New Jersey Public Safety Employee Lawyer & Attorney : Arpaia & Crivelli Law Firm : Police, Firefighters, Workers Compensation, Discipline Representation : New Jersey

On October 1, 2008, Governor Jon Corzine signed into law five bills aimed at fixing New Jersey’s Workers’ Compensation System. Significantly, the bills should reduce the long delays in making injured workers whole. The legislation, the State’s first workers’ compensation overhaul in thirty years, was the product of public hearings that followed a series of articles in the The Star-Ledger of Newark that were critical of systemic delays. The articles also described a bureaucracy that was easily manipulated by employers and their attorneys. 

The bills give workers’ comp judges more authority to enforce their orders, penalize employers who fail to provide workers’ comp insurance coverage for their workers, and ensure that employees injured on the job are given prompt and adequate treatment as well as short term disability benefits. In pertinent part, the bills provide:

• S-1913: Permits workers’ comp judges to hold a separate hearing on any issue of contempt, and if contempt is found, the successful party can file a motion in Superior Court for enforcement. A judge may also impose costs and simple interest on money due and, in the event of an unreasonable delay, may award legal fees of up to 20 percent of the award.

• S-1914: Strengthens enforcement actions against employers for failure to provide workers’ comp coverage. Those employers that knowingly fail to provide coverage can be charged with a second, third, or fourth degree crime and can be fined up to $5,000.

• S-1915: Requires all employers to submit proof of workers’ comp coverage as part of its annual report. If a statement of proof is not included, the annual report will not be considered as properly filed.

• S-1916: Requires that when a doctor states an injured worker is in need of emergent medical care that employer has not authorized, the worker can file a request for treatment with the Division of Workers’ Compensation. The division and the employer must answer the request within five calendar days.

•  S-1917: Revises the membership of the Compensation Rating and Inspection Bureau, presently made up primarily of insurance industry representatives. Instead, the bill requires the Department of Banking and Insurance to include members who do not represent the industry, but rather representatives of employers, labor, and licensed insurance producers. 

It will be interesting to see how these new measures alter the landscape of the New Jersey Workers’ Compensation System. Hopefully, these laws will prove to be adequate in aiding injured workers and ensuring unscrupulous employers and persons will not be able to “work” the system.       

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Last week we spoke about medical benefits in the New Jersey Workers’ Compensation System. In this entry we will give a brief overview regarding total permanent disability benefits, and partial total disability benefits.

The third type of benefit that an injured worker is entitled to receive under the New Jersey Workers’ Compensation Act is commonly referred to as total permanent disability benefits and/or partial total disability benefits. Total permanent disability benefits are reserved for the injured worker that has been declared permanently disabled and is unable to return to work. Partial total disability benefits are benefits that are paid for injuries that have not rendered the employee totally disabled.

Permanent and partial total disability benefits are often a one-time lump sum payment, or bi-weekly payments that an injured employee will receive at the end of his or her workers’ compensation case. The amount of money that the injured employee will receive is based upon a statutory schedule established by The New Jersey State Legislature and is particular to the severity of the injury, and the injury to the particular body part.

The benefits associated with permanent and partial total disability are based on a weekly compensation system. The seriousness of the disability is taken into consideration in awarding permanent and partial total disability benefits. The more serious the injury, the greater the award an injured worker can expect to receive. The benefits paid as a result of receiving permanent and partial total disability benefits are not subject to taxation by either the State or Federal Government. Furthermore, attorney’s fees associated for representation in a New Jersey workers’ compensation case are deducted from an award of permanent and partial total disability benefits. Additionally, certain expenses that an attorney expends in representing an injured worker are also deducted from the award of permanent and partial total disability benefits. 

It is important to remember that if a public safety officer is declared totally disabled and is going to collect an ordinary disability pension, there will be a monetary offset for the pension award in regard to the money received for total and/or partial disability benefits under the New Jersey Workers’ Compensation System. Furthermore, if the public safety officer is awarded accidental disability benefits, the workers’ compensation permanent and/or partial disability award will be negated in its entirety.

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We haven’t spoken about the New Jersey Workers’ Compensation system in a little while and there is still a great amount of information regarding the available benefits that all public safety officers and first responders should be made aware of. With that being said, let’s talk a little about medical benefits under the New Jersey Workers Compensation Act. 

Under the New Jersey Workers’ Compensation system, the injured employee is entitled to reasonable and necessary medical treatment to cure and relieve the effects of the injury, illness, or condition that occurred either on the job or as a result of the job. In New Jersey, due to the fact that the employer is responsible for payment of 100% of the injured worker’s medical treatment associated with the workplace injury, the employer has the right and ability to control treatment. What this means, is that the employer or the employer’s workers’ compensation insurance carrier will select the doctors that will treat the injured worker for his or her injury. 

When the injured worker is treated by medical physicians that have been chosen by the employer or the employer’s insurance company, this treatment is commonly referred to as “Authorized Treatment”. However, if the injured employee receives treatment for his or her workplace injuries from physicians, doctors, or hospitals that have not been chosen or authorized by the employer or the employer’s insurance company, this particular treatment is referred to as “Unauthorized Treatment”. 

The New Jersey Workers’ Compensation Act only requires employers to make payment for “authorized treatment” in a New Jersey workers’ compensation case. Therefore, should an injured employee obtain treatment from physicians or medical providers that have not been chosen by their employer or their employer’s insurance company, he or she may be responsible for paying these medical bills out of his or her own pocket.

It is important for an injured employee to understand that the only medical treatment that has to be provided under The New Jersey Workers’ Compensation Act is treatment that is medically necessary to cure and relieve the effects of the injury or condition. Palliative medical treatment does not have to be provided by the employer. Palliative medical care has been described as medical care or treatment that concentrates on reducing the severity of pain associated with the injury, rather than halting or delaying the progression of the injury itself. To clarify, palliative medical treatment is care that provides pain relief only. It is not medical care or treatment that will improve the medical condition of the injured worker.

Medical treatment under the New Jersey Workers Compensation Act must continue until one of two events occurs; the employee is returned to work, or in the alternative, a doctor declares that the employee has reached maximum medical improvement or “MMI”. When one of these two events occurs, medical benefits and temporary total disability benefits will cease, and the injured employee’s claim will move to the establishment of a permanent disability rating and thus the settlement of the case. We will discuss permanent disability and partial total disability in a later entry.   

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Let’s talk about temporary total disability benefits injured public safety officers are entitled to receive under the New Jersey Workers’ Compensation Act. 

The New Jersey Workers Compensation Act provides each employee who has suffered a workplace injury with temporary total disability benefits. Temporary total disability benefits are those benefits that are most akin, or similar, to temporary disability benefits one would receive from The State of New Jersey during the period of time that he or she could not work as a result of an injury or illness. However, temporary total disability benefits in the workers’ compensation arena are limited to those individuals who have been injured at work. 

An injured worker in the state of New Jersey can expect to receive 70% of his or her gross average weekly wage for 26 weeks before he or she was injured subject to a maximum amount established by The New Jersey Department of Labor. The maximum amount of weekly temporary total disability benefits change year to year and rise based on cost of living adjustments as enacted by The New Jersey State Legislature. Payments of temporary total disability benefits will continue for the injured worker until one of two events occur. Benefits will cease at the time that the injured worker is medically cleared to return to work, or has recovered to the point that he or she would no longer benefit from medical treatment. Attorneys often refer to this standard as Maximum Medical Improvement (MMI). When one of these two events occurs, temporary total workers’ compensation benefits will cease, and the employee will no longer receive 70% of the gross weekly wage.

However the payment of temporary total disability benefits as it pertains to public safety officers in the state of New Jersey is different. Most public safety officers that are injured on the job, the injury is “documentable” as occurring on the job, and the injury is not a reoccurring pre-existing injury, will receive Sick Leave Injury benefits. Sick Leave Injury benefits are more commonly referred to as SLI benefits. SLI benefits entitle the injured public safety officer to receive full pay for a period of one year from the date of injury, or until the individual has reached maximum medical improvement and has returned to employment, whichever occurs first. Unfortunately, SLI benefits do not include overtime wages that would have been earned but for the injury. Furthermore, it is very important to understand that if the injured public safety officer cannot return to work due to the severity of the injury within one year from the date of the accident, SLI benefits will cease and convert to temporary total disability benefits under the New Jersey Workers Compensation Act.  The particular legal nuances that pertain to SLI benefits will be discussed in more detail in a later post. 

In our next entry we will talk about the medical benefits injured public safety officers are entitled to receive under the New Jersey Workers Compensation Act.

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This will be the first entry of many regarding the topic of workers’ compensation in New Jersey. This topic, perhaps more than any other is of particular import to the public safety officer. This is due to the inherent dangers and physicality of police, fire and corrections work. If you are a public safety officer and reading this blog entry, the odds are favorable that you are presently injured and in the workers compensation system; were previously injured at work and went through the workers’ compensation system; or you will be injured in future employment, and will have to go through the workers compensation system. In any event, pay close attention to this series of blog entries as they will answer many of the questions you may have regarding workers’ compensation, and give you an overview of how the system works. 

New Jersey has been one of the leading states in enacting legislation to protect the injured worker. The New Jersey Workers’ Compensation Act, or a version thereof, has been in effect in The State of New Jersey since the year 1911. Prior to the enactment of The New Jersey Workers’ Compensation Act, workers who were injured during the time of their employment were forced to initiate litigation against their employer to receive benefits and compensation for the injuries that they suffered in the workplace. The legislature found this particular system to be ineffective due to the fact that litigation of the case would take several years to work its way through the court system, often leaving the injured worker without benefits, compensation, or a means to support his/her family during this difficult period in their lives. Today, filing and settling a workers’ compensation case takes time, however it is normally as lengthy a procedure as litigating a case in the Superior Court of New Jersey.

1979 was a breakthrough year for a New Jersey Workers’ Compensation Act. Legislative reforms were initiated in 1979 that revamped the entire workers’ compensation system, created a chart of injuries that is currently in use in one form or another, and placed an emphasis on insuring workers with injuries received benefits that were commensurate with the severity of the injuries. Furthermore, the new system initiated in 1979 discouraged workers with minor injuries from receiving disproportionate benefits based upon only their subjective complaints. In the end, the 1979 legislative reforms have led to the workers’ compensation system that is presently in use. Undoubtedly, it is not a perfect system. However it does provide a fair means of compensation for the injured worker. It can best be described as a functional system that enables the injured worker to receive benefits that will hopefully sustain the worker and their family during this difficult period in their lives. 

In our next entry, we will give you an overview of the three types of benefits available under the New Jersey Workers Compensation Act.

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