Workers’ compensation is designed to provide necessary medical treatment and rehabilitative services to injured workers and, when applicable, to reimburse the worker for lost wages.
Unlike compensation in personal injury cases, workers' compensation benefits don’t provide compensation for non-economic damages such as pain, suffering and loss of enjoyment of life.
The amount of workers' compensation benefits an injured worker is entitled to is based on a number of factors, including the type and severity of injury, the length of the disability, the individual's wages and other factors. This overview covers some of the general benefits you may be eligible to receive as an injured worker.
Temporary Disability Benefits to Replace Lost Wages
When your injury prevents you from working at your job for more than seven calendar days, you may be eligible to receive temporary disability benefits. These benefits are intended to replace lost wages during the time the injured worker is deemed temporarily totally disabled and unable to work due to the injuries.
In NJ, temporary disability benefits are typically about 70% of the injured worker's regular wages. These benefits terminate after the injured worker is deemed able to return to work or 400 weeks elapse, whichever comes first.
Determining Your Wage Loss Payment
The simple formula for calculating a weekly workers’ compensation temporary disability payment is to take your average weekly wage and multiply it by 70 percent (AWW x 70% = weekly wage replacement amount). There are, however, exceptions to this formula, and maximum and minimum thresholds for this pay as well.
- AWW = the average of your weekly pay over the eight calendar weeks prior to your disabling injury -- includes tips, bonuses, commissions, overtime and other pay received in excess of your hourly wage or salary.
- State Maximum: 75% of the New Jersey average weekly wage
- State Minimum: 20% of the New Jersey average weekly wage
The New Jersey Department of Labor calculates the state average weekly wage (SAWW) each year, as determined by the average earned two years prior. For 2016, the rate was $1,161.04 and then changed to 1,195.08 for 2017. For 2018, the amount rose to $1,203.43. This means the maximum weekly amount a worker could receive for workers' compensation temporary disability in 2018 is $903, while the minimum is $241.
Unreasonable Delays
When your injury temporarily disables you, and you are authorized to be out of work for more than 7 days, you should start to receive temporary disability benefits fairly soon thereafter. Payments are retroactive to the date of disability. If your employer or their workers' compensation carrier unreasonably delays these payments, they could be subject to penalties.
Medical Treatment Benefits
Medical treatment benefits are valuable benefits which you are entitled to when you sustain a compensable work injury requiring medical attention. Your employer and their insurance carrier are required to pay for all reasonable and necessary healthcare, treatment, medication and other related medical expenses for your injury.
This may include emergency room care, surgical procedures, physical therapy, pain management and other services. They are allowed to select the medical providers from whom you receive this care. The duty to provide medical treatment benefits extends up to the point that the injured worker is deemed to have reached Maximum Medical Improvement (MMI).
Survivor Benefits
When a job-related accident results in death, workers' compensation insurance pays survivor benefits. In these instances, the decedent’s eligible dependents may receive the weekly wage replacement payments calculated by multiplying the employee’s gross weekly earnings by 70 percent, subject to the state maximum and minimum thresholds. A judge determines how the amounts are divided among eligible surviving dependents.
The worker’s spouse and children who lived in the household at the time of death are eligible dependents. If these individuals weren’t part of the household, they must prove that they were financially dependent on the decedent’s income in order to receive weekly survivor benefit payments. For eligible children, payments stop at age 18, or age 23 if enrolled full-time in school. Disabled dependent children may receive payments for a longer period.
Any outstanding medical bills incurred from the fatal work injury should be paid by workers' compensation, including funeral and burial expenses up to $3,500.
Permanent Disability Benefits
In the case of a serious accident, you may suffer permanent disability – either partial or total. In the event of permanent total disability, your employer and their insurer must continue paying 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.
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.
Scheduled Loss
This refers to the loss of any of 23 specific body parts that are identified on the state schedule. This schedule identifies the number of weeks that you receive your payments, as well as the dollar amount you will receive.
Unscheduled Loss
This refers to an injury to a body part that is not explicitly identified on the state schedule. Examples include spinal, shoulder and hip injuries. The severity of the injury impacts the dollar amount received and length of time you will receive these payments.
Your New Jersey Workers’ Compensation Legal Representative
The Reinartz Law Firm provides experienced legal representation in New Jersey workers’ compensation claims. We help our clients pursue the full amount of the benefits they deserve. If you were injured at work and are unsure of what to do next, contact our firm to discuss how we may assist.