The Workers’ Compensation Process in New Jersey

Getting hurt on the job can turn your life upside down with medical bills, lost paychecks, and pressure from your employer to get back to work too soon. New Jersey’s workers’ compensation system exists to keep that from happening. It covers medical treatment, partial wage replacement, permanent disability, and even death benefits for job-related injuries and occupational diseases. A South Jersey workers’ compensation lawyer can explain your rights, guide you through each requirement, and help protect your claim from employer or insurance pushback.

You must notify your employer within 90 days under N.J.S.A. § 34:15-17, and the Division of Workers’ Compensation handles all claims. Benefits include free authorized medical care under N.J.S.A. § 34:15-15 and temporary disability payments that replace a share of lost wages. To preserve your rights, a Claim Petition must be filed within two years of the accident or the last payment of benefits under N.J.S.A. § 34:15-51.

Grungo Law represents injured workers throughout South Jersey. Our firm has recovered over $135 million in settlements and verdicts for injured clients. We handle workers’ compensation claims in Cherry Hill, Medford, Hamilton Township, and Vineland. If we can help, we will.

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Key Takeaways for New Jersey Workers’ Compensation Claims

• Workers must report injuries to employers within 90 days under N.J.S.A. § 34:15-17 or risk complete claim denial, though late notice may still permit claims if good cause is shown or the employer had actual or constructive notice.
• New Jersey provides temporary disability benefits equal to 85% of your average weekly wage; for 2025, the maximum weekly temporary disability rate is $1,081, paid tax-free after a seven-day waiting period.
• All reasonable and necessary medical treatment is covered by workers’ compensation under N.J.S.A. § 34:15-15 without co-pays or deductibles, including emergency care, surgery, physical therapy, and prescriptions.
• Retaliation for filing workers’ compensation claims is prohibited by N.J.S.A. § 34:15-39.1, which provides specific remedies for unlawful discharge or discrimination.
• You must file a Claim Petition with the Division of Workers’ Compensation within two years of the accident or last payment of compensation or medical benefits under N.J.S.A. § 34:15-51.

Phase 1: Immediate Steps After Your Work Injury

Act quickly to protect both your health and your claim. Written notice, prompt treatment, and basic documentation are the building blocks that carriers and judges rely on, forming the foundation of the workers’ compensation process in New Jersey as your case moves forward.

Report Your Injury Immediately

Tell your supervisor, manager, or HR department about your injury as soon as possible. Verbal notice works initially, but follow up in writing through email or text message. Ask for written confirmation. New Jersey law under N.J.S.A. § 34:15-17 requires reporting within 90 days, but immediate reporting prevents disputes about whether the injury happened at work.

Document everything: where you were, what you were doing, witnesses present, how the injury occurred. Take photos of the accident scene if possible. Get contact information from anyone who saw what happened.

Your employer should provide a medical authorization form allowing you to seek treatment. Request workers’ compensation insurance information, including the carrier’s name and policy number. If your employer refuses to provide forms or claims you cannot file, contact the New Jersey Division of Workers’ Compensation immediately.

Seek Medical Treatment Right Away

Visit an emergency room for serious injuries. Go to urgent care or your primary care doctor for less severe injuries. Do not delay treatment hoping the pain will go away. Insurance companies argue that delayed treatment means the injury wasn’t serious or didn’t happen at work.

Except for emergencies, the employer (or its carrier) furnishes and controls authorized medical care under N.J.S.A. § 34:15-15. Keep all medical records, bills, and receipts. Attend every scheduled appointment. Follow your physician’s treatment recommendations. Missing appointments or ignoring medical advice gives insurance companies reasons to deny or stop benefits.

Emergency treatment is covered at any hospital or provider. For ongoing care, your employer’s workers’ compensation carrier authorizes and controls medical treatment providers.

Phase 2: Filing Your Formal Claim

Reporting to your employer is not the same as filing with the Division. A Claim Petition preserves your rights if benefits stop or a dispute arises. Use the e-file portal or paper filing and keep copies.

Complete and File Your Claim Petition

Filing a Claim Petition officially starts your workers’ compensation case. Your Claim Petition requires:

• Your personal information and contact details
• Employer’s name, address, and insurance information
• Date and time of injury
• Location where injury occurred
• Body parts injured
• Detailed description of how the accident happened
• Witnesses to the injury

File online or submit paper forms by mail or in person at Division offices in Newark, Trenton, Camden, or New Brunswick. Keep a copy for your records. You must file a Claim Petition within two years of the accident or last payment of compensation or medical benefits under N.J.S.A. § 34:15-51.

Understanding the Insurance Response

Insurance carriers investigate your claim and may accept liability by paying benefits or deny your claim entirely. Common denial reasons include:

• Failure to report within 90 days
• No accident report filed with employer
• Preexisting condition claims
• Independent medical examination findings
• Missing medical documentation
• Disputes about whether injury occurred at work

Denials trigger the need for informal hearings before Workers’ Compensation judges to compel benefits. Most denials at this stage require attorney representation to overcome.

Phase 3: Receiving Temporary Disability Benefits

Cash benefits replace part of your paycheck while you recover. The amount and start date depend on statute and your wage records. The timing and calculation work as follows, and these factors can influence personal injury claims when a third party is also responsible for your work-related injury.

When Benefits Start and How Much You Receive

A seven-day waiting period applies before benefits begin. The first week remains unpaid unless your disability exceeds seven days, making that first week retroactively compensable. Benefits typically start two to four weeks after filing, depending on carrier processing times and medical documentation completeness.

New Jersey pays 85% of your average weekly wage (AWW). For 2025, the maximum weekly temporary disability rate is $1,081. Calculate your AWW by averaging your gross earnings over the 26 weeks before injury, or 52 weeks for seasonal workers with irregular employment patterns.

Because benefits are tax-free, your take-home replacement rate may exceed 85%. Payments arrive biweekly or weekly, depending on the carrier’s schedule.

Common economic records to collect:

• Pay stubs covering 26 weeks before injury (52 weeks for seasonal workers)
• Tax returns (W-2s, 1099s) for the prior year
• Employer wage verification letters
• Medical bills and treatment records
• Travel logs for medical appointments (for mileage reimbursement if authorized by the carrier or ordered by the court)

How Long Benefits Continue

Temporary disability is payable during the period of disability, but not beyond 400 weeks. Benefits stop when:

• Your physician releases you to return to full-duty work
• You reach maximum medical improvement
• You fail to attend medical appointments without an excuse
• Independent medical examinations find you capable of working (which may be disputed through hearings)
• You refuse suitable light-duty work offered by your employer

Phase 4: Medical Treatment Throughout Your Claim

Authorized medical care is a core benefit in New Jersey. The carrier typically directs treatment after emergencies, but you should still track appointments and records. The items below explain coverage and how disputes are handled, and a personal injury team can help make sure disputed treatment, delayed approvals, or denied referrals are challenged promptly.

What Medical Care Is Covered

Workers’ compensation pays all reasonable and necessary medical treatment related to your work injury under N.J.S.A. § 34:15-15. Covered treatment includes:

• Doctor visits with specialists and primary care physicians
• Surgery and hospitalization
• Physical therapy and rehabilitation
• Chiropractic care when medically necessary
• Prescription medications
• Medical equipment (wheelchairs, braces, crutches)
• Diagnostic testing (X-rays, MRIs, CT scans)
• Home health care when prescribed

You pay no co-pays or deductibles. Providers bill the insurance carrier directly. Pre-authorization may be required for surgery, specialized treatments, or expensive procedures.

Independent Medical Examinations

Insurance carriers may require you to attend independent medical examinations (IME) with physicians they select. These evaluations assess your injury, treatment needs, work capacity, and disability rating. IME physicians work for insurance companies and may provide opinions favorable to carriers.

You must attend scheduled IMEs or risk having your benefits suspended. Failure to attend scheduled IMEs can lead to suspension or forfeiture of workers’ compensation benefits. Bring all medical records. Answer questions honestly, but don’t volunteer information beyond what’s asked. IME reports may contradict treating physicians, claiming you’ve recovered or need no further treatment.

Your treating physician’s opinion carries significant weight, especially when backed by objective medical findings. Disputes between treating physicians and IME doctors get resolved through Workers’ Compensation Court hearings with testimony from both sides.

Phase 5: Maximum Medical Improvement and Permanent Disability

When your condition stabilizes, the focus shifts from wage replacement to lasting impairment. Doctors assign ratings that translate into weeks of benefits. The categories below show how permanency is measured.

Understanding Permanency Ratings

Maximum medical improvement (MMI) is the point at which your condition has stabilized and further treatment is unlikely to improve it. MMI doesn’t mean you’re fully healed. Many workers have permanent limitations, chronic pain, or reduced function. Your treating physician evaluates lasting impairment and issues a permanent disability rating expressed as a percentage.

New Jersey recognizes two permanency categories:

• Scheduled Loss (Specific Body Parts): Injuries to hands, arms, legs, feet, eyes, and hearing receive set compensation based on weeks.
• Unscheduled Loss (Body as a Whole): Back, neck, head injuries, and internal organ damage are rated as percentages of total body impairment. Maximum compensation is 600 weeks for 100% total permanent disability. A 15% rating means 90 weeks (15% × 600 weeks).

Receiving Permanent Disability Benefits

Permanent disability benefits equal a percentage of your weekly benefit rate paid for the number of weeks corresponding to your rating. Payments can be made weekly, biweekly, or as a lump sum if both parties agree.

Phase 6: Settlement Negotiations

Not every case should settle, but many do. The form of settlement determines future medical rights and whether the case can be reopened. The two common settlement paths are outlined below, and a personal injury attorney can help you evaluate which option protects your long-term medical needs and financial recovery.

Two Types of New Jersey Workers’ Compensation Settlements

Two settlement paths are common:

• Section 20 (N.J.S.A. § 34:15-20): This lump-sum final disposition results in dismissal of your claim. Generally, no future medical benefits are available and the case cannot be reopened after a Section 20 settlement.
• Section 22 (N.J.S.A. § 34:15-22): This Order Approving Settlement resolves disputes about the extent of disability. Section 22 settlements can be reopened under N.J.S.A. § 34:15-27 within the statutory period if circumstances change. Section 22 settlements typically allow reopening within two years following discovery of a change in condition.

Court Approval Process

All settlements require Workers’ Compensation Court approval. A judge reviews settlement terms to confirm fairness. You appear before the judge, answer questions about your understanding of settlement terms, and confirm your voluntary agreement.

Never settle before reaching maximum medical improvement. You cannot know your permanent disability’s extent while still treating and improving. Never settle without understanding what rights you’re giving up, especially future medical care access.

Insurers may pressure early settlement with large offers. Consult an attorney before accepting any settlement to evaluate fairness based on your injury severity, age, occupation, and future medical needs.

Understanding Disputes and Hearings

When benefits are denied or cut off, the court process provides a path to relief. Cases often start informally and may proceed to formal hearings if needed. Here’s what to expect at each stage, and how these steps can affect your personal injury case when disputes over medical treatment, disability ratings, or benefit eligibility arise.

Informal Hearings

Informal hearings represent the first step when carriers deny claims or stop benefits. These proceedings occur before Workers’ Compensation judges with relaxed evidence rules. Both sides present arguments and medical evidence. Judges issue recommended decisions.

Either party can object to recommended decisions and request formal hearings. Informal hearings often resolve disputes without lengthy litigation, but complex cases typically proceed to formal hearings.

Formal Hearings

Formal hearings resemble trials. Testimony occurs under oath. Lawyers present exhibits, including medical records. Expert witnesses testify (treating physicians, independent medical examiners, vocational experts). Judges issue written decisions after reviewing all evidence.

Formal hearings may take months to schedule due to court backlogs. Cases may require multiple hearing dates for all testimony. Decisions are appealable to the Appellate Division of New Jersey Superior Court, potentially adding years to resolution.

Contact Grungo Law for Your New Jersey Workers’ Compensation Claim

Grungo Law represents injured workers throughout South Jersey including Cherry Hill, Medford, Hamilton Township, and Vineland. We handle denied claims, benefit disputes, retaliation cases, and settlement negotiations.

If we can help, we will. You’re not a case file—you’re someone injured at work facing medical bills and lost wages while your employer’s insurance company delays and denies benefits. Call (856) 548-8347 for free consultation. We advance all costs and charge no fees unless we recover compensation for you. We advance expert witness fees, court costs, and other litigation-related expenses. For injured workers unable to travel, we conduct consultations at homes and hospitals. We will fight for the benefits you need for medical treatment, wage replacement, and recovery.

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