Welcome to our Orthopedics Practice Workers’ Compensation Guide! This resource aims to provide a concise overview of workers’ compensation pertaining to orthopedic injuries. It’s important to emphasize that this guide serves as a general reference and is not a replacement for professional advice.
For more specific and detailed information tailored to your situation, we recommend visiting the official workers’ compensation portal. This portal is a reliable source for the latest regulations, forms, and additional resources, ensuring access to the most current and accurate information.
Your well-being is our priority, and we hope this guide serves as a helpful starting point for understanding workers’ compensation in the context of orthopedic care.
Benefits FAQs
What opportunities do employees or their dependents have in terms of Workers’ Compensation benefits for injuries or deaths that occur during employment?
Employees or their dependents have the opportunity to receive Workers’ Compensation benefits for injuries or deaths occurring during employment. The employer or their insurance carrier is responsible for covering necessary and reasonable medical treatment, temporary disability benefits replacing lost wages during the disability period, and, when documented, benefits for permanent disability.
When does an injured worker become eligible for temporary disability benefits, and what rate is set for these benefits?
If an injured worker experiences a disability lasting more than seven days, they become eligible for temporary disability benefits, set at a rate of 70% of their average weekly wage. This rate is subject to statutory limits, not exceeding the maximum or falling below the minimum rate in effect during the accident year. These benefits are provided when a worker is unable to work and is actively receiving medical care.
When do temporary disability benefits typically cease, and what does the term “maximum medical improvement” (MMI) signify?
Typically, benefits cease when a worker is deemed fit to return to work in some capacity or when they reach maximum medical improvement (MMI). MMI is a term used when further treatment would no longer enhance the injured worker’s medical condition.
Does New Jersey’s Workers’ Compensation law prevent an employer from discontinuing an employee’s health benefits coverage during an inability to work due to a work-related injury?
New Jersey’s Workers’ Compensation law does not prevent an employer from discontinuing an employee’s health benefits coverage during an inability to work due to a work-related injury. However, some protections are available under the Federal Family Medical Leave Act.
Where can individuals seek more detailed information about federal protections related to Workers’ Compensation and health benefits coverage during an inability to work?
For more detailed information on federal protections related to Workers’ Compensation and health benefits coverage during an inability to work, contacting the US Department of Labor, Employment Standards Administration at 1-866-4-USA-DOL or visiting their website at http://www.dol.gov/ is recommended.
Who is eligible for supplemental benefits or cost of living increases under the statute, and what are the limitations regarding the time of injury or death?
Under the statute, eligibility for supplemental benefits or cost of living increases is limited to totally and permanently disabled workers and dependents of deceased workers whose injury or death occurred before January 1, 1980. In some cases, dependents of deceased workers may be eligible if the death, post-1979, is directly linked to the injury causing total and permanent disability before 1980.
What does the NJ Temporary Disability Benefits Law cover in terms of work-related injuries or illnesses, and under what circumstances does Temporary Disability Insurance (TDI) come into play?
Work-related injuries or illnesses are not covered by the NJ Temporary Disability Benefits Law. However, if an individual claims Workers’ Compensation benefits and the claim is disputed by the Workers’ Compensation insurance carrier, Temporary Disability Insurance (TDI) may provide benefits until the resolution of a formal Workers’ Compensation claim petition.
A lien is filed by the Disability Insurance Service to protect its subrogation rights against any subsequent Workers’ Compensation award. For more details, you can visit the Division of Temporary Disability Insurance’s website or contact them at (609) 292-7060.
What waiting period is required for individuals to become eligible for temporary disability benefits according to the law, and how does it differ for medical benefits or permanent disability benefits?
According to the law, a waiting period of seven days (including weekends and holidays) is required before an individual becomes eligible for temporary disability benefits. These benefits are retroactive to the first day, and the seven days do not need to be consecutive. Unlike temporary disability benefits, medical benefits or permanent disability benefits have no waiting period and are due if warranted, irrespective of the number of lost workdays.
What is the statute of limitations for Workers’ Compensation cases, and how does it vary for different circumstances such as injuries or occupational illnesses?
Workers’ Compensation cases are subject to a two-year statute of limitations. A formal claim petition must be filed within two years from the date of injury or the last payment of compensation, whichever is later. In cases of occupational illness (e.g., asbestosis, lead poisoning, or hearing loss), the petition must be filed within two years from the date the worker becomes aware of the condition and its link to employment. Filing an application for an informal hearing does not pause the two-year statute of limitations.
What is the expected waiting period before receiving temporary disability benefits, and under what circumstances can an employer or their insurance carrier be held liable for additional amounts and legal fees related to a claim delay?
Generally, a two-week waiting period is expected before receiving temporary disability benefits. If the employer or their insurance carrier unreasonably delays or negligently denies a claim, they may be liable for an additional amount of 25% of the due amounts, along with reasonable legal fees related to the delay. A delay exceeding 30 days is presumed to be unreasonable.
