In many ways, a New Jersey workers compensation claim looks and feels just like a personal injury claim. In other ways they are completely different.
In fact, the workers compensation system exists, in part, to protect employers from the kinds of liability that are invoked in a personal injury suit. Employers admit no fault, but take responsibility for the fact that employees do get hurt on the job.
Here are some of the other key differences.
Difference #1 – No Pain & Suffering
Personal injury suits come with pain and suffering damages. In New Jersey, these damages are not capped and can be any amount based solely on the extent to which the victim’s life has changed as a result of the injuries.
As you can imagine these pain and suffering awards can get quite large, and so workers compensation law was written to allow employers to avoid them in return for asking employers to pay for workers compensation insurance. (If yours isn’t, you can report them by using this form).
Difference #2 – Lost Wages
In a personal injury case you can be compensated for 100% of your lost wages, whatever those wages happen to be, if you can’t work while you’re recovering from your injuries.
In a New Jersey workers compensation case, there are caps on the amount of money you can receive each week, regardless of how much you made, though the amount you made will also determine how much you get. The most money …Read More
On its surface, workers compensation is a reasonably straightforward system. If you get hurt on the job, insurance exists to make sure your medical bills get paid. If you can’t work while you’re hurt, that same insurance pays you to stay home and recover.
Sometimes, the system works as its meant to work. This is especially true when injuries are minor or the disability is temporary. It’s not worth your employer’s time to fight these claims in most cases, more is it worth the insurance company’s time. The accommodations you’ll need tend to be cheap and minor in these cases, and everyone is willing to play along as a result.
When injuries are more extensive and expensive, the equation changes.
Let’s assume you’ve done everything right during this process. You reported the injury to your employer, went straight to the correct doctor, filed your claim, and have followed your physician’s instructions to the letter. Why is workers compensation continuing to be such a beast?
Your employer faces rate hikes.
Your employer is worried about their budget just like you are likely to be worried about yours, and every claim can raise premiums.
Here’s a nice example from a construction magazine.
“In this example, the claim-free experience mod is 66 percent, which means the premium for the workers’ compensation policy is $105,600. However, this single claim, where the fracture with direct costs is $50,000, will drive the mod up 15 points. When this claim hits the mod (experience modifications …Read More
On September 14th Governor Phil Murphy signed S2380 into law. This means that every essential worker who has to go into a physical location to do their job now benefits from a rebuttable presumption of worker’s compensation coverage for Covid-19 cases.
The law took effect on the day of signing, and is offering retroactive coverage to March 9, 2020. This means if you got sick while on the job after that date you can now begin your worker’s compensation claim.
Note that the law does outline exactly who qualifies as an “essential employee.” The rebuttable presumption does not apply to everyone who might step into an office and get sick.
According to S380 an essential worker is:
- A public safety worker or first responder, including fire, police, or other emergency responders.
- Provides medical or health care services, including emergency transportation and social services.
- Performs services which involve physical proximity to members of the public and are essential to the public’s health, safety, and welfare, including transportation services, hotel and other residential services, financial services, and the production, preparation, storage, sale, and distribution of essential goods like food, beverages, medicine, fuel, and supplies
- Is any other employee deemed essential by the public authority declaring a state of emergency.
Note that the presumption is rebuttable. That means your employer may still have a defense if you contract or contracted Covid-19 on the job. They will have to show “by a preponderance of evidence” that you were at no point exposed to the …Read More
There is a Social Security and Supplemental Security Offset that has to be considered if you receive either form of government aid in addition to your workers compensation. In some cases you may have to pay tax on those benefits in those cases. The specific amount will depend on whether you’re receiving permanent or partial benefits.
In fact, if you’re receiving temporary benefits then the amount you’re paid is equal to the amount you would have typically received after taxes.
Do I still have to file a tax return?
Yes, you will want to file a tax return. This will not create a situation where benefits that aren’t taxable become taxable. It merely reports your individual situation to the Internal Revenue Service. It also accounts for other forms of income that may be taxable, such as W2 income earned earlier in the year, retirement benefits, or capital gains.
In addition, if your payments are delayed, for example, in cases where you receive a lump sum settlement because you and your lawyer had to fight for your benefits, then any interest earned on that sum can be taxable as well.
Can other parties put liens on workers compensation benefits?
Yes. If you owe child support, for example, and that amount is in arrears, then the child support enforcement office …Read More
Every business that has employees, even one, must take out a workers compensation policy. If you’re a small business owner like a sole proprietor, partner, or LLC member then you would generally add yourself to the policy at that time.
You don’t have to, of course. It’s an optional thing, and it’s not done automatically.
Yet you probably should.
After all, you’re just as likely to get hurt on the job as your employees are. In some cases, you may even be a “key” employee, as in your business cannot easily survive without you. While workers compensation won’t help with that (that’s what key employee insurance is for) your duties do help to demonstrate that as a small business owners you may well be taking actions, every single day, that could mean you get hurt.
Even office workers and telecommuters can get hurt on the job, after all.
When you take out the policy you have to use a payroll amount. Payroll can be a little fuzzy for small business owners, but New Jersey law has a solution. You must use a minimum payroll amount of $34,320 for the purposes of calculating both your premiums and your eventual benefits in the event that you get hurt.
Of course, you may not want to use the minimum. You may make significantly more than that.
If that’s the case, the you should know that there’s a maximum payroll of $127,400 for the purposes of calculating premiums. Good news for you if you …Read More
Many people in New Jersey work multiple jobs, or work part time in the gig economy while working full-time at more traditional pursuits. Yet many don’t know that having multiple jobs can complicate workers compensation.
The first thing you have to know is that if you get injured on the job you only get workers compensation for the job you were injured at. This means if you get injured on your part-time job you’ll only get replacement wages for the part-time job, while being forced to quit work at your full-time job.
Life can get even more complicated if your problem is a repetitive stress injury. In that case you might have sustained the injury on both jobs but would have to prove it, with each employer trying to shift the responsibility to the other employer.
Your full-time job will also be under no obligation to hold your job or put you on light duty the way they would if you’d been injured at their workplace.
This means holding on to two jobs provides an additional layer of risk that many people are not aware of.
In addition, if you’re injured on your full-time job you cannot keep working your part time job. If you do, you will be accused of workers compensation fraud. You are also likely to lose your benefits.
These realities can add an additional layer of struggle at a time when families are already struggling, but it’s important to understand them so you don’t threaten …Read More
One reason some workers are reluctant to claim workers compensation benefits is they feel as though the accident was their fault. Sometimes anyone can have an off day and work a little clumsily, forget a vital safety precaution, or otherwise create a condition which can lead to an accident or an injury.
Fortunately, New Jersey’s workers compensation system is a no-fault system. For the most part, the only condition you will have to meet to be eligible for benefits is to be injured at work and to report that injury.
What Disqualifies You From Workers Comp?
The first thing that can disqualify you is willful misconduct. That is you were horsing around, abusing alcohol or drugs, or were willfully ignoring or violating company policies. A self-inflicted injury also won’t be covered by workers compensation, i.e., slitting your wrists while you’re in the workplace bathroom.
You can also lose your workers compensation by failing to report the injury in a timely fashion. Some employees do this because they fear retaliation or other consequences. It’s important to remember that retaliating against an employee for claiming workers compensation benefits is against the law.
What is Considered an On-the-Job Injury?
Any injury that occurs while you are working, or while you’re at work. This covers almost any injury that takes place at the workplace location, during working hours, or while performing activities that are within the scope of your employment.
This can even include things you are doing while working from home, so …Read More
Any job can put a lot of stress and strain on the body. In both industrial jobs and office jobs, there are opportunities to incur repetitive stress injuries.
Under New Jersey laws these are known as “wear and tear” injuries. While this terminology may make you feel a little bit like you’re being treated like an apartment or a car, the fact is that the law does allow you to receive compensation when work inexorably robs you of your health. It doesn’t all come down to traumatic accidents or chemical exposure.
Carpal tunnel syndrome is a well-known example, but there are others, such as rotator cuff injuries. Some of these injuries can have a severe impact on a person’s ability to function in their day-to-day lives.
However, you do have to take the appropriate steps to get the compensation you deserve.
First, you’ll need to provide your employer with written notice, just as if you’d suffered from an accident at work. This can be as simple as a dated letter which says, “I have begun experiencing severe wrist pain on the job, the result of a work-related repetitive stress injury. I would like to start the workers compensation process.”
At that point your workplace should assign you to a doctor or a medical facility who will provide you with a diagnosis and treatment. Be sure to bring a copy of your job description with you to your appointment.
Somewhat suspicious of an employer-run clinic? It’s not a bad idea …Read More
Right now, New Jersey workers compensation does allow for claims related to the Covid-19 virus. There’s just one problem.
In most cases, employers and their insurance companies don’t have to pay the claim if you can’t prove there was a direct line from your job to your infection. Because Covid-19 is so ubiquitous, and capable of spreading through asymptomatic carriers, this can be very difficult.
Currently, many essential workers are having to turn to other New Jersey programs liked paid sick leave to try to bridge the gap. For some, this aid will be enough. For others it won’t, especially if the infection lands them in the hospital.
Many essential workers are uninsured, which means Covid-19 could cost them up to $75,000. Going to the ICU or being put on a ventilator is extremely expensive.
In fact, if your symptoms aren’t severe it’s usually best to just isolate at home, drink lots of water, and wait it out, or to use telehealth or other, less expensive services than the ER if you’re not sure.
Nevertheless, workers compensation was created to help pay for worker medical bills when their jobs expose them to a hazard.
Public safety workers like fire fighters, EMTs, nurses, and medical technicians are protected by a presumption that if they contract Covid-19 in the middle of a pandemic while responding to the pandemic then that relationship exists. They’re entitled to workers compensation benefits without having to offer any other proof that the infection came from their …Read More
Many employers will do just about anything to save a buck, even if it means sacrificing employee well-being. If that weren’t the case, there’d be no need for workers compensation lawyers or lawsuits.
Some tricks are common and even expected. You can watch out for them if you’ve taken the time to educate yourself about New Jersey workers compensation law.
Trick #1: Misreporting
After you report your injury to your employer you should receive a First Report of Injury form back from the insurance company. It’s important to scrutinize this document closely to ensure the facts listed on the document match the facts of your case.
Don’t just look at the injury description, since employers sometimes misreport wages too. This is especially common in cases where employees often work overtime. The employers “forget” to include that overtime when calculating average weekly wages.
Trick #2: Failing to Report the Injury Fast Enough
You are responsible for reporting the claim to your employer right away. Your employer is responsible for making the claim with workers compensation.
Some fail to do so fast enough, delaying the process and giving the workers compensation insurance company leverage to deny the claim. Some fail to do it at all, and claim you never reported the injury to them.
Some will try to convince you they shouldn’t report the injury, assuring you they’ll pay your medical bills out of pocket instead of filing the claim. They may even channel you to on-site clinics with doctors …Read More