February 9, 2017

What Does a Workers Compensation Policy Cover?

 As an employee, you probably don’t give much thought to the coverage provided by your employer for workers’ compensation benefits. Most people don’t pay any attention to it at all, right up until the point where they get hurt or sick and end up realizing that they actually need it.  Workers’ compensation is a no-fault type of insurance that employers provide in exchange for employees not being permitted to file personal injury lawsuits against them for negligence. That means that as long as injured workers follow the correct procedures and deadlines for filing a claim, and the claim is legitimate, employers’ insurance companies are supposed to provide the benefits that are covered. So what does a workers’ compensation policy cover?

In short, workers’ compensation provides payment of medical treatment, wage replacement and permanent disability compensation for injuries or illnesses that are job-related. It provides death benefits to the families of those who are killed on the job or as a result of their employment, and also provides compensation for specifically identified injuries such as loss of limb or permanent disfigurements.  In the state of New Jersey, these payments are administered through the Division of Workers’ Compensation, which has been tasked with making sure that employers are treated fairly and that all laws regarding workers’ compensation insurance are enforced.  The New Jersey state laws define the various workers’ compensation benefits as follows:

  • Medical Benefits – includes necessary and reasonable medical treatment, medications, hospitalization expenses.
  • Temporary Total Benefits – workers who are unable to return to work for more than seven days as a result of their illness or injury, are entitled to retroactive pay at a rate of 70% of their average weekly wage. This payment can’t exceed the maximum rate or fall lower than the minimum rate established by law. These payments are to be paid until the worker’s condition has improved to the point of maximum medical improvement, and are limited to a 400-week period.
  • Permanent Partial Benefits – for employees whose injuries result in a permanent impairment of their body resulting in a functional loss, specifically identified benefits based on the individual loss are offered weekly when the temporary disability period is over.
  • Permanent Total Benefits – workers who are unable to return to any type of gainful work can receive permanent total disability benefits, to initially be provided for a period of 450 weeks, after which the worker has to demonstrate that they continue to be totally disabled. The benefits are paid at a rate of 70% of their average weekly wage, not to exceed the minimums or maximums as established by law.
  • Death Benefits – for the families of workers who have died as a result of a workplace accident or illness, benefits include funeral expenses up to $3500 and weekly benefits representing 70% of the deceased worker’s average weekly rage, not to exceed the statutory maximum.

If you have been injured on the job and need legal advice, the attorneys at Brown & Connery are here to help. Contact us today to schedule a convenient appointment.