results in a partial permanent disability, benefits are based upon a percentage of certain “scheduled” or “non-scheduled” losses. A “scheduled” loss is one involving arms, hands, fingers, legs, feet, toes, eyes, ears or teeth. A “non-scheduled” loss is one involving any area or system of the body not specifically identified in the schedule, such as the back, the heart, the lungs. These benefits are paid weekly and are due after the date temporary disability ends.

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All necessary and reasonable medical treatment, prescriptions and hospitalization services related to the work injury are paid by the employer’s insurance carrier or directly by the employer if they are self-insured.

The employer has the right to designate the authorized treating physician for all work related injuries. Only in the situations where the employer inappropriately refuses to provide medical treatment or if an emergency exists, may the injured worker choose the treating physician. In the case of the latter, the injured worker should notify the employer as soon as possible concerning the treatment being received.

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An employee or their dependents can receive workers’ compensation benefits for an injury or death arising out of and in the course of employment. The employer or their insurance carrier pays for necessary and reasonable medical treatment, loss of wages during the period of rehabilitation and when documented, benefits for permanent disability.

In the event that a worker is injured while working for an uninsured employer, application for medical and temporary benefits can be made to the Division’s Uninsured Employers Fund (UEF).

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If an injured worker is disabled for a period of more than seven days, he or she will be eligible to receive temporary total benefits at a rate of 70% their average weekly wage, not to exceed 75% of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20% of the SAWW. These benefits are provided during the period when a worker is unable to work and is under active medical care.

Benefits are usually terminated when the worker is released to return to work in some capacity or if he or she has reached maximum medical improvement (MMI). MMI is a term that is used when additional treatment will no longer improve the medical condition of the injured worker. The worker, in some cases, may be left with either partial permanent injuries or total permanent injuries, details of which are addressed in the next two sections.

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If you have sustained an injury, it’s important to contact a Personal Injury attorney as soon as possible to protect your rights.

If you plan to file a lawsuit, it is important to file the lawsuit before the Statue of Limitations has expired. In New Jersey, the Statute of Limitations is two (2) years from the date of the accident.

Please note that if the accident is subject to Title 59, the injured individual only has 90 days within which to file the Notice of Claim. For more information, please view the State of New Jersey Claim Form.

For more information, click on one of the Personal Injury Services provided by Garces & Grabler, PC.

• Automobile Accidents
• Construction Site Accidents
• Dog Bites/Animal Attacks
• Fall Downs
• Medical Malpractice
• Negligent Security
• Nursing Home Abuse & Neglect
• Product Liability
• Victims of Crime Compensation Board
• Workers’ Compensation
• Wrongful Death

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1. I was awarded Disability Benefits by a Workers’ Compensation Judge. When will I receive my benefits?

The Workers’ Compensation Insurance carrier has by law, 60 days in which to process the payment after which time you may be entitled to receive simple interest on the delayed payments. However, it is more realistic to expect receipt of your initial payment within 6 to 8 weeks from the date of the execution of the judge’s order.

2. I do not like the doctor to whom I was referred by my employer’s insurance company. What recourse is available to me?

The statute, N.J.S.A. 34:15-15 does give the employer the authority to select the health service professionals to provide care to an injured worker. However, if the employer refuses or neglects to provide services reasonable and necessary to cure and relieve the worker of the effect of the injury or restore function where possible, the employee may take action by filing a Motion for Medical and/or Temporary Disability Benefits. The filing procedures are outlined in the Rules of the Division of Workers’ Compensation,  N.J.A.C. 12:235-3.2. These proceedings are given a very high priority and are scheduled before a judge within 30 days of the proper filing of the motion.

3. What is the date of my next workers’ compensation hearing?

You should contact your attorney to determine the tentative date of your next workers’ compensation hearing. If you are representing yourself, the Division will provide written notice through the mail approximately two (2) weeks before the scheduled hearing.

Pamela J. Johnson, Esq., is a New Jersey Supreme Court Certified Workers’ Compensation Attorney.

Before you file a Workers’ Compensation claim in New Jersey, get more Workers’ Compensation information at our website, or contact a New Jersey Workers’ Compensation Attorney today.

1. One of my employees just reported a work-related injury to me. Do I have to report this to the State?

You should report all work related injuries/illnesses directly to your WC carrier or Third Party Administrator who in turn must file the necessary forms with the Compensation Rating & Inspection Bureau (CRIB) in an electronic format.  CRIB will then forward the accident data to the Division for oversight and compliance enforcement responsibilities.

2. For insurance carriers/third party administrators and self-administered self-insurers, what forms to they have to submit to the State?

The following two forms are now required:

First Report of Accident (FROI/IA-1),  which replaces the L&I1, RM-2, WC-1 and WC-2 forms, must be filed within three weeks after learning of an accident, or obtaining knowledge of the occurrence of a compensable occupational disease.  A copy of this report is sent to the employer;

Subsequent (Final) Report of Accident (SROI /SA/ IA-2), which replaces the WC-3, must be filed within 26 weeks after employee has recovered so as to be able to resume work or has reached maximum medical improvement.  Information on this report is copied to the employee via a form called the Benefits Status Letter.

Pamela J. Johnson, Esq., is a New Jersey Supreme Court Certified Workers’ Compensation Attorney.

Before you file a Workers’ Compensation claim in New Jersey, get more Workers’ Compensation information at our website, or contact a New Jersey Workers’ Compensation Attorney today.

1. One of my employees just reported a work-related injury to me. Do I have to report this to the State?

You should report all work related injuries/illnesses directly to your WC carrier or Third Party Administrator who in turn must file the necessary forms with the Compensation Rating & Inspection Bureau (CRIB) in an electronic format.  CRIB will then forward the accident data to the Division for oversight and compliance enforcement responsibilities.

2. For insurance carriers/third party administrators and self-administered self-insurers, what forms to they have to submit to the State?

The following two forms are now required:

First Report of Accident (FROI/IA-1),  which replaces the L&I1, RM-2, WC-1 and WC-2 forms, must be filed within three weeks after learning of an accident, or obtaining knowledge of the occurrence of a compensable occupational disease.  A copy of this report is sent to the employer;

Subsequent (Final) Report of Accident (SROI /SA/ IA-2), which replaces the WC-3, must be filed within 26 weeks after employee has recovered so as to be able to resume work or has reached maximum medical improvement.  Information on this report is copied to the employee via a form called the Benefits Status Letter.

Pamela J. Johnson, Esq., is a New Jersey Supreme Court Certified Workers’ Compensation Attorney.

Before you file a Workers’ Compensation claim in New Jersey, get more Workers’ Compensation information at our website, orcontact a New Jersey Workers’ Compensation Attorneytoday.