In New Jersey, employers are required to have workers’ compensation insurance for every employee working within the state. This system helps pay medical expenses and compensate for wages that were lost due to a work-related injury or illness. Workers’ compensation insurance also covers permanency awards, which are monetary awards that compensate an employee for any residual disability he or she has after treatment is completed. This type of benefit is also called a permanent partial disability benefit.
Once you have reached maximum medical improvement, meaning that no additional treatment will improve your condition, you will be examined and evaluated in order to find out whether your injury or illness has left you permanently impaired. If you are determined to be suffering from a permanent partial disability, or a residual disability, then you will be entitled to permanent partial disability benefits, or a permanency award, to help compensate you for your loss of function.
Permanent total disability is defined under the New Jersey Workers’ Compensation system as a “physical or mental neuropsychiatric total permanent impairment caused by a compensable accident or compensable occupational disease, where no fundamental or marked improvement in such condition can be reasonably expected.”
If you are found to be totally disabled due to a work-related accident, you may qualify for benefits for the rest of your life. Partial disability, alternatively, means an individual can still work in some capacity, even if the old job is modified.
A permanency award is one form of workers’ compensation benefit and is granted when an employee loses the permanent use of a body part, including a limb or organ. In the state of New Jersey, however, loss of use does not need to factor into the individual’s job duties. If the injury impedes daily activities or hobbies, a permanency award can still be granted in NJ. It’s worth noting that permanency awards are distinct from other award counterparts, such as medical benefits or temporary disability benefits.
A permanency award amount is measured by weeks, percentage of functional loss of the particular body part injured, as well as the employee’s weekly wage. New Jersey has two types of awards, both defined by the percentage of impairment: scheduled and unscheduled. Evaluation of impairment occurs after the injured employee reaches maximum medical improvement, which is determined by a medical professional. Subsequently, it will be judged whether the injury has a permanent impact on the employee’s ability to work and function.
Permanent disability benefits are only paid indefinitely where an employee is found to be totally and permanently disabled. PPD benefits are paid out over a particular course of weeks and are awarded based on a predetermined Schedule of Benefits, which is updated every year. The Schedule of Benefits outlines the monetary value of each percentage of disability as it relates to different body parts. The body parts that are outlined in the Schedule of Benefits are as follows:
There are also “non-scheduled” injuries that involve any area or system of the body not covered by the Schedule of Benefits. This includes the back, heart, lungs, or psychological injuries.
In order to determine the percentage of residual disability an injured worker has been left with as a result of the work injury, the worker will be scheduled for examinations with expert physicians (one retained by the worker and one retained by the employer), who will review the workers’ medical records, examine the worker, and issue a report outlining the percentage of residual disability the injured working is left with as a result of the work injury.
Thereafter, the attorneys using the reports will attempt to negotiate an agreed-upon percentage of residual disability. If the attorneys can come to an agreed percentage of residual disability, in New Jersey, a Judge of Compensation must evaluate the injured worker’s impairment and approve the agreed-upon settlement.
In doing this, the Judge of Compensation will review the medical reports and evaluate the effect the injury(ies) have on the worker, in both his or her ability to work and his or her ability to function outside of work.
The Judge of Compensation will also hold a hearing, where the Judge will consider the following information:
If a settlement cannot be reached between the parties, then there will be a trial, and the Judge of Compensation will determine the percentage of residual disability based upon the testimony of the injured workers, the testimony of the expert physicians, and sometimes the testimony of the treating doctors.
Many times an employer will voluntarily provide medical treatment and temporary disability benefits, but rarely will an employer voluntarily pay an injured worker a permanency award. This is why you may need to hire an attorney to represent you with regard to your work-related injury claim. An attorney can make a formal workers’ compensation claim on your behalf and obtain a fair and just permanency award.
Permanent partial disabilities and other areas of workers’ compensation law can be complex. Therefore, it is a good idea to get in touch with an attorney who has experience handling workers’ compensation claims, like the attorneys at Cerussi & Gunn, so you can ensure you receive just compensation for your workplace injury or illness. The Monmouth County workers’ compensation lawyers at Cerussi & Gunn will make sure you are prepared to present your case to the Judge of Compensation so that you obtain the benefits you deserve.