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Frequently Asked Questions (FAQ) About New Jersey Workers’ Compensation Benefits

car accident frequently asked questions

New Jersey workers’ compensation benefits provide medical treatment and partial income replacement to employees who have been injured on the job or developed a compensable occupational illness due to their job duties. These FAQ’s may address some of the questions and concerns you have when you or someone you love has been injured on the job.

 

  1. When do I report a workplace injury?
  2. How should I inform my employer if I’m injured?
  3. How much time do I have to file a Workers’ Comp claim?
  4. What’s a First Report of Injury or Illness form?
  5. What benefits are available under Workers’ Comp?
  6. What laws govern Workers’ Compensation?
  7. Can I get Workers’ Comp if my job makes me sick?
  8. What if my workplace injury was my fault?
  9. Can I file a new claim if I already had a medical condition and an accident makes it worse?
  10. What does Workers’ Comp pay if I die on the job?
  11. Can I go to my own doctor for treatment for my work injury?
  12. What can I do if I need to see a doctor for my work injury, but my employer won’t approve my claim?
  13. How long do I have to wait to start getting workers’ comp benefits?
  14. What if I’m permanently disabled from my work injury?
  15. How much does Workers’ Comp pay for my lost wages?
  16. How is my average weekly wage (AWW) determined for my workers’ compensation payments?
  17. If I’m permanently disabled, can I just get a lump sum instead of weekly payments?
  18. Can I sue my employer instead of going through Workers’ Comp?
  19. What can I do if my employer doesn’t have Workers’ Comp insurance?
  20. What do I do if my employer and/or their insurance company denies my claim?

When do I report a workplace injury?

If there’s an accident and you’re injured while performing your job duties, your employer should be informed as soon as safely possible. Workers’ Compensation rules and regulations require you to provide verbal or written notification within *14 days of the incident. After *90 days, failure to provide notification may lead to the loss of your right to benefits.
*N.J.S.A. 34:15-17

How should I inform my employer if I’m injured?

Many companies provide their employees with guidance for reporting accidents and injuries in an employee manual, onboarding literature or posted notices. If your company doesn’t have an established policy, then just be sure to tell an HR person, a manager or someone else in a supervisory position about the incident. This is important whether you believe you have suffered injury or not. And if you have been hurt or don’t feel well, inform your employer of your condition.

How much time do I have to file a Workers’ Comp claim?

For most claims, you have up to *2 years to file. In the case of work-related illness that doesn’t present for many years, you may have longer to file. But you need to report the suspected occupational disease as soon as you become aware of it.
*N.J.S.A. 34:15-51

What’s a First Report of Injury or Illness form?

This is a Department of Labor and Workforce Development (DLWD) Workers’ Compensation form (FORM 1A-1). It represents an official report of a job-related injury/illness. Your company will ask you questions to complete some sections of this form. It covers many details, including the following:

  • Time and date of the incident
  • When you started work
  • When you reported your injury
  • Details of the incident
  • Number of injuries reported, and parts of the body affected
  • Where the injury occurred and what equipment or chemicals were involved
  • Information on medical treatment
  • Date disability initially began
  • Names and phone numbers of any witnesses to the incident

What benefits are available under Workers’ Comp?

If you’re injured or become ill due to your work duties, you are eligible to receive medical care, treatment and medication for your illness or injury. When your injury prevents you from working, you may receive wage replacement payments on a temporary or permanent basis for your disability. Permanent disability benefits are categorized as partial or total. When a worker dies due to a workplace accident, injury or illness, his dependents may be eligible to receive death benefits.

What laws govern Workers’ Compensation?

The New Jersey Workers’ Compensation Act is the state law mandating and governing this coverage. The Division of Workers’ Compensation of the New Jersey Department of Labor and Workforce Development (NJDLWD) oversees much of the process, including claims approvals, benefits payments, and hearings. The Division of Risk Management (DRM) deals with case management and investigations, as well as budgeting.
*N.J.S.A. 34:15-1

Can I get Workers’ Comp if my job makes me sick?

Some occupational diseases are covered through New Jersey Workers’ Compensation insurance, but your condition must meet very specific requirements.

What if my workplace injury was my fault?

Fault is typically not a determining factor in a Workers’ Compensation claim. However, if you were inebriated or under the influence of drugs and it contributed to your accident or injury, your claim could be denied.

Can I file a new claim if I already had a medical condition and an accident makes it worse?

While this type of situation can make your claim more complicated, it is possible to get workers’ comp benefits for a pre-existing condition that was re-injured or worsened by your job-related duties or a workplace accident.

What does Workers’ Comp pay if I die on the job?

Workers’ compensation death benefits are paid to the decedent’s surviving dependents, such as their spouse and children. These benefits are equal to 70% of the worker’s average weekly wage, subject to statutory maximums. Death benefits also include funeral expenses of up to $3,500.

Can I go to my own doctor for treatment for my work injury?

Your employer and their insurer are responsible for choosing the medical professionals who diagnose and treat your compensable workers’ compensation injury/illness.* To seek treatment from your own medical provider, you would have to secure advance approval from your employer or their insurance company, though they are not required to provide this approval.
*N.J.S.A. 34:15-15

What can I do if I need to see a doctor for my work injury, but my employer won’t approve my claim?

If you are temporarily disabled, you or your attorney can file a Motion for Medical and Temporary Benefits with the Division of Workers’ Compensation. Your employer and their insurer will have up to 30 days to respond. The court will then hold a hearing on the matter within 30 days and give you a decision within 15 days of the hearing.

How long do I have to wait to start getting Workers’ Comp benefits?

If you’re deemed temporarily disabled and unable to work due to a work injury, you may be eligible for temporary disability benefits to partially replace your wages. Temporary disability benefits become available after you are authorized to be out of work for at least seven days.

How long can I get temporary disability benefits for my work injury?

You are no longer eligible for temporary disability benefits once you reach maximum medical improvement (MMI), or you can return to work in some capacity. However, temporary benefits will cease, regardless, after you receive 400 weeks of benefits.

What if I’m permanently disabled from my work injury?

Permanent disability benefits, at 70% of your average weekly wage, and subject to statutory minimum and maximum rates, are paid for up to 450 weeks. At that time, you will need to demonstrate that you are still permanently disabled to continue receiving benefits.

How much does Workers’ Comp pay for my lost wages?

Workers’ comp wage replacement benefits typically equal 70% of your average weekly wage, subject to statutory minimum and maximum rates set by the Division of Workers’ Compensation for the year in which you were injured.

How is my average weekly wage (AWW) determined for my workers’ compensation payments?

Your AWW is calculated using your hourly or salaried income over the 6-month period prior to your injury/illness. Any overtime, tips, bonuses, commissions and other financial in-kind income you received from your employer for the job where you were injured during those 6 months is included. The total amount is then divided by 26 to determine the average weekly rate. If the amount falls below the statutory minimum, your benefits will be based on the minimum statutory rate. If the amount calculated falls above the statutory maximum, your payments will be based on the maximum allowable rate under the law.

If I’m permanently disabled, can I just get a lump sum instead of weekly payments?

In some cases, this may be possible, but in others, it might not be warranted and an injured worker will be better off receiving ongoing lifetime benefits.

Can I sue my employer instead of using Workers’ Comp?

The workers’ compensation system is designed to eliminate civil lawsuits for workplace injuries, so its very difficult to sue for job-related injuries. A workers’ comp claim is usually, though not always, your sole recourse against your employer. However, when a third-party who is not your employer is wholly or partially responsible for the accident/injury, you may be able to pursue additional compensation from them in a separate case.

What can I do if my employer doesn’t have Workers’ Comp insurance?

New Jersey established the Uninsured Employers Fund (UEF) to compensate injured workers whose employers failed to follow the law mandating Workers’ Compensation insurance. You may be eligible to receive medical treatment and temporary disability benefits from the UEF if your employer is uninsured.

What do I do if my employer and/or their insurance company denies my claim?

Injured workers can challenge denials through formal claims with the Division of Workers’ Compensation.

How We Can Help

The New Jersey workers’ compensation attorneys at The Reinartz Law Firm has many years of experience helping injured workers. Contact us today to get the help you need.