Understanding NJ Workers Comp Rates
New Jersey uses different coverage rates for the various types of expenses it covers. Worker’s compensation can cover a variety of expenses such as:
- Medical care
- Vocational rehabilitation
- Death Benefits
- Funeral Expenses
When determining if the worker’s compensation carrier or the employer directly pays the expenses it varies based on the facts and situation. Employers have specific responsibilities, rights, and privileges to keep in mind.
Worker’s Comp Medical Benefits
The New Jersey Department of Labor and Workforce Development explains that workers’ compensation covers all medical bills related to reasonable and necessary treatment for injuries received at work or during the course of employment related activities. This includes hospitalization, medical treatments received and prescriptions. If you are injured and have to make a claim but are worried about your employer having to pay the expenses directly, do not. Typically the employer does not cover these expenses directly out of their pocket; their insurance carrier does. Its is very important for you to check with your employer to determine what doctors and medical facilities are covered by the worker’s comp carrier. Frequently carriers will restrict which providers they will coverage treatment for. This is because employers have the right to choose designated physicians or facilities to treat their injured employees. In this instance, if the worker receives treatment from a physician or facility outside of the employer’s insurance network the employer likely and legally may refuse to pay for that treatment. Checking with your employer or the carrier before getting the treatment can help you avoid incurring costs for uncovered treatment that will have to be paid for out of your pocket.
NJ Temporary Disability Benefits
Workers become eligible for temporary disability benefits if they become unable to work for seven consecutive days. When this happens, they may begin to receive 70% of their average weekly wag. This creates a maximum weekly payment of $945 for 2020, which has increased since 2019 when it was a maximum of $921 weekly. When the doctor determines an individual can return to work or if they do so on their own, then they no longer receive these benefits. If you are cleared by your doctor to return to work but do not, your temporary benefits will cease based on the date your doctor cleared you to return to work.
NJ Permanent Disability Benefits
Often individuals will have reached “maximum medical recover” but still have lingering issues. In these instances, your attorney can try and help you get permanent disability benefits. There are two types of permanent disability benefits:
- NJ Partial Disability: you are injured but still able to work in some capacity just not at the level you previously performed.
- NJ Total Disability: you are no longer able to work due to the injuries
NJ Permanent Partial Disability Benefits
New Jersey partial disability benefits can cover scheduled and non-scheduled losses.
- Scheduled losses refer to losing limbs or other visible body parts.
- Non-scheduled losses refer to disabilities involving internal injuries, such as back pain or lung cancer.
Both scheduled and non-scheduled losses for partial disability allow you to recover up to 70% of your weekly wages, capped at $945 a week. Worker’s comp carriers go on to calculate this amount based on a capped number of weeks.
NJ Permanent Total Disability Benefits
Permanent total benefits get paid when someone has disabilities that make it impossible for them to engage in gainful employment. Like partial benefits, the state requires payments of 70% of weekly wages capped at $945 and a minimum of $252. The amount of time worker’s can receive these benefits is capped and varies from case to case. A licensed attorney can help you determine how many weeks you are covered based on the facts of your case and what your doctor says.
Death Benefits
Unfortunately, some people never recover and pass away due to their injuries received on the job. When this happens, qualifying family members might become entitled to the payments they would have received. The state identifies surviving natural children and a spouse as qualifying dependents who may receive these payments. Other dependents might also make a claim, but they must be able to prove they were dependent on the worker’s income at the time of the worker’s injury. Children who claim dependent status can receive payments until they turn 18. If they then become full-time students, they continue to receive benefits until they turn 23 years old. Children who suffer from disabilities might continue to receive benefits beyond this age. The employer or its insurance carrier must also pay up to $3,500 to the entity that takes responsibility for the burial and funeral expenses, which might be the state in some instances.
Calculating NJ Workers Comp Rates
To put things into better perspective, consider the following example: John is the lead roofer at Booker Construction and makes $1,000 per week. At the start of 2020, the roof he is working on fails and he falls three floors to the ground. He suffers injuries and successfully applies for worker’s compensation benefits. His employer designates a health facility and John initially receives treatment here that totaled $14,000. When the doctor prescribed lifesaving surgery, his family expresses doubts about the designated facility and relies on a surgeon they trust which totaled $20,000. The employer’s insurance company might only need to pay that initial $14,000 since the family went out of the carrier’s network for the treatment. John survives the surgery and begins to receive $700 in temporary disability while still recovering in the hospital post-surgery. Unfortunately, John unexpectedly passes away in the hospital due to his injuries. His family incurs $5,000 in funeral and burial expenses. Based on NJ death benefits Booker Construction would be liable to reimburse the family $3,500 toward funeral and burial expenses. John’s dependents and spouse, if any, could then apply to receive payments to cover some of John’s living wages.
Contact Us
The information provided attempts to simplify what is a complex area of law, so it is only natural that you might still have questions about how to proceed with your case. Costello Law Firm has been serving New Jersey workers for more than 20 years. Contact us today for a free consultation. This article is for informational purposes only and should NOT be relied upon or interpreted as legal advice. Every case is different, and you ALWAYS consult a licensed worker’s compensation attorney in a timely manner for the best outcome of your claim.
0 Comments