The Workers’ Compensation Process in New JerseyRequest a Free Consultation
Answers to 25 of the most frequently asked workers’ compensation questions. Learn about the process, important deadlines, and other advice to guide you through the process.
What is workers’ compensation?
A: As a general rule, if you are an employee in the state of New Jersey and you are injured or become ill as a result of your work, you are entitled to workers’ compensation benefits. Workers’ compensation is a no-fault insurance program that provides medical treatment, wage replacement and other benefits who become ill or injured on the job. Examples of injuries that may qualify you for benefits include:
- Accidents resulting in physical injuries such as broken bones, burns, or lacerations.
- Repetitive stress injuries, such as carpal tunnel syndrome or tendinitis, caused by continuous or repetitive use of a body part.
- Occupational diseases, such as asbestosis, silicosis, or hearing loss caused by exposure to toxins or harmful substances in the workplace.
- Mental or emotional conditions, such as depression or post-traumatic stress disorder caused by a traumatic event or ongoing stress in the workplace.
- Pre-existing conditions that are aggravated or worsened by work-related activities, such as back pain or respiratory issues.
How do I file a claim in New Jersey?
A: You must report your injury or illness to your employer and complete the necessary paperwork. Your employer is required to provide you with a claim form within one business day of your report.
- Report your injury or illness to your employer as soon as possible, either verbally or in writing.
- Seek medical treatment: If your injury or illness requires medical attention, you should seek treatment as soon as possible. Your employer or their insurance carrier may have a list of approved healthcare providers that you must use for your treatment.
- Fill out a workers’ compensation claim form: After reporting your injury or illness, your employer will provide you with a claim form (Form C-3) to complete. Fill out the form completely and accurately, including all the details of your injury or illness, and the date and time it occurred.
- Submit the claim form: Once you have completed the claim form, you should submit it to your employer, who will forward it to their workers’ compensation insurance carrier.
- Wait for a decision: The insurance carrier will investigate your claim and determine its validity. If your claim is approved, the insurance carrier will pay for your medical treatment and lost wages.
- File an appeal if necessary: If your claim is denied, you have the right to file an appeal within the New Jersey Division of Workers’ Compensation within two years of the date of your injury or illness. This is a legal process that involves a hearing before a judge. You may want to consider hiring an attorney who specializes in this area to aid you in the process.
What types of injuries are covered by workers’ compensation in New Jersey?
A: Workers’ compensation covers injuries that arise out of and in the course of employment, including injuries caused by accidents, exposure to harmful substances, repetitive motion injuries, and occupational diseases, among others.
Are mental health conditions covered by workers’ compensation?
A: Yes, mental health conditions that are a result of work-related stress or trauma are covered by workers’ compensation.
Who is eligible for workers’ comp benefits?
A: Employees who are injured or become ill as a result of their employment are eligible for benefits. Most employees are eligible; however, independent contractors and some other types of workers are ineligible. These include:
- Domestic workers: Household workers, such as nannies or housekeepers, are not covered by workers’ compensation in New Jersey unless their employer has specifically elected to provide coverage.
- Casual employees: Casual employees who work for an employer on a sporadic or occasional basis may not be eligible for benefits.
- Business owners: Sole proprietors and partners in a partnership are not considered employees under New Jersey’s workers’ compensation law and are therefore not eligible for benefits.
- Volunteer workers: Volunteer workers, including those who perform charitable work are generally not covered.
- Certain agricultural workers: Some who work on small family farms and fall under other circumstances may not be covered in New Jersey. Exemption criteria from coverage is as follows:
- The employee must work on a farm that employes fewer than three full-time workers.
- The farm must be owned and operated by the same family.
- The farm must be used for agricultural production and not commercial purposes.
- The farm must be fewer than five acres in size.
- The employee must be a member of the employer’s family or a close relative of the employer.
*While agricultural workers who meet this criterion may be exempt from workers’ compensation coverage, their employers may choose to provide coverage voluntarily. Additionally, agricultural workers who do not meet these criteria may still be eligible for workers’ compensation benefits if they are injured on the job.
How are workers’ compensation benefits calculated?
A: Benefits are calculated based on the employee’s average weekly wage, which is calculated by taking the total earnings in the 26 weeks prior to the injury and dividing that by 26.
What types of benefits are available through workers’ compensation benefits?
A: Benefits can include wage replacement, medical treatment, permanent disability benefits, and vocational rehabilitation.
Can I sue my employer for my work-related injury or illness?
A: In most cases, you cannot sue your employer if you are covered by workers’ compensation. There are limited circumstances in which you may be able to sue, such as if your employer intentionally caused your injury or illness.
How long do I have to file a workers’ compensation claim?
A: You have up to two years from the date of the injury or the date of the last payment of compensation to file a claim in New Jersey.
What is the deadline for reporting a work-related injury or illness in New Jersey?
A: You should report your injury or illness to your employer within 90 days of the incident or within 90 days of becoming aware of the illness.
Can I choose my own doctor for workers’ compensation?
A: In some cases, you may be able to choose your own doctor, but you may be required to see a doctor approved by your employer or the workers’ compensation insurance company. Your employer may have a designated doctor or medical provider that you must see initially. After that, you can choose your own doctor from a list provided by your employer or the workers’ compensation insurance carrier.
What happens if I was injured while working from home?
A: If you were injured while working from home, you may be eligible for workers’ compensation benefits if the injury occurred while you were performing work-related tasks. It can sometimes be more challenging to prove that an at-home office injury was work -related, so it is important to document the circumstances of the injury and report it to your employer as soon as possible.
Can I be fired for filing a workers’ compensation claim?
A: No, in New Jersey, it is illegal for an employer to terminate an employee for filing a workers’ compensation claim. If you are fired for filing a workers’ compensation claim, you may be able to file a claim for wrongful termination.
Under NJ law, an employee who is terminated for filing a workers’ compensation claim may be entitled to reinstatement, back pay, and other damages. It is important to document any evidence that supports your claim, such as witness statements, emails, or performance reviews.
If you believe you have been wrongfully terminated for filing a workers’ compensation claim, you should consult with an experienced employment law attorney for advisement on your rights and assistance pursuing legal action if necessary.
How long do workers’ compensation benefits last?
A: The length of workers’ compensation benefits varies depending on the severity of your injury or illness, your recovery time, and other factors. In some cases, benefits may be paid for a limited period, while in other cases they may be paid for the rest of your life.
How long can I receive temporary disability payments?
A: In New Jersey, temporary disability payments can be received for up to 400 weeks or until the injured worker reaches maximum medical improvement, whichever comes first.
What happens if I am permanently disabled as a result of my injury?
A: If you are permanently disabled as a result of your injuries, you may be entitled to permanent disability payments.
Can I receive benefits if I was at fault for my injury?
A: In most cases, you can receive workers’ compensation benefits regardless of who was at fault for your injuries.
Can I receive workers’ compensation benefits if I was injured outside of work?
A: Benefits are only generally available for injuries or illnesses that occur as a direct result of your job duties.
Can I receive workers’ compensation benefits if I have a pre-existing condition?
A: If your pre-existing condition was made worse by your work duties or if it was aggravated by a work-related injury, you may be eligible for workers’ compensation benefits.
Can I receive both workers’ compensation benefits and disability benefits?
A: Yes, in some cases, you may be eligible to receive both workers’ compensation and disability benefits.
What if my employer does not have workers’ compensation insurance in NJ?
A: If your employer does not have workers’ compensation insurance, you may be able to file a claim with the Uninsured Employer’s Fund (UEF). The UEF in NJ is a program that provides workers’ compensation benefits to employees who are injured while working for employers who do not have workers’ comp insurance coverage. Employers in New Jersey are required by law to carry workers’ compensation insurance to cover their employees for work-related injuries, illnesses, and deaths; however, if they fail to obtain coverage, the UEF may step in to provide benefits to injured employees.
To file a claim with the UEF, you should follow these steps:
- Report your injury to your employer: Notify your employer of your injury as soon as possible. Your employer should complete an accident report and submit it to the Uninsured Employers Fund.
- File a claim with the UEF: If your employer does not have workers’ compensation insurance, or if your claim is denied, you van file a claim with the UEF. To file a claim, contact the UEF office and request a claim form at (609) 292-0052, or (609) 292-2515.
- Submit the claim form: Fill out the claim form, and submit it to the UEF, along with any supporting documents like medical bills, doctor’s reports, and witness statements.
- Attend a hearing: The UEF will review your claim and may schedule a hearing to determine your eligibility for benefits. You will need to attend the hearing and provide testimony about your injury.
- Receive benefits: If your claim is approved, you will receive benefits to cover your medical expenses, lost wages, and other related costs.
*It is important to note that there are strict deadlines for filing a claim with the UEF, so it is important to act quickly if you have been injured while working for an uninsured employer.
In New Jersey, you can also file a claim with the New Jersey Division of Workers’ Compensation.
How does the New Jersey Division of Workers’ Compensation play a role in my workers’ compensation?
A: The NJ Division of Workers’ Compensation is a state agency responsible for administering the workers’ compensation system in NJ. The Division’s mission is to ensure that injured workers receive timely and appropriate benefits, and that employers and insurance companies comply with the state’s workers’ compensation laws. In addition to filing claims, they also provide a variety of other services to injured workers, including:
- Information and assistance: The Division provides information and assistance to injured workers, their families, and employers and insurance companies.
- Mediation services: The Division offers mediation services to help resolve disputes between injured workers and their employers or insurance companies.
- Vocational rehabilitation: They provide rehabilitation services to help injured workers return to work after an injury or illness.
- Legal services” The Division provides legal assistance to workers who are unable to afford an attorney.
What happens if my employer disputes my workers’ compensation claim?
A: If your employer disputes your claim, you will need to attend a hearing before a judge in the NJ Division of Workers’ Compensation. You can take the following steps if your claim has been denied:
- Request an explanation: Ask your employer for an explanation of why your claim was denied. They are required, by law, to provide a reason for the denial in writing.
- File a claim petition: If you disagree with the reason given for the denial, or if your employer refuses to give you a reason, you can file a claim petition with the NJ Division of Workers’ Compensation. You can obtain the necessary forms on the Division’s website or by visiting one of their offices.
- Attend the hearing: After the hearing, the judge will issue a decision. If the judge rules in your favor, your employer will be required to provide workers’ compensation benefits. If the judge rules against you, you may have the option to appeal the decision.
- Consider an appeal: If you are not satisfied with the decision, you can appeal to the New Jersey Superior Court Appellate Division. The appeal must be filed within 45 days of the decision.
There are strict deadlines for filing a claim petition and an appeal, so act quickly if your workers’ compensation claim has been denied.
Can I return to work while still receiving workers’ compensation benefits?
A: Yes, you may be able to return to work in a modified or light-duty capacity while receiving workers’ compensation benefits.
Can I receive workers’ compensation benefits in NJ if I am an illegal immigrant?
A: Yes, undocumented workers in New Jersey are eligible for workers’ compensation benefits. NJ employers are required by law to carry workers’ compensation insurance, regardless of the immigration status of their workers. If you have concerns about your immigration status and filing a workers’ compensation claim, you may want to consult with an experienced workers’ compensation attorney who can provide you with guidance and advice based on your specific circumstances. Here are the steps you should take to file a workers’ compensation claim as an undocumented worker in NJ:
- Report the injury to your employer: As soon as possible after your injury, you should report the incident to your employer. Provide them with information about the nature and extent of your injury, as well as any medical treatment you have received.
- Seek medical treatment: You should seek medical treatment for your injury as soon as possible. Your employer may provide you with a list of approved healthcare providers, or you may be able to see your own doctor.
- File a workers’ compensation claim: Your employer should file a workers’ compensation claim with their insurance company. If your employer does not file a claim, you can file your own using the Employee Claim Petition Form. Provide your personal information as accurately as possible, including your name, address, and phone number.
- Attend a hearing: If your claim is disputed by your employer or their insurance company, you may need to attend a hearing before the Division of Workers’ Compensation. At the hearing, an administrative law judge will hear testimony from both sides and make a decision about your claim.