New Jersey Workers’ Compensation Insurance – Filing a Workers’ Comp Claim

The losses surrounding an injury can be devastating, and it’s even more unfair if it came from simply doing your job. That’s why New Jersey workers’ compensation insurance exists to pay for such grave losses while protecting employers from civil liability.

Workers’ compensation in the Garden State of New Jersey may provide the following benefits to those who qualify:

• Medical treatment
• Wage replacement
• Temporary and permanent disability compensation
• Death benefits to dependents

Private industry employers reported 69,200 nonfatal workplace injuries and illnesses in New Jersey in 2022. If you’re one of those workers, it’s important to file your claim as soon as possible to keep evidence fresh.

Knowing where to start with a New Jersey workers’ compensation claim may be confusing, but you don’t have to tackle it alone. Hire a workers’ compensation attorney familiar with New Jersey’s laws to raise your chances of approval.

Who is Eligible for NJ Workers’ Compensation Insurance?

New Jersey law requires all New Jersey employers, not covered by Federal programs, maintain workers’ compensation coverage or be self-insured.

Examples of entities forced to carry NJ workers’ compensation insurance or be self-insured include:

• Corporations – As long as one or more employees (including corporate officers themselves) performs services for the purpose of compensation.
• Partnerships/LLCs – If one or more employees, excluding partners or members of the LLC, perform services for the purpose of compensation.
• Sole Proprietorships – If one or more employees, excluding the owner, perform services for the purpose of compensation.

Even out-of-state employers may need workers’ comp coverage if the employment contract was signed in New Jersey or if work was performed in New Jersey.

Injured employees in New Jersey receive weekly benefits payments regardless of who was at-fault for an accident. In exchange, an employee cannot bring a civil action against the employer for pain and suffering or other damages.

Who is Exempt From New Jersey Workers’ Comp?

Government agencies are exempt from carrying New Jersey workers’ compensation insurance, but they still must provide workers’ comp benefits to their employees.

To do this, they often perform the following:

• Take out an insurance policy
• Contribute to an insurance pool
• Set aside funds for workers’ compensation claims

There is one more exemption in the state of New Jersey: sole proprietors and independent contractors. If you own and operate your own business, you do not have to carry workers’ comp insurance.

Likewise, if you employ independent contractors, you do not need to offer them workers’ comp coverage.

Penalties for Not Possessing Workers’ Comp in New Jersey

The consequences for failure to provide workers’ comp coverage to employees in New Jersey are severe. This is the case even without a work-related injury claim.

New Jersey law (N.J. Stat. § 34:15-79) says that failing to insure is a disorderly person’s offense and, if willful, a fourth-degree crime.

IMPORTANT: Penalties for such failure can be assessed up to $5,000 for the first ten days, and up to $5,000 for each additional ten-day period of failure to insure thereafter.

In the case of a corporation, liability for failure to insure can extend to the corporate officers individually.

This means that if a work-related injury or death happens, the employer, including individual corporate officers, partners, or members of an LLC, are directly liable for medical expenses, temporary disability, and permanent disability or dependency benefits if there’s no workers’ comp coverage.

IMPORTANT: Having an attorney on your workers’ comp case is key if you were hurt and your employer was not insured. New Jersey law provides for civil penalties against the employer and its officers if they failed to insure you while hurt.

How to File a Workers’ Compensation Claim in New Jersey

If you were injured at work, follow these steps to ensure your workers’ comp claim reaches the right people. Don’t be afraid to start, because your employer cannot fire you for covering your injuries with a workers’ comp claim.

1. Notify your employer of your work-related injury or illness immediately. If you fail to notify them after 14 days from your injury, you risk losing your ability to gain benefits.
2. If you need medical treatment, request it from your employer right away. This gives time for your employer to select an adequate healthcare provider. NJ workers’ compensation law prevents you from selecting your own doctor.

Your employer’s insurance, will investigate your claim and make a determination as to your eligibility to receive benefits.

Employer Responsibilities

If someone sustained a work-related injury, employers have an obligation to follow these steps to comply with NJ workers’ compensation laws. If they fail to follow up after 90 days from when a worker reports their injury, workers’ comp benefits are automatically awarded.

To prevent such blunders from occurring, employers must keep track of incoming workers’ comp claims by executing these steps:

1. Once an accident is reported to an employer, the employer’s workers’ compensation insurance carrier will file a First Report of Injury electronically with the State.
2. The employer’s insurance carrier then evaluates your claim to determine its eligibility for benefits. The carrier will contact you, your employer, and your medical provider to make this assessment. If you’re out of work after 7 days, you’ll be provided temporary disability benefits for that period.
3. If they accept your claim, your employer directs you to an authorized medical provider for treatment.

If you return to work within 26 weeks or your condition reaches maximum medical improvement, your employer must submit a Subsequent Report of Injury form.

Injuries Covered Under New Jersey Workers’ Compensation

Any injury that occurred during your course and scope of employment is covered by NJ workers’ compensation. This could include an injury from a sudden accident, like a burn or a back injury. It could also include an injury from repetitive motion, such as carpal tunnel syndrome in a worker’s wrist.

Jobs in trade, transportation, utilities, education and health services accounted for 63 percent of the occupational injuries and illnesses in New Jersey in 2022.

In 2020 and 2021, the costliest lost-time workers’ compensation claims by cause of injury resulted from motor-vehicle crashes, averaging $89,152 per workers’ compensation claim.

Benefits Under New Jersey Workers’ Compensation

Workers’ compensation is a “no-fault” insurance program that provides the following benefits to employees who suffer job-related injuries or illnesses.

• Medical Benefits: this includes all doctor bills, rehab, and physical therapy. It also includes travel costs to and from treatment appointments.
• Temporary Total & Temporary Partial Benefits: this compensates for a portion of your lost wages while you recover; generally 70% of your average weekly wages.
• Permanent Total & Permanent Partial Benefits: if an injury forces you to leave work permanently, you can seek permanent disability benefits.
• Death benefits to dependents of workers who have died as a result of their employment.

Deadlines to File for Workers’ Comp in New Jersey

You should report your work-related injury or illness right away. You can expect to wait two weeks before receiving temporary disability benefits.

There is a two-year statute of limitations that applies to workers’ compensation cases in New Jersey. A formal claim petition must be filed within two years of the date of injury or the date of last payment of compensation, whichever is later.

How to Calculate a NJ Workers’ Comp Settlement

The temporary disability rate is calculated as 70% of your average weekly wages. In 2023, New Jersey set a $1,131 per week maximum and $302/week minimum for workers’ comp benefits.

For permanent partial disability, the rate depends on the type and severity of injury. Your total disability rate is also 70% of wages. Rates go into effect on the date of accident or exposure/manifestation in cases of occupational exposure.

How to Respond to a Workers’ Compensation Dispute

If your NJ workers’ compensation claim was disputed, you have options to reapply. If you chose to reopen your case, it’s vital to hire an attorney who can spot flaws in your application.

You have a right to contact the Division of Workers’ Compensation if you dispute your claim. This can be done by either filing an application for an informal hearing or by filing a formal claim petition.

Disputed issues may include whether:

• The injury/illness was considered work-related
• The type and extent of medical treatment
• The payment of disability benefits

Upon filing, the case will be assigned to a judge and a district office based upon the county of residence of the injured worker. Contact an attorney to help you navigate your disputed claim.

Find a NJ Workers’ Comp Attorney Through LegalASAP

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Time is crucial when filing for workers’ comp, so fill out this short evaluation form, and we will contact you as soon as possible.