Posts by Albert Talone

New Jersey created the Second Injury Fund in 1923. This fund was meant to encourage employers to hire disabled workers by limiting their liability for compensation payments.

Employers were afraid that workers who had already been injured on the job or who have pre-existing conditions would be more prone to injuries on the new job thanks to their partial disability. 

When does the Second Injury Fund take over?

If you are injured in a new way on the new job and are rendered totally disabled by the new injury, the Second Injury Fund eventually takes over payments, rather than the employer’s workers compensation policy. This policy also covers you in cases where a combination of a preexisting injury or illness and a workplace injury cause total permanent disability. 

You may still receive temporary benefits from your employer for a second injury. Fund benefits kick in six months before the end of the first 450 weeks of permanent and total disability. During that time, you will need to complete forms and receive medical certification that you are 100% totally and permanently disabled and are unable to work any job. 

What does the Second Injury fund cover? 

The fund only covers lost wages up to 70% of your weekly wage. It does not cover medical expenses. These must still be covered by the employer’s workers compensation plan. In addition, Second Injury Fund payments are reduced if you receive other benefits, such as social security benefits. 

These benefits will pay for life, …

Dependency benefits are the benefits awarded to the dependents of a worker who dies on the job in New Jersey. They are not to be confused with unemployment dependency benefits, which are different. 

Benefits cover:

• Up to 70% of the deceased worker’s applicable wage, subject to state minimum and maximum rates for the year of death
• Payment of any medical bills that were incurred before the worker died
• Reimbursement of up to $3,500 in burial costs.

These benefits are offered instead of wrongful death benefits when a worker dies on the job. 

Who counts as a dependent? 

A person’s spouse and children generally count as dependents. Adopted children, parents, grandparents, grandchildren, and siblings can sometimes count as dependents if they were residing in the household of the deceased at the time of death.

How to Claim Dependency Benefits

To start, contact your loved one’s employer. They should be providing you with the paperwork to file the claim. 

How long do dependency benefits last?

A spouse may claim death benefits for as long as they live, unless they remarry. Once the spouse of the deceased remarries, then the spouse is only entitled to the remainder of compensation that would have been due had the spouse not remarried, or 100x the amount of weekly compensation paid immediately preceding the remarriage, whichever is less.

Children may receive benefits until they reach the age of 18, or until they reach the age of 23 if they are students. Mentally or physically disabled children …

Income reconstruction usually happens in cases where an employee works part-time, and does not work the same number of hours every week. 

This allows the employee to receive fair compensation for lost wages.

Examples of Income Reconstruction

For example, if you work an average of $20 a week at $20 an hour, then your average weekly wage should be computed at $400…not the $200 you would have made on the off week where the employer only had ten hours of work for you. 

Income reconstruction may also be used in cases where the employee usually works full time, but is sometimes part time due to business demand. This often happens in the construction industry, wherein the employee might be very busy during the warmer months but have a shorter work week during the winter months. The judge might opt to use the normal 40 hour workweek for that employee’s wages instead. 

Reconstruction can also be used in cases where the employee works a great deal of overtime. If it’s common for the employee to work 50 or 60 hours a week in a nonexempt position then the courts would look at the normal income and hours for that employee. 

How many weeks should be used to reconstruct income?

Usually claims adjusters use 26 weeks worth of wage statements to compute the wage. This is a six-month lookback. The adjuster will take the average of your weekly hours to determine your usual wage. 

What if you also had a

Many jobs in New Jersey require copious amounts of overtime. If you are a non-exempt employee who works more than 40 hours a week, you are generally entitled to time-and-a-half pay. 

Exempt employees are salaried employees. In general, you must make at least $455 a week before you can be considered an exempt employee. Some employers try hard to misclassify employees as exempt when they should not be, and this is an issue your New Jersey workers compensation lawyer can handle for you if this is true in your case. 

If you routinely work overtime, you will be happy to know that New Jersey workers compensation law does require your overtime pay to be taken into account when determining your average weekly wage for the purpose of paying temporary disability benefits.

The workers compensation insurance company must take your average weekly wage, including overtime, paid during a six month period. You then receive 70% of that wage, up to the $921 weekly maximum currently set by the New Jersey Department of Labor. 

Permanent partial disabilities work a little differently. If you have a scheduled disability involving the loss of a body part or system identified on the New Jersey disability schedule, then you will receive 24 weeks of permanent partial disability benefits at the rate offered by the chart, dependent on how much loss of function you have suffered. These benefits are paid weekly after your temporary disability benefits end.

Permanent total disability benefits kick in after it …

One of the worst things about the workers compensation process is that you’re not working with you’re own doctor. You’re working with a doctor chosen by your employer and affiliated with your employer. That means that your doctor may not be working in your best interests. 

That doctor might well tell you that you’re fine to return to work even while you’re still suffering from extreme pain or disabilities. They might ignore every concern you raise about returning to work. 

And if you don’t go back when the doctor orders you to go back, you could lose your workers compensation benefits. Many people return to work before they’ve reached Maximum Medical Improvement (MMI), so it’s not even unusual. 

Some particularly unscrupulous doctors may even reduce the amount of restrictions you should really be laboring under for your health so that you are returned to full duty, or so that your “light duty” isn’t really very light at all. This can mean an inability to return to full health. You can exacerbate your injuries, or even take on additional injuries.This is in addition to many of the dirty tricks that employers play around light duty, such as making work particularly onerous in the hopes that they can encourage you to quit. 

To make matters worse, the on-staff medical case managers at the insurance company will often raise questions about your ability to work or your need for certain treatments. 

Fortunately, you do have the right to get a second opinion, …

A new job is exciting, and the last thing you’re probably anticipating is an injury when you show up for your very first day.

Nevertheless, accidents happen, especially on hazardous worksites where injuries are an occupational hazard. 

Fortunately, you are entitled to workers compensation benefits from the moment you are employed. You could be on the job for 5 minutes, get hurt, and receive benefits. 

The process is exactly the same. You report your injury to the supervisor and they send you to a doctor. Your treatment should be covered. 

The process is only slightly complicated by the fact that you won’t have paystubs or a work history to draw a salary from in the event that you need to take time off work to heal. You’re eligible for up to 70% of your weekly wage, but what is that amount?

When that happens, employers will generally draw on your offer letter and the number of hours you were hired to work. If you were hired to work 40 hours at $20 an hour, then they’ll use that weekly wage. You’ll then receive 70% of that wage while you are off work.

This does not mean that taking an injury in the early stages of your relationship with an employer won’t cause complications. If you need to be put on light duty you might find employers attempting to ignore doctor’s orders, or attempting to make life unpleasant for you so you quit.  

In addition, an employer has no obligation …

In New Jersey, independent contractors are not covered by workers compensation. So, of course, many employers try to classify workers as independent contractors, even when they’re not. 

You might find yourself being treated like an employee right up until the moment you get hurt.

Fortunately, New Jersey courts are on to this behavior, and they aren’t tolerating it.

The East Bay Drywall Case 

Recently, the New Jersey Supreme Court ruled in East Bay Drywall, LLC v. Department of Labor and Workforce Development. 

In this case, workers employed by East Bay Drywall did meet some of the criteria laid out under the “ABC Test” which determines whether an individual is an employee or an independent contractor. East Bay would contact workers to see if they were available for certain jobs, and they were free to accept or decline the offer. Some workers even left the jobs mid-installation if they found a better job, and some worked for other area businesses. East Bay would provide the workers with the raw materials necessary to complete installations, and the workers provided tools and transportation. East Bay did not direct the workers in how to finish the drywall, but remained responsible for the finished product. 

As a result, East Bay stopped making their reports to the Department of Labor and Workforce Development. They also stopped contributing to the unemployment compensation and temporary disability fund. The DoJ sent out an auditor. The auditor determined that four of the individuals working for the company should …

Getting injured on the job means you need money fast: you’ve got to pay your bills. So it’s natural to want to know how long it takes for workers comp to start paying.

Here’s what you need to know.

Temporary Disability Benefits 

In general, it will take 7 days between reporting your injury and receiving your temporary disability benefits, which replace 70% of your paycheck while you’re recovering from your injuries.

The reasoning for the waiting period is simple: some injuries are mild enough that you can return to work within that seven day period. You still have to report them and get them seen by a doctor, but in those minor cases you might not have to do more than take a few sick days. 

Medical Benefits

There is no waiting period for medical benefits. You can go to the doctor your employer selects for you right away, and you can expect that your total costs for your initial visits and any visits that the insurance company approves to be “zero.” The law requires the insurance company to cover all necessary and reasonable medical treatment.

If the doctor won’t provide medically necessary treatment you might be able to obtain an Independent Medical Examination (IME), and the insurance company must pay for it. You do have the right to a second opinion. Nevertheless, if you get into a dispute about which medical benefits workers comp will and will not pay for it is probably time to talk to an attorney. …