In the state of New Jersey, workers’ compensation courts have a set of complicated rules that determine exactly which types of benefits you can claim if you get hurt on the job.
We’re going to give you a general idea of what each type is about, and how it’s determined whether a worker is eligible in N.J. Every state has its own set of regulations, so don’t go by anything you’ve heard outside N.J.
The only benefits we won’t cover here are death benefits for dependents.
Medical Care From the Insurance Company’s Doctor
When you get hurt or sickened on the job you will file your claim with your employer immediately and he or she must notify the company’s insurance company. You will see a doctor who is chosen by the insurer to provide what the state calls “necessary and reasonable” treatment (here’s what happens if there’s a dispute)
If all goes well, the doctor will diagnose your problems correctly and you will receive benefits to cover your medical expenses. If you can’t return to work within seven days, you are eligible for “temporary benefits.”
Temporary Benefits Are for Missed Wages
Temporary total benefits in NJ are paid at a rate of 70 percent of your average weekly wage, with some constraints. If you are fortunate enough to make a complete recovery from your injury or illness and return to work, you won’t need anything else. Once you are back on the job, you will get a paycheck again and not lose any more wages.
Temporary benefits stop when you reach what’s called maximum medical improvement (MMI), meaning that additional treatment will no longer help you.
This does not always mean you are completely recovered, because if you are unlucky, you may have what’s called “partial permanent injuries” or “total permanent injuries.”
Unfortunately, for many workplace accidents and illnesses, the victim is either out of work permanently or is impaired so that he or she cannot again do the job at the same level of pay as before. It means you have lost the functioning that you had before.
Permanent Benefits Are More Common Than You Might Think
How many workers are in this situation? According to the Social Security Administration, a government agency, permanent partial disability cases are more than one-half of all workers’ comp cases in the U.S., typically where temporary disability has lasted more than seven days.
That’s a lot of injuries.
The doctor will document your injury or illness, which will go into determining your level of benefits. Every year a new “Schedule of Disabilities” is published that sets the payment amounts for injuries such as amputations and loss of vision or hearing. Other types of injuries, such as back or lung injuries, are also eligible for compensation.
If you are awarded “permanent partial benefits,” it means that you may be able to work, but with some measure of difficulty or discomfort. You are partially impaired, but this is not expected to change. Permanent benefits are paid weekly and go into effect after your temporary disability ends.
“Permanent total benefits“ are given when you are diagnosed as being unable to work at all. We hope you are not in this situation, but if you are, we will do our best to help you maximize your benefits.
If you have lost two major members (arms, legs) or a combination of members of the body, such as eyes, arms, hands, legs or feet, the state considers you eligible for permanent total benefits.
After 450 weeks, your case will be reevaluated to see if you still qualify for benefits.
For more details about how benefits are calculated and about the worker’s comp process in NJ, contact us at 732-275-9555 for a free consultation. We’ll be happy to chat at no cost to you and answer your questions.