Summary of New Jersey Workers’ Compensation. NEW JERSEY’S COMPUTERIZED SYSTEM Most Comprehensive In The United States (
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Summary of New Jersey Workers’ Compensation
NEW JERSEY’S COMPUTERIZED SYSTEM
• Most Comprehensive In The United States
(http://www.state.nj.us/labor/wc/Default.ht)
BENEFITS OF WORKERS’ COMPENSATION
• Temporary Total Disability Benefits• Disabled For More Than 7 Days• Under Active Medical Care• Calculation Of Wage – 26 Week Wage
Statement
BENEFITS OF WORKERS’ COMPENSATION
Temporary Total Disability Benefits• Rate – 70% of Gross Average Weekly Wage• Minimum and Maximum Rate• 400 Week Limit
BENEFITS OF WORKERS’ COMPENSATION
• Cessation Of Temporary Benefits• Discharge From Active Medical Care• Light Duty Restrictions And Still Treating
• Must be a job available• RTW
• Loss in wages – partial/temp?
BENEFITS OF WORKERS’ COMPENSATION
• Medical Benefits• Cure And Relieve The Effects Of The Injury
(NJSA 34:15-15)• Emergency Medical Care• Employer’s Right To Authorize Providers
BENEFITS OF WORKERS’ COMPENSATION
• Medical Benefits• Second Opinions• Maximum Medical Improvement
BENEFITS OF WORKERS’ COMPENSATION
• Permanent Partial Disability– Permanent Disability Defined
(NJSA 34:15-36) – Demonstrable Objective Medical
Evidence– Functional Restriction Of The Body,
Member Or Organ
BENEFITS OF WORKERS’ COMPENSATION
Permanent Partial Disability• Lessening To A Material Degree Of
Working Ability
• Ordinary Pursuits of Life
STATUTE OF LIMITATIONS• Two Years From Injury Or Date Of Last
Benefit Provided• In Occupational Disease 2 Years From
The Date Claimant Knew Of Condition And Its Relationship To The Job
RE-OPENER PETITION
• Re-Opener Rights– 2 years to seek further ttd; medical; increase in
permanency;– 2 years runs from date of last payment of
permanency or last benefit provided
TYPES OF SETTLEMENT
• OAS: Order Approving Settlement • Section 20 Settlement (N.J.S.A. 34: 15-
20)
ORDER APPROVING SETTLEMENT
• Order Approving Settlement– The parties settle a compensable claim where all
temporary total disability benefits and medical benefits have been provided and now the parties have tentatively settled permanency subject to approval by judge
– Requires testimony or Affidavit by petitioner supporting terms of settlement
SECTION 20 SETTLEMENT
• N.J.S.A. 34: 15-20 – Must Be Approved By A Judge And Must Have Counsel
• Dismisses The Claims With Prejudice – No Re-opener Rights
SECTION 20 SETTLEMENT
• Must Be An Issue Of Jurisdiction, Liability, Causal Relationship Or Dependency
• State TDB Lien Must Be Paid Out Of Proceeds But Waives Balance
• Kibble: Dependents Rights Survive Unless Waived
Stroke Claim
• Renner vs. AT&T, (No. A-3237-09; App. Div. 11/29/2010)– Facts:• Petitioner worked for AT&T for 25 years – salaried
manager• Sat at her computer for long hours to meet various
deadlines• On 9/24/2007, worked throughout the night in order
to complete a project
Stroke Claim
• Renner vs. AT&T– Facts:• At 9:00 am, advised a co-worker she was not feeling
well but would keep working to complete the project• Finished the project and sent an email at 10:30 am
regarding same• At 11:34 am called 911 but pronounced dead upon
arrival at the hospital from a pulmonary embolism
Stroke Claim
• Renner vs. AT&T– Issue:• Was the employee’s death compensable as a
cardiovascular event pursuant to Section 7.2 of the Act?
– Holding:• WCJ and Appellate Division both found
compensability
Stroke Claim• Renner vs. AT&T– Reasoning:
• Although the employee lead a sedentary lifestyle in and out of work, credible evidence proved that her work inactivity was greater than her non-work activity
• Section 7.2 requires that in a cardiovascular claim that an employee prove that the injury or death was produced by work effort or strain involving a substantial condition, event or happening in excess of the wear and tear of the employee’s daily living
Stroke Claim• Renner vs. AT&T, New Jersey Supreme Court
reverses Decision – 7/31/2014– Holding:
• The petitioner did not meet the burden of proof required by Section 7.2 that the deceased’s cardiovascular death is compensable.
– Reasoning:• Section 7.2 enacted to prevent recovery from cardiac
incidents that simply manifest at work• Burden of proof requires work exposure of a greater risk
than those faced in their daily life
Stroke Claim• Renner vs. AT&T, New Jersey Supreme Court
reverses Decision – 7/31/2014– Reasoning:• Petitioner not confined to a specific work space or
instructed not to move from her work station• Prolonged sitting, uninterrupted breaks to stand,
walk or exercise not compelled by the employer• Long work hours with extended periods of sitting do
not constitute a work effort or strain “involving a substantial condition, event or happening”.
Stroke Claim• Renner vs. AT&T, New Jersey Supreme Court
reverses Decision – 7/31/2014– Thoughts:• Strengthens the heightened burden of proof for
cardiovascular claims• Supreme Court seems to touch upon a “fault”
concept with respect to the employee’s choice to sit uninterrupted.
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