HOW DOES WORKERS COMPENSATION WORK IN NEW JERSEY | PART FIVE
In my discussion earlier this week I mentioned that typical cases our firm encounters fall under the Second Injury Fund. I will explain what actually happens in a real-world situation.
In that scenario, employers and their insurers are understandably reluctant to assume responsibility for continuing the temp rate of disability payments for the duration of someone’s life. The case will go on the Second Injury Fund list whenever an argument can be made that the disability was only partially attributable to the work-related accident. (That, of course, requires the filing of another claim petition).
For example, the total disability can be due to a combination of pre-existing medical conditions upon which the accidental injury was superimposed and thereby rendered one totally disabled. Then the insurer’s liability for perm benefits is limited to that percentage of disability that the accident alone would have caused had the individual not experienced pre-existing conditions.
As previously discussed, no counsel fees are awarded on the portion of the award which is paid by the Second Injury Fund. At one time the Fund was known as the Two Percent Fund because it was funded by 2% of all workers’ compensation premiums collected by insurers in New Jersey. Regardless, the state does not contribute any of its tax revenues to the Fund. It is still financed by contributions for which workers’ compensation insurers are assessed.
Over time, it will be interesting to see how many Second Injury Fund cases will involve folks who had pre-existing morbidities. Those conditions include heart disease, lung disease, cardiovascular conditions and the like. Or, for that matter, folks who may have been overweight when they contracted Covid-19.
These essential employees were fully functional and employable before Covid-19 rendered them temporarily, partially or totally unemployable. Under New Jersey’s Workers’ Compensation system, benefits are payable.
Those who became totally disabled due to the combination of pre-existing and the Long Covid related illness, will likely be entitled to Second Injury Fund Benefits as long as they remain totally disabled from gainful employment.
Employers and their insurers will limit their exposure to payment of total disability benefits by virtue of the Second Injury Fund’s assumption of responsibility in due course. When it comes to ongoing medical treatment those obligations continue to be imposed on the employer’s insurer for the duration of the employee’s life (in most cases). These treatments often involve pain management or potentially future surgical procedures,
One more caveat. In virtually all Second Injury Fund cases, the petitioner will have been awarded Social Security Disability (SSD) benefits by the time the final hearing takes place. It will be comparatively easier to prove one’s total disability to the Social Security Administrative Judge than to slog through many adjournments before attaining an Order for Total Disability with Second Injury Fund in New Jersey’s workers’ compensation courts.
It should also be noted that a complex process of offsets for Social Security benefits will need to be calculated in order to avoid having the disabled individual receive more in income while disabled than when he or she was employed.
This concludes this series of articles which began with: “How Does Workers Compensation Work In New Jersey | Part One”. You can also read more about New Jersey’s on our Workers’ Compensation page.
Are you a worker who was injured while at work? Then our firm will provide you with a confidential, no-obligation consultation. You can call us today at 856.235.1234 or use our contact form.