Edison Workers’ Compensation Attorney
New Jersey law requires virtually all employers to carry workers’ compensation insurance, a form of coverage that protects New Jersey workers against the costs of getting injured or falling ill in connection with their employment.
In New Jersey, workers’ compensation is a no-fault insurance system, which means that employees receive compensation regardless of who is at fault for the employee’s injury or illness.
Despite that, however, injured workers and families of workers who died tragically because of a workplace condition or incident sometimes face challenges in obtaining the workers’ compensation benefits they need and deserve. Workers in and around Edison, New Jersey, who suffer on-the-job injuries can increase their odds of recovering every penny the law requires by hiring an experienced Edison Workers’ Compensation attorney.
Jacoby & Meyers, LLP’s New Jersey Workers’ Compensation Practice
Since our founding in 1972, the lawyers at Jacoby & Meyers, LLP have committed their careers to fighting for the rights of fellow New Jerseyans who have sustained serious injuries and lost loved ones in preventable accidents and incidents. From the beginning, a significant part of our law practice has focused on representing injured workers in connection with obtaining workers’ compensation benefits and in pursuing other types of compensation through legal action.
The team at our Edison, New Jersey office has a long track record of making sure workers get fair and just treatment from the state workers’ compensation system and, when applicable, in New Jersey courts. Finally, Jacoby & Meyers, LLP, has an important asset we can use in cases like yours—our sister law firm has a half a century of experience fighting for workers’ compensation and Social Security disability benefits for injured workers like you. Find out about them at https://www.foalaw.com/, then call us today to take advantage of that partnership.
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New Jersey Workers’ Compensation Benefits
In New Jersey, workers’ compensation insurance provides an array of potential benefits for injured and sick workers, and for the families of workers who die because of a workplace incident or condition. These benefits include the following categories.
Medical Benefits
Workers’ compensation insurance pays for the reasonable medical care an injured worker needs to diagnose, treat, and recover from a work-related injury or illness. This includes prescriptions, hospitalization, and other types of medical treatment. An employer or its insurance company has a right to require that a worker who has suffered a work injury or contracted a work-related illness obtain medical care from a specific health care provider. If the employee needs emergency care or if an employer or insurance company unreasonably refuses to approve medical treatment, the employee may seek the care of the provider of his or her choosing.
Temporary Permanent Disability Benefits
If you are disabled cannot work while under active medical care for longer than seven days, you are eligible to receive temporary total disability benefits. These benefits are paid at a rate of 70 percent of your average weekly wage. Regardless of the amount of your average weekly wage, this type of disability benefit may not exceed 75 percent of the Statewide Average Weekly Wage (SAWW – the average wage earned by all employees covered by the unemployment compensation law) or fall below 20 percent of the SAWW.
Temporary permanent disability benefits usually end as soon as the employee is discharged from medical treatment and can return to work in some capacity, or has reached maximum medical improvement (MMI). At this point, the worker may still be left with either partial or total permanent injuries, which may entitle the worker to additional benefits.
Partial Permanent Disability Benefits
Sometimes a work-related injury or illness causes a partial permanent disability and results in benefits payments for the worker. These benefits are based upon the percentage of either scheduled or non-scheduled losses the employee has suffered. Losses involving toes, feet, eyes, ears, teeth, arms, legs, hands, or fingers are scheduled losses. Non-scheduled losses involve any other type of system or area of the body not specified as a scheduled loss. Partial permanent disability benefits are only paid once temporary disability payments end. The employer’s insurance company pays these benefits weekly.
Permanent Total Disability Benefits
Some work-related injuries or illnesses make it impossible for an employee to return to any kind of meaningful or gainful employment. An employee is presumed to have a permanent total disability if he or she has lost two major members of the body (limbs, digits, etc.), or some other combination of injuries that make a worker unemployable. These employees may receive permanent total disability benefits.
Such benefits are paid every week for an initial period of 450 weeks—just a bit longer than 8.5 years. Upon a showing by the employee that he or she is cannot earn an income after that period, payments will continue beyond 450 weeks.
Permanent total disability benefits, like other workers’ compensation benefits, are based on the employee’s average weekly wage and may not exceed 75 percent of the SAWW or fall below 20 percent of the SAWW.
Death Benefits
The family of a worker who suffers a fatal injury or passes away from an illness contracted at work can file a claim for death benefits under New Jersey workers’ compensation law. The Commissioner of Labor establishes a maximum annual death benefit, which the amount of weekly benefits paid as death benefits (calculated at 70 percent of the weekly wage of the deceased family member) may not exceed.
Death benefits are divided among the deceased worker’s surviving dependents in the manner determined by a judge after holding a hearing. The deceased worker’s spouse and children who, at the time of death, were a part of the household are presumed to be dependents. Children of a deceased worker are considered dependents until they reach the age of 18, or in the case of a full-time student until they reach age 23.
Other dependents, such as a surviving spouse or children who weren’t a part of the decedent’s household at the time of death, as well as grandchildren, siblings, parents, and grandparents, must prove that they were actually dependent of the deceased worker. The deceased’s children with mental or physical disabilities may be eligible for additional benefits.
In addition to weekly cash death benefits, the family of a fatally injured worker may receive up to $3,500 in funeral and burial expenses.
Can I Also Sue for a New Jersey Workplace Injury or Illness?
It’s possible, depending upon the facts of your injury or illness.
Generally speaking, you cannot sue your employer. The tradeoff for New Jersey’s no-fault system of workers’ compensation insurance is that employees may not bring a civil lawsuit against their employers for damages arising from a workplace injury or illness, except in the case of an injury or illness resulting from an employer’s intentional wrong. Speak with a lawyer to understand your rights, if any, against your employer.
Some workplace injuries and illnesses, however, happen because of the poor decisions or dangerous actions of a third party—someone other than the injured worker or the worker’s employer or co-workers. For example, if a defect in a gas storage tank causes it to explode on a job site, the tank’s manufacturer could have legal liability to a worker injured in the explosion, even if the worker also recovers workers’ compensation benefits (although the worker’s employer may receive credit against amounts paid by a third party). As above, the best way to determine if you may have legal rights against third parties for your workplace injury or illness is to speak with an experienced Edison workers’ compensation attorney.
What if an Employer Does Not Carry Workers’ Compensation Insurance?
Employers who fail to carry workers’ compensation as required by New Jersey law are subject to serious financial penalties. For the first 20 days of noncompliance, they can be fined up to $5,000. For each subsequent 10-day period, they can be fined up to an additional $5,000.
Anyone who learns of an employer’s noncompliance with workers’ compensation law can file a complaint with the Office of Special Compensation Funds. Speak with an experienced workers’ compensation attorney before taking this step, to ensure your rights stay protected.
What to Do When You Get Hurt or Sick at Work
Edison, New Jersey-area workers who get hurt or sick in connection with their employment should follow some basic steps to protect their legal rights and to help ensure they receive the maximum compensation they deserve.
Notify Your Employer
Tell your employer about your injury or illness as soon as possible. Preferably, notify your employer immediately, but do not wait more than 90 days or you could lose your rights to workers’ compensation benefits. It is especially important to notify your employer of any injury or illness that will require medical care. You can give notice orally or in writing to a supervisor, HR person, or anyone else in a position of authority at your workplace.
Seek Medical Treatment
If you need medical care for your injury or illness, then get it. Keep in mind, however, that unless you need emergency care, your employer has the right to select the doctor who treats you. Even if you receive medical care, you will need to notify your employer of who treated you, and you may subsequently be required to receive care from an employer-approved physician. Do not make the mistake of assuming that any doctor is covered by workers’ compensation. In New Jersey, it is best to check with your employer first before scheduling an appointment with a health care provider to make sure the provider is covered by workers’ comp.
In all events, be sure to follow your doctor’s treatment plan. Take your medicine, keep follow-up appointments, and go to prescribed physical therapy. Failing to follow a treatment plan could put your workers’ compensation benefits at risk.
Wait for a Decision
In New Jersey, injured workers do not need to file a claim right away to receive benefits. Instead, after you have fulfilled your obligation by reporting your injury to your employer and seeking care from an approved medical provider, your employer then has certain requirements it must follow. Firstly, your employer must notify its workers’ compensation insurance carrier immediately. This allows a First Report of Injury to be filed with the State, which the insurance company must file within 21 days of receipt of the report.
Once the insurance company has received a report from an employer whose employee has been injured at work, it will evaluate the claim and decide whether to pay benefits to the employee covered under the employer’s plan. It will do this by contacting the employer, the employee, and those who provided medical treatment to the employee.
What to Do if Workers’ Comp Denies Your Claim
As you may have guessed, an insurance company or employer can refuse to provide benefits to an injured or sick worker. Disputes between the parties may arise regarding the type or extent of required medical treatment, disagreements over whether the injury or illness actually resulted from a work-related accident, or the payment of disability benefits.
If your claim is denied, then you have the right to file a claim with the Department of Labor’s Division of Workers’ Compensation. You have the right to request an informal or formal hearing at which the dispute will be decided by a judge of compensation. Any party that disagrees with that judge’s decision may then file an appeal.
Speak with an experienced New Jersey workers’ compensation attorney as soon as possible if you receive notice of denial of workers’ compensation benefits. You have important rights at stake, and it is easy to make an error in choosing how to address your claim denial. Even deciding between a formal and informal hearing request can have significant legal and practical consequences. Do not risk your rights by making a decision that can affect the workers’ compensation benefits you receive without first consulting with experienced legal counsel.
Call Our Edison Workers’ Compensation Lawyers Now
At Jacoby & Meyers, LLP, our team has committed itself to fighting for the rights of fellow Edison residents struggling with the aftermath of a work injury or illness. If you got hurt or sick at work, then call the experienced workers’ compensation team in our Edison office to learn about your rights. We have three easy ways for you to reach us whenever it’s convenient for you. You can start a live chat with us, call (732) 287-6890, or contact us online for a free case evaluation.
Edison Workers’ Compensation FAQs
According to recent census numbers, there are more than 10,000 businesses in Edison. The government includes in this count all nonfarm businesses filing tax forms as individual proprietorships, partnerships, or any corporation, and with receipts of at least $1,000. These businesses are in all types of sectors and industries, but they all have something in common: workers’ compensation covers their employees.
Read on for the answers to frequently asked questions about Edison workers’ compensation claims. If you have sustained an injury in a workplace accident or have suffered an occupational injury, trust the experienced workers’ compensation lawyers from Jacoby & Meyers LLP to assist you with your claim.
What is workers’ compensation?
Workers’ compensation is a no-fault insurance policy that most employers in New Jersey must purchase on behalf of their employees.
If the worker becomes injured at the workplace or suffers an illness related to his or her job, the policy provides:
- Medical benefits
All necessary and reasonable treatment, prescription medications, and hospitalization services related to the workplace injury or illness will be paid by the insurance provider or by the employer directly.
- Temporary total disability payments
If a worker misses at least seven days of work due to the injury or illness, he or she will qualify for temporary total disability payments equaling 70 percent of his or her average weekly income, with minimum and maximum levels established by the statewide average weekly wage. These benefits usually last until the worker returns to work in some capacity or has reached maximum medical improvement for his or her condition and cannot perform job-related tasks.
- Permanent partial benefits
If your injury results in a partial permanent disability, you will receive benefits equaling a percentage of the state’s scheduled or non-scheduled losses, which determine how much an individual will receive for permanent loss of function of certain body parts. Scheduled losses include body parts, such as the arms, legs, feet, eyes, or ears. Non-scheduled losses refer to injuries to other areas of the body, such as the back, heart, or lungs. These benefits are due immediately after your temporary total disability benefits end.
- Permanent total benefits
Sometimes, an occupational injury or illness is so severe that the worker cannot return to any employment. These benefits are 70 percent of the worker’s average weekly wage and are provided initially for 450 weeks. Workers may extend the benefits if they can show they can’t perform any job-related tasks.
- Death benefits
Including wage replacement and funeral and burial costs.
How do I know if I qualify for workers’ compensation benefits?
The law requires all New Jersey employers that federal programs don’t cover to provide a workers’ compensation policy for their employees or to be self-insured. This means that if you are injured at the workplace or suffer a work-related illness, and a federal workers’ benefits program doesn’t cover you, your employer should cover you. If you become injured or ill on the job, your employer (if self-insured) or your employer’s insurance provider will decide whether your injury or illness meets the coverage criteria.
What is the process for receiving workers’ comp?
If you become injured at the workplace, you should inform your employer as soon as possible. You may provide your notice either orally or in writing to your supervisor, personnel office, or anyone in a position of authority at the business. If your injury requires medical treatment, you should also notify your employer as soon as possible, as the employer (if self-insured) or the insurance provider who holds the workers’ comp policy has the right to determine where you receive treatment.
Once you report your accident to your employer, the employer must notify the insurance company immediately so that it can file a first report of the injury with the state. The insurance provider will evaluate the claim and determine if it is compensable according to New Jersey’s workers’ compensation law. If the claim does qualify as compensable, the injured worker may need to see an authorized health care provider for treatment. If the worker must miss work because of the injury for at least seven days, he or she will begin receiving temporary total disability benefits.
Can I recover additional compensation by filing a lawsuit against my employer?
In most cases, filing a lawsuit against your employer is not an option. New Jersey’s workers’ compensation provides wage loss and medical benefits to injured workers regardless of who was at fault for the accident that resulted in injury. In exchange for the provision of these benefits, the worker generally can’t seek damages from the employer through a lawsuit.
You are, however, permitted to file a lawsuit against a third party who was liable for the accident. An example of third-party liability in a workplace accident would be a delivery driver who was injured in a motor vehicle accident that a third party—someone who is not your employer or a coworker—caused. If you file a lawsuit against a third party while receiving workers’ compensation benefits, you may need to repay portions of the workers’ comp benefits that you received for which you also received compensation through the courts. We can help you determine if and how this requirement applies to you.
My husband died in a workplace injury. Does workers’ compensation have death benefits?
Yes.
In New Jersey, the death benefits provided to family members of a worker who died in a workplace accident include:
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- 70 percent of the average weekly wage for the deceased worker not to exceed the maximum benefit amount established annually by the state’s Commissioner of Labor. Beneficiaries will divide this amount. Beneficiaries include the deceased’s spouse and natural children who were living in the deceased’s household when they died, and other family members and dependents not living in the deceased’s household but who are beneficiaries based on dependency on the deceased. Children are dependents until 18 years old, or—if enrolled as a full-time student—until 23. Children who are older than 23 but who are mentally or physically disabled are also entitled to benefits.
- Up to $3,500 for funeral expenses, paid to the individual who incurred the expense or to the estate.
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What happens if workers’ compensation denies my claim?
You have two options:
1). You can file a formal claim petition with the state Division of Workers’ Compensation; or
2). You can apply for an informal hearing with the Division. This process resolves issues without a more formal proceeding. The judge can suggest how to resolve the issue, but in the informal process, these suggestions are not legally binding.
Upon filing your formal claim petition or your application for an informal hearing, either a judge or a district office will hear your case. You will receive scheduling information within a few weeks for an informal hearing and most cases resolve within two sessions. In formal claim petitions, you will generally have your first hearing within six months of the filing date. Most cases settle by mutual agreement in the pre-trial stage. However, if your formal petition does go to court, a trial will take place, involving testimony from you as well as medical and other witnesses.
You definitely want our attorneys to represent you in either of these proceedings.
What are some causes of a workers’ compensation claim denial?
There are many reasons why an employer or insurer would choose to deny a claim.
Some of those reasons include:
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- No one witnessed your injury, and your employer has reason to believe it did not occur at work.
- Your employer believes that you deliberately sustained an injury to obtain benefits.
- You did not immediately report your injury to your employer.
- Your initial medical records indicate alcohol or illegal drugs in your system.
- You were fired or laid off before you attempted to file a claim and therefore no longer had the workers’ compensation policy available to you.
- You refused to give the insurance company a statement or authorize the release of your medical records.
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What happens if my employer does not have workers’ compensation?
If your employer does not have workers’ compensation insurance, but the law required it, you can report your employer to the Division of Workers’ Compensation for compliance enforcement. Employers that refuse to provide workers’ comp coverage are subject to enforcement actions, such as monetary penalties, restitution, and even criminal charges. The penalties collected from non-compliant employers go into a fund to pay the claims of workers who have suffered a workplace injury and whose employers failed to provide insurance.
I am injured, but I am afraid that if I tell my boss, she will fire me. What should I do?
It is against the law for an employer to fire you or otherwise retaliate against an employee who claimed or attempted to claim workers’ compensation benefits, or because the employee testified or must testify in a workers’ compensation matter. The most common remedy in situations like this is reinstatement by the Division of the worker’s employment, provided that the worker is ready, willing, and able to perform the duties required for that employment. You also are permitted after retaliation for workers’ compensation matters to seek recourse through a civil lawsuit.
Will I have to pay taxes on my workers’ compensation benefits?
Generally, workers’ compensation benefits are not taxable at either the state or federal level. However, an exception to this rule exists when the injured worker also receives benefits from other programs, such as Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), and the combination of wage replacement and other compensation from the programs drive the amount the recipient receives through these programs over certain income levels. In these situations, the recipient may have to pay taxes on a portion of the benefits.
How can an Edison workers’ compensation lawyer help with my claim?
An experienced workers’ compensation lawyer from Jacoby & Meyers LLP can ensure that you receive the benefits you deserve.
We provide:
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- A no-obligation free consultation with one of our attorneys. This is time to discuss your workers’ compensation-related issue and to obtain answers to your questions about the process of obtaining workers’ compensation benefits.
- Assistance with claim denials, including attendance and representation at all informal and formal proceedings.
- Assistance with filing the required paperwork to receive, dispute, or increase your benefits.
- Assistance with issues regarding the timing of your release to return to work and the availability of a job that you can perform.
- Guidance with problems with your benefits, such as feeling unhappy with the provider who is treating your work-related injury or having your benefits delayed.
- Help accessing state funds that are available for workers whose employers failed to provide a workers’ compensation policy or who refuse to submit the claim to their insurer.
- A review of the details of your injury and other aspects of your case to determine if you may receive additional compensation from other programs, such as SSDI or SSI.
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We understand how concerning it is to have an injury that requires you to miss work. Let us help you access the workers’ compensation benefits for which you are eligible. To discuss your Edison workers’ compensation claim, contact us for a free consultation.
Edison Office
1929 NJ-27
Edison, NJ 08817
732-287-6890
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“I’m really grateful for the settlement my lawyers at Jacoby & Meyers helped me to obtain. I was badly hurt when another driver crashed into my card. The driver was carelessly. My team at Jacoby & Meyers didn’t let the reckless driver get away with it. I’m really glad I made the call to Jacoby & Meyers and would suggest anyone hurt in a car crash do the same.”
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