What is workers compensation? 2017-12-14T21:44:46+00:00

What is Workers Compensation?

Workers compensation is a “no fault” insurance program that provides medical treatment, wage replacement, and permanent disability compensation to employees who suffer job-related injuries or illnesses. It also provides death benefits to dependents of workers who have died as a result of their employment. An injured employee will receive benefits regardless of who was at fault. In exchange for these guaranteed benefits, the worker does not have the right to bring a civil action against the employer for pain and suffering or other damages, except in cases of intentional acts.

The Division of Workers’ Compensation is responsible for the administration of the New Jersey Workers’ Compensation Act (N.J.S.A. 34:15-1 et seq.). This is accomplished by:

  • Ensuring that workers receive fair and timely workers’ compensation benefits for work-related injuries from their employers and / or insurance carriers.
  • Enforcing the law that requires employers to secure workers’ compensation insurance coverage from commercial insurance carriers or self-insurance programs.
  • Providing certain benefit payments to injured workers who are totally and permanently disabled as a result of their last work-related injury combined with the worker’s pre-existing disabilities. These benefits commence at the conclusion of the payment of benefits from the worker’s employer.

The Division of Workers’ Compensation does not have jurisdiction over insurance premium rate setting. That responsibility falls under the jurisdiction of the Compensation Rating and Inspection Bureau of the Department of Banking and Insurance.

Workers’ Compensation – How, When, And Why To Retain An Attorney

The sooner you consult with an attorney, the better. Even if you decide that you do not want to proceed with a Workers’ Compensation case, it is wise to speak with an attorney.

There is a two-year statute of limitation that applies in Workers’ Compensation cases. A formal claim petition must be filed within two years ofWorkers-Compensation2 the date of injury or the date of last payment of compensation, whichever is later. In cases of occupational illnesses, for example, carpal tunnel syndrome, asthma, or hearing loss, the claim petition must be filed within two years from the date the worker first became aware of the condition and its relationship to employment. IF YOU CANNOT WORK WHILE RECOVERING FROM AN “ON THE JOB INJURY’ YOU ARE ENTITLED TO BENEFITS FOR THE PERIOD YOU ARE OUT OF WORK.

The laws of New Jersey provide that you are entitled to Temporary Workers’ Compensation Benefits for the period that you are: (1) Not able to work, even at a light duty position; AND (2) under active medical treatment. Temporary Workers’ Compensation Benefits start after the seventh day that you are unable to work at which time you will receive 70% of your lost wages going back to the first day that you are out of work. These benefits are not considered taxable income.

Disability Benefits

Permanent Partial Disability Benefits is an amount of money to compensate you for the loss of function you have suffered from the work related disability. This loss of function is sometimes identified by a percentage of the loss of function of the specific body part injured. The particular percentage of the award in your case will depend upon many things, including the amount of time you were out of work, how the injury impacts your ability to perform your job and how it affects your personal life.

If your injury is profound and prevents you from working, you may be entitled to permanent total disability benefits for the rest of your life.
Workers’ Compensation benefits are not considered taxable income and are usually paid over a period of time. Most cases are resolved in about one to three years after treatment is completed.

The attorneys’ fees in Workers’ Compensation cases are contingent, thus, there are no attorneys’ fees if you do not win. There is no retainer agreement to sign and only a judge of Workers’ Compensation can award an attorneys’ fee limited to no more than 20% of your award.

Signing Documents

It is important that you not sign any document that you do not fully and completely understand. Furthermore, you should always verify anything told to you by the adjuster handling your workers’ compensation case with a qualified workers’ compensation attorney. Always have and workers’ compensation document explained fully to you by an attorney. Signing the wrong document could result in suspension of your benefits while you are still disabled.

Social Security Disability

  • You may also be entitled to Social Security Disability if you cannot work.
  • You should apply for Social Security Disability where you live. If you live in New York or New Jersey, it may be advisable to retain an attorney from the beginning of your Social Security Disability case.
  • In order to qualify for Social Security Disability, you must be considered totally disabled from performing any substantial, gainful work and you must be disabled or expected to be disabled for at least 12 months. The Social Security Administration (SSA) may consider other sources of income, such as Workers’ Compensation benefits, in determining the amount of a disability entitlement.
  • Your local Social Security office will supply all necessary applications and provide assistance in completing all forms for Social Security Disability.

If you have further questions visit our workers compensation frequently asked questions page

Case Study

MDL successfully argued total disability for a 34 year old truck driver who sustained an aggravation of a previously surgically repaired lower back injury. Insurance carrier argued that his condition was pre-existing and that he had not been involved in a work related accident therefore they were not responsible, however we were able to establish that the type of work he did and the specific nature of his occupation resulted in an aggravation of his lower back condition and prevented him from returning to his employment.