The NJ State workers' compensation system aims to relieve the injured employee of the burden of paying for medical care and replace lost wages temporarily and permanently when necessary. It is a system based upon expeditious administration. It pays compensation with a minimum of delay and without proof of fault. The Workers' Compensation Act [Act] also provides employers with a defined liability that is limited and determinate. The administrative system, which the NJ Workers Compensation Act established, was created both to provide a direct remedy to the employee and to limit litigation against the employer.
The system ensures a dependable method of providing benefits to an injured employee during the period of his disability. The social purpose of the Act is to make sure that employees are not reduced to poverty because of an occupational or traumatic injury. The system has shifted the burden of industrial exposure into the cost of production. It has established a means of guaranteed compensation for legitimate injury and disability. The Workers' Compensation system aims to provide security for all employees who are injured during their employment. Speed, dependability, and financial assistance were the main criteria in formulating the Workers' Compensation system—a remedy to the employee irrespective of fault or negligence.
The system is remedial social legislation. The NJ Legislature intended the Workers' Compensation Act in New Jersey to be generous to the employee who had lost the use of a valuable portion of his body. The Act's primary purpose is to assure the injured worker prompt benefit payments, adequate and competent medical services, and prompt and adequate rehabilitation.
Summary of Benefits
1. Temporary Disability Benefits
When an injured worker is out of work and under authorized medical care for more than seven days (retroactive), the worker is entitled to receive temporary disability benefits.
a. The benefits do not exceed 70% of the State Average Weekly Wage (SAWW).
b. The courts interpret authorization to return to "light duty" as a return to full-time employment, and temporary disability benefits will stop. Temporary benefits may continue to be paid if you remain under medical treatment and you have been authorized to return to "light-duty," and none is available.
2. Medical Benefits
The employer or its workers' compensation insurance carrier will pay for all authorized medical treatment.
3. Permanent Disability (Partially Disabled or Disabled)
When you have reached maximum medical improvement, your disability will be by medical experts on your behalf and your employer's.
The petitioner must prove, by demonstrable, objective medical evidence:
a. There is a disability restricting the functions of the body or its members or organs
b. The disability appreciably impairs the ability to work or substantially interferes with other aspects of life.
4. Dependency Benefits
Those individuals who have been given the status of a dependent by law and who have met the criteria established by the statute may qualify for dependency benefits available to the survivors of an injured worker whose death was causally related to occupational exposure or industrial accident. The rights of dependents are not derived from the rights of the injured worker but are separate and independent
Fees and Expenses
1. Attorney's Fee - The Court sets the attorney's fee after the case. It is contingent upon recovery. If there is no recovery, then no fee is payable. By NJ law, the fee cannot exceed 20% of the award.
a. Treating Medical Reports and Records - If the reports or records are required to prepare your claim adequately, your attorney will request them. It will be the client's responsibility to pay for the actual cost of the document(s). The providers of medical services are usually reasonable in their charges for reports and records. The State of NJ regulates these charges.
b. Medical Expert Evaluations - Unless otherwise indicated, there is no advance charge for these evaluations. The cost will be payable before the examination if sophisticated examinations are requested, i.e., pulmonary, cardiovascular, blood gas, or hearing. The Court may allow credits or require additional payments when an award for benefits is entered in your favor.
c. Insurance Company Expert Examinations - These are conducted at no cost to you and are the sole obligation of the insurance company.
Who is eligible?
1. Employees -The New Jersey Workers' Compensation Act includes various employment positions under its coverage umbrella. All workers who can be considered "employees" are eligible for state workers' compensation benefits unless their specific job classification has been statutorily removed from the control of the state by the federal government. Every homeowner's policy is required to carry coverage for household employees.
2. Public Employees - Public employees have been given express coverage for workers' compensation benefits by statutory authority. Whether elected or appointed, the Act covers every state, county, municipality, and any other governing board employee. The Act also expressly covers volunteer firefighters doing public fire duty and every active volunteer of a first aid or rescue squad.
3. Corporate Officers and Shareholders - Corporate officers are expressly covered under the Workers' Compensation Act. The corporate officer must be an employee to fall within the scope of those who may receive benefits.
4. Partners - Partners are covered under workers' compensation and sole (single) owners if an election is made to adopt coverage.
5. Minors--Double Indemnity – Minor children under the NJ Workers' Compensation Act are treated as a particular class. They are provided with additional benefits and options not available to other workers. Minors are defined as those individuals under 14 years of age, who are employed in violation of the law, or between the ages of 14 and 18 who are employed without a certificate or special permit, or employed at any occupation prohibited by law.
6. Volunteers - In general, a volunteer is not an employee under the Workers' Compensation Act. The facts of each circumstance must be evaluated individually to decide eligibility.
7. Palisades Interstate Park Commission -The Palisades Interstate Park Commission is governed under the Palisades Interstate Park compact provisions. By statutory mandate, they are deemed to be employees of the State of New Jersey. They are subject to the New Jersey Workers' Compensation Act.
8. New Jersey Horse Racing Injury Compensation Board - On January 5, 1996, in recognition of the difficulties in ensuring adequate workers' compensation coverage for the horse racing industry, the New Jersey Legislature enacted legislation to establish the New Jersey Horse Racing Injury Compensation Board. Horse racing employees are deemed to include a jockey, jockey apprentice, exercise rider, driver, and driver-trainer who perform services for an owner in conjunction with the exercising or racing of a horse. Furthermore, a trainer is a horse racing industry employee.
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