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An employee or their dependents can receive workers' compensation benefits for any injury or death arising in the course of employment. The employer of the insurance carrier pays for necessary and reasonable medical treatment, loss of wages during the period of rehabilitation and when documented, benefits for permanent disability.
Medical BenefitsAll 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 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 treatment being received.
Temporary Disability BenefitsIf an injured worker is disabled for a period more than seven consecutive days, he or she will be eligible to receive temporary disability benefits at a rate of 70 percent of their average weekly wage, not to exceed 75% of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20 percent 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 a 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.
Permanent Partial BenefitsWhen a job-related injury or illness results in a permanent partial 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, heart, lungs, etc. These benefits are paid weekly and are due after temporary disability ends.
Permanent Total BenefitsSometimes, when a work related 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 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 percent of the average weekly wage, not to exceed 75% of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20 percent 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 other injuries or a combination of injuries that render the worker unemployable.
Death BenefitsDependents of a worker who dies because of a work related injury or illness may be eligible to receive death benefits. The weekly benefit payments are based upon the number of dependents, not to exceed the maximum benefit established annually by the Commissioner of Labor.
Compensation is computed, but not distributed, on the following basis:
A surviving spouse and natural children who were a part of the decedent's household at the time of death are conclusively presumed 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 dependents remain so until the age of 18 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. Source: New Jersey Department of Labor, Division of workers' Compensation.
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