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Calculating Temporary Workers Compensation Pay and Medical Benefits in New Jersey
The New Jersey legislature enacted the Workers’ Compensation Law with the purpose of reliving an injured employee of the burden of having to pay for their own medical care and additionally to replace the employee’s lost wages. The New Jersey legislature reasoned that the Workers’ Compensation Law should provide generous relief toward the injured employee in the form of prompt benefit payments, effective medical services, and adequate rehabilitation programs post-injury. An additional goal of the New Jersey Workers’ Compensation Law was to provide expeditious relief to the injured employee and to limit any potential for litigation against the employer.
In New Jersey, workers’ compensation is intended to provide wage benefits and necessary medical treatment to injured workers. You receive this pay and necessary medical benefits regardless of whether the incident that caused the injury is your fault. Unlike obtaining an award in a third-party personal injury case, you do not have to prove that another person or entity is the cause of the accident. If the accident occurred at your place of work, you are entitled to compensation, regardless of the employer’s fault, contributory negligence on behalf of the injured employee or assumption of risk by the employee.
The amount and length of workers' compensation benefits an injured worker obtains is based on a number of factors, which include the type and severity of injury, how long the disability lasts, the amount of your wages, and the classification of employment status along with other factors.
Recovery and Payment of Temporary Disability Benefits
An injured worker is entitled to receive temporary compensation benefits if the period of work lost is seven days or longer. All benefits must be paid retroactively, going back to the first day the injured employee was unable to work. The calculation of the lost time commences with the first day that the employee is out of work. The seven-day waiting period includes Saturdays, Sundays, and holidays. Emergency volunteers, such as volunteer fire fighters, do not have to wait the seven-day waiting period and are entitled to compensation from the first day out of work forward.
The injured worker is entitled to temporary disability benefits equal to about 70% of the worker's regular wages. The benefits will terminate upon the worker being deemed able to return to work or when the employee is deemed as far restored as possible given the type and severity of the injury. There is an exception if the employee is capable of performing “light-duty” work but there is no such type of work available at their current employer; in that case, the employee may still qualify to continue receiving temporary disability benefits. Tobin v. All Shore All Star Gymnastics, 378 N.J. Super. 495 (App. Div. 2005). Additionally, the temporary disability benefits cannot last more than 400 weeks.
Determining Your Wage Loss Payment
The easiest way to calculate a weekly workers’ compensation temporary disability payment is to take the average weekly wage (AWW) and multiply it by 70% (AWW x 70% = weekly wage replacement amount). Exceptions to this calculation exist, and there are maximum and minimum thresholds for this pay: Below are the exceptions and maximum/minimum thresholds:
- State Maximum: 75% /New Jersey average weekly rate.
- State Minimum: 20% /New Jersey average weekly rate.
- Occupational Disease Exception: When the injury or death by occupational disease is caused by willful self-exposure to a known hazard or by willful failure to use reasonable and proper protective measures including personal protective devices furnished and required to be used by the employer.
- AWW = average of your weekly pay over the eight calendar weeks prior to your injury—includes all pay that comprises your hourly wage or salary (for example, tips, bonuses, commissions, overtime etc.).
Medical Treatment Benefits
In New Jersey, medical benefits are required by the Workers Compensation Act. The employer must provide the injured worker with medical, surgical and other treatment necessary to cure the worker and restore the worker to prior functions, if possible. The only remedy against the employer are the provisions provided for in the Workers' Compensation Act. Always keep in mind that there may be a third-party lawsuit or claim against another person, or company, that caused the accident while you were working. For example, if you are a truck driver for a company and another car rear ends your truck and you sustain an injury, you have a workers compensation claim against your employer and a claim against the driver of the car that rear ended you.
The employer must provide prompt and adequate medical treatment. If they do not, a motion in a workers compensation case to compel payment of temporary medical benefits can be filed. The injured worker does not have to wait until his workers compensation case is complete in order to obtain temporary medical benefits.
The employer must provide all medical benefits, such as emergency room care, surgical procedures, physical therapy, pain management and other services. Unfortunately, the employer, or the workers compensation insurance carrier, is allowed to select the medical providers from whom you receive this care in New Jersey. However, regardless of the chosen medical provider, the medical care must be provided up to the point that the worker has reached Maximum Medical Improvement (MMI).
Death at Work Requires Payment of Survivor Benefits
If a job accident results in a death, survivor benefits are available to individuals who are declared a survivor/dependent of the injured worker. A dependent is defined in N.J.S.A. 34:15-13 as individuals who were dependent on the deceased at the time of accident, including, but not limited to, the following: spouse, parents, stepparents, grandparents, children, grandchildren, siblings, and nieces and nephews.
Thus, the decedent’s dependents may receive the weekly wage replacement payments, calculated by the employee’s gross weekly earnings multiplied by 70%, and subject to the state maximum and minimum thresholds. Ultimately, a judge must determine the division of the benefits among the eligible surviving dependents.
Permanent Workers Compensation Disability Benefits in New Jersey
In the case of a serious accident, you may suffer permanent disability – either partial or total permanent disability. One important detail to note is that temporary disability benefit and permanent disability benefits cannot be paid at the same time.
In the event of permanent total disability, your employer, and their insurer, must continue to pay you a weekly wage replacement amount for as long as you remain disabled. The rate is calculated in the same manner as your temporary disability payments (average weekly wage x 70%).
Permanent partial disability (PPD) works differently. In these cases, injured workers receive PPD benefits for an established number of weeks after their medical treatment is concluded. PPD is categorized as either an unscheduled or a scheduled loss, based on the body parts that are injured.
For a chart, provided by the New Jersey government, that outlines that amounts that may be payable based on type of injury, click here.
Free Consultation with New Jersey Workers’ Compensation Attorneys
Scura, Wigfield, Heyer, Stevens & Cammarota’s New Jersey Attorneys provide experienced legal representation with New Jersey Workers’ Compensation Claims. The issues discussed above require knowledge of the way to maximize recovery and best protect you and your family’s income and medical benefits. Please call our firm for a free legal consultation concerning your claim.
John J. Scura III
John fights hard for his clients and tries to educate them so they understand what is going on with their particular legal problem. John has been Certified by The Supreme Court of New Jersey as a Civil Trial Attorney. Whether it is a personal injury case, bankruptcy case, litigation case or other type of matter, John wants his clients to participate in the decision making process toward solving their problem in the best way possible.
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