If you are injured or become ill while on the job (or as a result of your work), then you may be eligible for workers’ compensation benefits. This is a type of insurance that provides medical treatment and wage loss benefits to employees who have gotten sick or been injured on the job. These benefits are available regardless of fault — in other words, you don’t have to prove that your employer did something wrong in order to obtain workers’ comp benefits.
Many individuals who have been hurt on the job want to know what their case is worth. It can be challenging to estimate the exact value of a person’s case, as each claim is unique. The value of a case will depend on a number of factors, such as the type and severity of the injury and whether there is a need for ongoing medical treatment.
Most workers’ compensation cases end in a settlement, where the insurance company, representing the employer, agrees to pay a worker an amount of money to settle their claim. The amount that a person can expect to receive in a settlement is based on a number of factors. An experienced New Jersey workers’ compensation attorney can advocate for you to help you achieve the best possible settlement.
Types of Benefits in New Jersey Workers’ Compensation Cases
Workers’ compensation is a type of insurance that employers in New Jersey are required to carry. If an employee suffers a job-related illness or injury, then they are entitled to certain benefits. Similarly, if an employee dies as a result of a work-related illness or injury, then their survivors will receive death benefits.
There are five specific types of benefits that an employee may be entitled to under New Jersey law. These include:
- Medical Benefits: necessary and reasonable medical treatment, prescriptions, and hospital services related to the work injury or illness. These benefits are paid directly by the insurance carrier or by the employer if it is self-insured.
- Temporary Total Benefits: workers who are disabled for more than seven (7) days will be eligible for temporary total benefits, which will go back to the first day or lost time. This is paid at a rate of 70% of the worker’s average weekly wage, which cannot exceed the maximum rate or fall below the minimum rate set by the state. These benefits are provided until the worker returns to work, for a period of up to 400 weeks. In 2019, the temporary disability rate was set at $921 to maximum/$246 minimum each week.
- Permanent Partial Benefits: if a work-related injury or illness results in permanent bodily impairment, then benefits will be paid based on an employee’s functional loss. They will be paid weekly until the temporary disability ends. In 2019, permanent partial disability benefits are paid at a rate of $921 max/$35 minimum (per week).
- Permanent Total Benefits: if a work injury or illness prevents an employee from returning to any type of employment, they may be eligible for this type of benefit. Initially provided for 450 weeks, they can be continued if the injured worker can demonstrate that they remain totally disabled. These benefits are paid weekly, based on 70% of the average weekly wage (not to exceed or fall below the statutory minimum). In 2019, the rate for permanent total benefits per week is a maximum of $921 and a minimum of $241.
- Death Benefits: dependents of an employee who died from a work-related illness or injury may be entitled to receive death benefits (of up to 70% of the wage of the deceased worker) as well as funeral benefits up to $3,500. The maximum death benefit in 2019 was $921.
The exact amount that an individual will receive will depend on a number of factors. For this reason, it can be difficult to predict exactly how much a New Jersey workers’ comp case is worth.
Factors That Influence the Value of Your Claim
If you have been injured on the job or developed an illness as a result of your work, you are likely curious about just how much compensation you will receive. The answer to this question is based on several factors.
First, the type and severity of your injury greatly influence the value of your case. While a deep cut to your finger may hurt quite a bit and prevent you from working for an extended period of time, it will typically be worth less than something like a back injury. Generally, any type of injury to your back, neck or spine will require more extensive treatment, and possibly even surgery — making it more expensive to treat, and often a longer recovery.
The severity of your injury also has an impact on case value. If you broke your arm, that is a significant injury that may prevent you from working for a period of time. However, if your arm was amputated in an industrial accident, then you are more significantly disabled given the loss of a limb.
In addition, the amount of benefits that you will receive for an injury is determined by a statutory chart set by the State of New Jersey. This chart lists a range of disabilities and the maximum benefits that can be received based on the percentage that a person is deemed disabled. The chart is updated annually, so that when a person is injured can greatly impact the amount that they receive in benefits.
Second, your weekly wage will affect the amount of disability that you will receive. It is used as a factor, along with the type and severity of the injury, in determining your workers’ compensation benefits. This factor can be particularly frustrating for people who are seriously injured and work at a low paying job, as the amount that they are able to recover will be limited as a result.
Third, if you are currently receiving benefits for loss of wages due to disability, this is a major factor in the overall value of your case. It demonstrates that your disability is ongoing, as you are unable to work. If you were able to work, you would not be receiving these types of benefits — and your case will likely be settled for less money.
Fourth, the need for future medical care will impact the total value of your claim. This factor is tied to the severity and type of injury, which is proved through medical evidence. If you need ongoing medical treatment, then your workers’ comp claim is likely worth more money.
Fifth, the status of your case can affect its value. If you are involved in litigation after having your claim denied, that can reduce the total settlement amount. Alternatively, if your employer has accepted your injury and you have been awarded benefits, this can increase the total value of your case.
Sixth, your personal situation can impact a settlement value. If you are receiving benefits, the reduced amount of income may have a significant effect on your family’s finances. This may lead you to accept a lower offer than you otherwise would, in order to decrease the financial strain on your budget.
Seventh, the type of work that you performed will make a difference when it comes to your ability to return to work after your illness or injury. If you performed physical or skilled labor, any type of physical disability may make it difficult for you to return to your job. Being unable to go back to your job or perform similar work can affect case value.
Eighth, the opinion of medical professionals, including your treating physician, is a factor in the value of your case. If the experts believe that your ongoing symptoms are related to your work injury or illness, this will likely increase the value of your claim. Conversely, if doctors or other medical professionals believe that you are able to return to work, then the total value of your claim will be diminished.
In the majority of cases, the insurer will likely settle for more if they believe that there is “future exposure” — which means that they expect to pay future wage loss and medical treatment benefits. Your New Jersey workers’ compensation attorney can put together a strong case demonstrating exactly why you are entitled to future benefits, and how your settlement should reflect that fact.
Questions? We Are Here to Help.
Being off work due to an injury or illness can be devastating. Not only are you suffering from the pain associated with a disability, but you a limited income can make it more difficult to get by financially. Working with a skilled lawyer can help you get the benefits that you deserve for your work-related illness or injury.
Bross & Frankel represents employees across New Jersey and Pennsylvania in workers’ compensation cases, from the initial application for benefits through the final resolution of the case. With more than 20 years of experience, we know how the system works — and we’ll put that knowledge to work for you. Contact us today at 856-795-8880 or online to schedule a free initial consultation with a member of our team.
Rich Frankel is the managing partner of Bross & Frankel. He is a member of the New Jersey and Pennsylvania bars. He has focused exclusively on disability and social security benefits since 2005.
Mr. Frankel joined what is now Bross & Frankel after having watched his father struggle with disability, fighting a lengthy illness. Mr. Frankel founded the firm’s veteran’s law practice and substantially grew the social security disability practice, focusing Bross & Frankel’s ability to fight for all of the disability benefits available to his clients.
Mr. Frankel additionally fights for clients in court, obtaining frequent victories in Social Security appeals and against insurance companies in Federal court.