If you are unable to work due to an injury or illness, you may be wondering if you can get some type of benefits to cover your lost income. For many workers, there are two options for disabilities that are limited in duration: workers’ compensation and short-term disability benefits. While both are meant to help employees who can’t work because they’re sick or hurt, there are big differences between the two types of benefits.
Workers’ compensation is meant to ensure that people who suffer a work-related injury or who develop an occupational illness get the medical and financial benefits that they need to recover. By contrast, short-term disability is a type of insurance policy that will provide a percentage of your monthly income for injuries and illnesses that are not related to work.
Understanding the difference between the two benefits can ensure that you get the right kind — and that you aren’t required to pay back the benefits that you have received. A skilled Cherry Hill disability benefits lawyer can help you apply for and receive the right kind of benefits.
What Is Workers’ Compensation?
Workers’ compensation is a system of insurance, where employees who are hurt or become ill because of their jobs can receive medical and financial benefits. All employers in New Jersey are required to carry workers’ compensation insurance. Because workers’ comp is no-fault, employees don’t have to prove that their employers did anything wrong in order to recover for their injuries.
- Medical benefits
- Temporary disability benefits
- Permanent partial benefits
- Permanent total benefits
- Death benefits
If you qualify for workers’ compensation, your medical care will be paid for, and you will also receive financial compensation. The amount of money that you receive and the length of time that you receive these payments is based on a number of factors, including your average weekly wage and the severity of your illness or injury. If a worker dies as a result of a workplace injury or illness, their family may be entitled to certain death benefits.
What Is Short Term Disability?
Short term disability (STD) is a type of insurance coverage that many employers offer as part of a group insurance plan. If you are unable to work due to a disability for a relatively limited period of time (typically up to 6 months), then you can file a claim with your insurance company. You will then receive monthly payments of approximately 40 to 60% of your monthly income, depending on the terms of your policy.
Unlike workers’ compensation insurance, you are not required to carry short-term disability insurance. Usually, you pay for your STD insurance (even if your employer offers the coverage through a group plan). STD benefits only include financial compensation, not medical treatment.
In New Jersey, if you suffer a temporary illness or injury while you are employed, you may also be eligible for disability benefits through the New Jersey Temporary Disability Insurance (TDI) program. To qualify for TDI benefits, your illness or injury must not be related to work, must prevent you from working, and you must be under medical care for it. In addition, you must have worked for at least 20 calendar weeks, earning at least $145 per week, or have earned $7,300 or more during the 52 weeks prior to your disability beginning.
The TDI program is funded through contributions by New Jersey workers and employers. Benefit amounts are calculated by determining your average weekly wage, and then paying 85% of that wage for the duration of your disability. Benefits are paid for up to 26 weeks.
What Is the Difference Between Workers’ Comp and Short Term Disability?
There are a number of differences between workers’ compensation benefits and short term disability benefits. As outlined above, employers pay for workers’ comp insurance, while employees typically pay for their own STD coverage. Workers’ comp also provides both medical and financial benefits, while STD only provides financial payments. STD benefits are limited in time, while workers’ comp benefits may be paid out for an extended period of time.
Most importantly, workers’ compensation covers work-related injuries and illnesses, while short term disability is for any disability that isn’t related to your job. If you apply for short-term disability benefits for a work injury, your claim may be denied — or you will be required to pay back any benefits that you receive. Similarly, if you apply for workers’ comp for an injury that isn’t related to work, then your claim will most likely be denied.
In sum, if your injury or illness is related to work, then you will need to file for workers’ compensation benefits. If you can’t work because of something that isn’t related to work, then you will need to file for STD benefits. However, your workers’ compensation claim is denied, you may be able to apply for STD benefits, depending on the terms of your policy.
My Boss Told Me to File for Short Term Disability After I Was Hurt at Work. What Should I Do?
If you suffer a workplace injury or develop an occupational disease, then you should file for workers’ compensation — even if your employer tells you otherwise. Workers’ compensation is designed to pay for work-related illnesses and injuries, while short term disability covers disabilities that are not related to work.
There are two possibilities as to why your employer is telling you to file for STD instead of workers’ comp. First, your boss could simply be confused and not understand the difference between the two. Second, your employer may be trying to avoid an increase in their workers’ compensation insurance premiums.
When you file a workers’ compensation claim, your employer’s premium will typically go up. For this reason, your boss may prefer that you not file a workers’ comp claim, even though it will result in less money and no medical benefits for you — and there is a strong possibility that your claim will be denied. If your employer will not file a workers’ compensation claim with their insurance carrier, you can file one with the help of a New Jersey’s workers’ compensation attorney.
If I Am Denied Workers’ Compensation Benefits, Can I File for Short Term Disability?
In many workers’ compensation claims, it is obvious that the injury is related to work, such as if a worker fell off a ladder while on a job. However, there are other situations — such as repetitive injuries like carpal tunnel syndrome — where it may be less clear. If your workers’ compensation claim is denied, you may be able to file a claim with your short-term disability insurance company.
This claim may or may not be approved, depending on the terms of your policy. A New Jersey disability benefits attorney can review your policy to help you decide on how to proceed. It is possible that the STD insurance company will also deny the claim, and argue that workers’ comp needs to pay instead. Your lawyer can advocate for your right to benefits and increase the likelihood of your claim being covered.
If the insurance company denies your workers’ compensation claim, you can also file for TDI benefits through the state while you litigate your workers’ comp case. If you ultimately win your workers’ comp case, then you will have to repay the temporary disability benefits that you received during this time.
What Happens If I Am Approved for Short Term Disability and Later Get Approved for Workers’ Compensation Benefits?
If your injury or illness is work-related, then you should be applying for workers’ comp benefits, not STD benefits. These benefits are typically less favorable than workers’ compensation benefits, so it makes more sense to apply for workers’ comp for a work-related injury or illness.
However, there may be situations where you apply for STD because you are unable to access workers’ comp for some reason, such as your initial claim being denied. While your workers’ compensation claim is on appeal, you may decide to file for STD benefits. Keep in mind that most STD policies require you to certify that your disability is not work-related, which can harm your workers’ comp claim.
If your workers’ compensation claim is ultimately approved, then you may have to pay back any STD benefits that you receive. In other words, you cannot “double dip” and get both types of benefits at once. For this reason, it is important to consult with a skilled Cherry Hill disability benefits lawyer before proceeding with your claim.
How We Can Help
The world of disability benefits can be confusing. It’s hard to know what to apply for, when to apply, and how to make sure that your application for benefits gets approved. We’re here to help.
At Bross & Frankel, we advocate for the rights of people who cannot work due to an injury, illness, or other disability. With decades of experience, we work hard to help our clients get the money that they deserve. To learn more or to schedule a free consultation with a Cherry Hill, NJ disability benefits lawyer, contact us at 856-795-8880 or email us at any time.