Welcome to our Orthopedics Practice Workers’ Compensation Guide! This resource is designed to offer a concise overview of workers’ compensation pertaining to orthopedic injuries. It is important to emphasize that this guide is intended for informational purposes and does not replace professional advice.
To access more detailed and personalized information, we recommend visiting the official workers’ compensation portal. This portal provides the latest regulations, forms, and additional resources, ensuring you have access to accurate and current information.
Your well-being is our primary concern, and we hope this guide serves as a helpful starting point in understanding workers’ compensation in the context of orthopedic care. For more in-depth information, please explore the workers’ compensation portal.
Uninsured Employers Fund
Introduction to Uninsured Employers Fund: The Uninsured Employers Fund was established with the purpose of covering medical expenses and temporary disability benefits for injured workers in instances where their employers failed to furnish the mandated Workers’ Compensation insurance coverage. This applies to cases where employers either neglect or decline to make the required Workers’ Compensation benefit payments as determined.
Process of Joining the Fund: Upon the filing of a formal Workers’ Compensation claim with the Division of Workers’ Compensation, and a subsequent determination that the employer is uninsured, the injured worker or their attorney initiates a motion to involve the Uninsured Employers Fund. If the award includes temporary disability benefits and/or medical expenses, the Fund steps in to make payments in accordance with the Judge’s Order.
Establishment of Liens and Penalties: Before disbursements from the Fund, liens representing potential payments are officially recorded against the employer in the Superior Court. Although the Fund does not cover permanent disability benefits, any unpaid awards in this category are also docketed on behalf of the injured worker. Additionally, a penalty of up to $6,000 is levied against the employer after a default in award payment, with this penalty amount similarly docketed in the Superior Court.
Handling Permanent Disability Benefits and Liens: While the Fund itself does not provide for permanent disability benefits, any such award is documented as a lien against the employer in the Superior Court. In the event that the employer’s assets are identified, the injured worker or their attorney can pursue the collection of this lien.
Payment Timeframe and Documentation: Typically, it takes 90 to 120 days from the date of the award for payments to be processed from the Fund. This duration accounts for the necessary steps, including the docketing of liens in the Superior Court, as well as the approval and payment voucher process. Payments are contingent upon the courts of the Division of Workers’ Compensation endorsing the award and the subsequent docketing of the amounts owed.
Expediting Payment Process: While the statute or regulation dictates the overall time required, the injured worker and their attorney can facilitate quicker payments by ensuring the comprehensive inclusion of medical expense documentation in the case file sent to the Office of Special Compensation Funds. Providing UEF counsel with copies of all itemized bills and receipts promptly is essential, with originals of itemized billing statements to be submitted to UEF counsel during trial.
Legal Requirement for Workers’ Compensation Coverage: Except for public employers, New Jersey law mandates that employers must ensure the provision of Workers’ Compensation benefits either through an insurance policy or an approved self-insurance plan. If there are suspicions of a violation by an employer, individuals are urged to promptly inform the Office of Special Compensation Funds through various means, including an online Report of Non-Compliance form. Anonymous reporting is accepted, but specific details such as the employer’s name, exact address, and, if possible, the names of principal operators are necessary.
Display of Proof of Coverage: Proof of coverage should be visibly displayed at the workplace. Individuals can verify an employer’s coverage status by contacting the Compensation Rating & Inspection Bureau or checking their website.
Coverage for Domestic Employees: Domestic employees fall under the residential employment provisions of homeowner policies and must be covered accordingly.
Legal Consequences for Failure to Provide Insurance: Failure to comply with the mandatory insurance requirement is considered a disorderly persons offense and, if willful, a fourth-degree crime. Penalties can be as high as $5,000 for the initial twenty days and an additional $5,000 for each subsequent ten-day period. Penalties are recorded as liens against the employer in the Superior Court, and collection actions, including property seizure, are pursued to enforce these liens.
Sources of Noncompliance Reporting: Reports of noncompliance with insurance requirements come from various sources, including employees, other employers, community and union organizations, governmental agencies, and claims filed by injured workers. Periodic cross-matching of employer data from the Department of Labor and Workforce Development and the Department of Banking and Insurance is also conducted to identify potential noncompliant employers.
Contact Information for Coverage Verification: To obtain information about coverage, individuals can contact the Compensation Rating & Inspection Bureau at the provided address or visit their website.
Responsibilities of the Compensation Rating & Inspection Bureau: The Compensation Rating & Inspection Bureau, under the Department of Banking & Insurance, handles rate-setting matters for workers’ compensation. They can be reached by phone or through their website for relevant inquiries.
