Category Archives: Benefits

Video: Practical Application of New Jersey’s Temporary Disability Benefit

This video is presented by attorneys Michael Gervolino and Greg Lois and answers the following questions: “Should I issue temporary disability benefits?” and ”If so, how much?” and “When can I stop Paying?”

At the end of the presentation, the attendees will have a basic understanding of when to issue temporary disability benefits in New Jersey, how the amount issued is calculated, when payments can be terminated, and the risks associated with the benefit.

Subject: New Jersey, Workers’ Compensation Law, benefits, Temporary Disability
Date Presented: July 24, 2017
Presenter(s): Michael Gervolino and Greg Lois
Run time: 21:58 Continue reading Video: Practical Application of New Jersey’s Temporary Disability Benefit

Video: Temporary Disability Benefits in New York

Attorneys Elizabeth Perez and Greg Lois discuss the nuts-and-bolts of issuing temporary disability benefits – when the benefits are due, how much to pay, and when benefits can be stopped. They also discuss the new C-258.1 work search form issued by the Board on July 14, 2017 and the newly-changed rate of temporary disability compensation.

Subject: New York, Workers’ Compensation Law, benefits, Temporary Disability
Date Presented: July 17, 2017
Presenter(s): Elizabeth Perez and Greg Lois
Run time: 3306 Continue reading Video: Temporary Disability Benefits in New York

Don’t Forget! July 1st maximum rate change in New York.

New York’s maximum compensation rate – for temporary total disability and permanent total disability – will go up effective July 1st to $870.61. The new, higher rate will be in effect until June 30, 2018.

How is the New York Maximum benefit Rate Calculated?

The maximum weekly benefit rate for workers’ compensation claimants is two-thirds of the New York State average weekly wage for the previous calendar year, as determined by the New York State Department of Labor (Workers’ Compensation Law §§ 2(16);15(6)).

The Department of Labor reported to the Superintendent of the Department of Financial Services that the New York State average weekly wage for 2016 was $1,305.92. Accordingly, the maximum weekly benefit rate is $870.61 for compensable lost time for workers’ compensation claims with dates of accident during the period from July 1, 2017 through June 30, 2018. Continue reading Don’t Forget! July 1st maximum rate change in New York.

How to: Reducing Exposure by Offering Accommodated Positions in New York

We can stop paying temporary disability benefits in New York when:

  • The claimant has reached “maximum medical improvement” and is discharged from further care.
  • The claimant has voluntarily withdrawn from the labor market.
  • The claimant has refused a light duty offer that complies with the treating doctor’s work restrictions.

​Why seek a return to work in a light duty capacity?

Employees who do not return to work (transitional or otherwise) within 6 months of the date of loss have a less than 50% chance of returning to gainful employment. Injured workers who remain out of work for more than one year but less than two years have a 25% chance of returning to employment. Workers who have lost two or more years to injury have less than a 1% chance of returning to any type of employment. This drives up claims costs and is bad for the injured worker.

The Workers’ Compensation Board envisions a process in which an employer “creates” a light duty job tailored to each injured worker. In reality, most employers have a limited amount of potential light duty employment. In those cases, the goal of the claims professional is to get a clear statement of the claimant’s work ability from the treating physician and then to issue an appropriate offer letter to the claimant. Continue reading How to: Reducing Exposure by Offering Accommodated Positions in New York

Explainer: Permanency Benefits in New York

The New York Workers’ Compensation Law allows for four types of benefits to be provided to injured workers: medical treatment, lost time wage replacement, death benefits, and permanent disability benefits. This article discusses the three types of permanent disability benefit available to the injured worker:

  • Scheduled loss of use.
  • Classification/LWEC
  • Permanent Total Disability.

The employer is exposed for permanent disabilities which the claimant may prove. These three types of disability are compensated at different rates.

Scheduled Loss of Use.

Values come from tables which establish the compensation for loss of limbs, vision, and hearing in terms of ‘weeks of compensation.’ Scheduled loss is the percent of those weeks equal to the percentage loss of function of the member (for example a 10% schedule use loss of the arm equates to 31.2 weeks of compensation. The award is the number of weeks of compensation according to the schedule multiplied buy the workers’ maximum rate (2/3rd of Average Weekly Wages subject to the maximum and minimum rates in place according to the year of the accident). Prior payments of compensation and wages (all wages, not just those paid at the compensation rate) are deducted from the award. Continue reading Explainer: Permanency Benefits in New York

Settlements in New Jersey: What gets deducted?

What does the petitioner have to pay back when a settlement is reached in a New Jersey workers’ compensation case?

Has to be paid back: State Disability

Any petitioner’s award is offset by any amounts paid to the petitioner by State Disability as provided by N.J.S.A. 34:15-57.1. Temporary disability paid by the state for injuries later deemed compensable or settled via Section 20 must be reimbursed to the state. Before settling a case, counsel should be expected to investigate all outstanding liens. The New Jersey workers’ compensation law judge can provide the parties with the amount of the State temporary disability lien at the time of settlement.

Has to be paid back: Health Insurance

By the very terms of the Act, workers’ compensation insurance is primary to medical insurance. Therefore, any amounts paid on behalf of the petitioner for treatment deemed by a judge “reasonable and necessary” to cure the petitioner of the effects of the work-related accident, can be collected by the health insurer at the time of settlement, or later. Recent case law instructs that even matters disposed of pursuant to Section 20 may not extinguish a health insurer’s lien. Continue reading Settlements in New Jersey: What gets deducted?