New Jersey Workers' Compensation Medical Benefits

A New Jersey worker's comp claim form

Available Compensation for New Jersey Workplace Injuries and Illnesses

New Jersey workers’ compensation laws protect employees who are injured or become ill at work. Employers purchase a workers’ compensation insurance policy (or self-insure). A worker is entitled to receive benefits through this policy if he suffers an injury or illness while performing the required duties of his job.

Workers’ compensation is an “exclusive remedy” system. So, employers cannot be sued for their negligence due to a workplace accident. However, in some cases, a worker may file a personal injury lawsuit against a non-employer who is responsible for their injury or illness. This is called a “third-party liability lawsuit.”

Understanding your rights after a work injury or illness can be confusing. Also, you have limited time to act in order to obtain the compensation you deserve. That’s why it is crucial to get help from an experienced New Jersey workers’ compensation lawyer.

Davis, Saperstein & Salomon, P.C., has extensive experience with helping injured and ill workers throughout New Jersey to collect workers’ compensation benefits, third-party liability compensation or – in some cases – both. We’re ready to help you, too.

Contact us to arrange a free initial consultation, including a meeting in your home or hospital room depending on your situation. We charge no fee until there is a recovery for you and your family. Simply call us today at (800) LAW-2000 or use our online form.

Workers’ Compensation Benefits

Workers compensation benefits are available in any situation where a worker was hurt performing required work duties. Negligence (of the employer or employee) is not a factor in determining whether a worker can obtain workers’ compensation benefits.

The types of benefits that a worker can receive through workers’ compensation depend on the extent of his injuries. The amount of benefits is set by New Jersey laws.

Benefits that may be obtained include:

Let’s take a closer look at each of these available benefits.

Medical Benefits

Under New Jersey workers’ compensation law, an employer must provide an employee with all medical, surgical and hospital benefits after a work injury or illness. There is no co-pay. Benefits are 100 percent covered. These benefits include payment for:

  • Prescriptions
  • Diagnostic testing
  • Surgery
  • Hospital stays
  • All other medical procedures a doctor determines are necessary.

When you are initially harmed, employers will pay up to $50 in medical or surgical benefits. To ensure coverage for more than $50 in costs, a petition should be filed with the Division of Workers’ Compensation (DWC) by a worker, his representative or physician.

The DWC reviews the petition. If an employer doesn’t believe they should be responsible for paying, the employer can make an argument to the DWC.

When obtaining any type of covered medical benefits, employers can choose which doctor you see. Unless your employer unreasonably refuses to provide medical care or the situation is an emergency, you have to go to the doctor your employer selects.  If you do seek emergency care from a doctor of your own choice, you must let your employer know as soon as possible.

Temporary Disability Benefits

Temporary disability benefits may begin after you have missed at least seven days of work. Your temporary disability benefits provide partial coverage for income that you are unable to earn as a result of your workplace injury or illness. You may receive up to 70 percent of the weekly wages that you were earning when you became disabled.

For 2015, the maximum that an employee can be paid in temporary disability benefits in New Jersey is $855 per week. The minimum is $220 per week.  These benefits can be paid for as long as you are disabled but for no more than 400 weeks.

Permanent Disability Benefits

Sometimes, a work injury or illness causes you to suffer permanent harm. As a result, you may be completely unable to work, or you may be restricted to working in a different job that involves lighter duty and pays less money. When this occurs, you may be eligible for one of two types of permanent disability benefits:

  • Permanent Partial Disability Benefits – These benefits are payable if you have sustained a permanent injury which partially impairs your ability to function at home, at work or in your day-to-day life. You may receive a portion of your lost income, or up to 70 percent of weekly wages that you were earning at the time of your injury or illness. Your award of money is based on a schedule of disabilities identifying body parts, percentages of disabilities to those body parts and a corresponding award of money for that disability percentage.
  • Permanent Total Disability Benefits – These benefits are paid where you cannot work again because of the injury or illness you suffered on the job. You can obtain benefits for up to 70 percent of the wages you earned prior to the injury or illness. The maximum benefit you can receive for a total disability award for an injury that occurred in 2015 is $855 per week, and the minimum is $35 per week. These benefits can be paid for up to 450 weeks.

For the benefits to continue beyond 450 weeks, you must show that your disability makes it impossible to obtain earnings equal to what you were making before the accident. You may need to submit to physical and educational rehabilitation in order to demonstrate your ongoing eligibility. The minimum payment limit does not apply to benefits payments after 450 weeks.

Additional Benefits for Amputees and the Loss of an Eye

For certain types of injuries, New Jersey allows for additional benefits. For example, if a person suffers an amputation of a limb or loses an eye in an accident, the injured worker is entitled to a heightened award.

Death Benefits

In some tragic cases, a work accident or occupational disease causes death. When this occurs, an employer must pay funeral expenses and death benefits to the dependents of the deceased worker. These benefits cover up to 70 percent of the worker’s average weekly wage. The maximum weekly payout for a death caused by a 2015 accident is $855 per week. The benefits may continue for up to 450 weeks. They may continue after if the deceased spouse does not remarry.  If there are minor children, they will share in the benefit until the youngest dependent turns 18 (or age 23 if the dependent is a full-time student).

Third-Party Liability Claims

Personal injury compensation can be much broader than workers’ compensation benefits. This is because damages are determined on a case-by-case basis. They are also based on the actual losses that a worker suffers.

A personal injury lawsuit can be brought when someone other than the employer causes the injury. This is called a third-party liability claim.

Damages that can be recovered in a personal injury lawsuit include:

  • Past and future medical expenses
  • Lost income
  • Pain and suffering.

A wrongful death lawsuit may also be filed to recover funeral expenses as well as lost financial support that the deceased would have provided had the death not occurred.

You must prove negligence to be entitled to these benefits. A New Jersey work accident lawyer should be consulted.

Getting Legal Help with Workers’ Compensation Benefits

Unfortunately, many employers try to deny legitimate benefits claims or unfairly limit the benefits that a worker is entitled to receive. To ensure you get the full compensation you deserve, it is important that you understand your legal rights. It is also important that you consult with an experienced workers’ compensation attorney.

At Davis, Saperstein & Salomon, P.C., our experienced New Jersey workers’ compensation lawyers are here to help. We have secured compensation for thousands of injured and ill employees throughout New Jersey and obtained more than $350 million in settlements and verdicts for our clients. Let us put our legal experience to work for you.

Call us toll-free at (800) LAW-2000 or use our online form for a free initial consultation, including home and hospital consultations. We charge no fee unless we recover for you and your family.

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