Attorney Greg Lois discusses the availability of a lump-sum dismissal settlement in New Jersey Workers’ Compensation cases. The presentation looks at the limitations on this type of compromise in the statute (N.J.S.A. 34:15-20), the rules (N.J.A.C. 12:235-13.1) and the case law. Attorney Lois reviews the barriers to Section 20 settlements and presents practical advice and opinion on obtaining the dismissal in court. The discussion also include an overview of the Medicare Secondary Payer Act as a barrier to full compromise settlements in New Jersey, with practical tips for resolving cases quickly.
Subject: New Jersey, Workers’ Compensation Law, Exposure, Permanency, MMI
Date Presented: January 22, 2018
Presenter: Greg Lois
Run time: 34:34
Here is the post-webinar video from our most recent presentation, “Medicare Secondary Payer Issues in New Jersey Workers’ Compensation Cases” from our New Jersey workers’ compensation webinar training series.
In New York, when an individual suffers an accident or illness arising out of and in the course of employment, workers’ compensation becomes the primary source of wage replacement and medical benefits. It is important to understand how workers’ compensation benefits affect or are affected by other available benefit programs. Some of these additional benefit programs duplicate workers’ compensation benefits, some supplement workers’ compensation benefits, and others are paid instead of workers’ compensation benefits.
Private Long Term Disability Benefits: Some employers voluntarily provide employees with long term disability benefits. Individuals can also obtain these policies on their own. Long term disability benefits are typically available for periods of disability which extend beyond an ‘elimination period.’ These policies issue indemnity benefits to policyholders who are disabled and unable to work beyond a set period of time, i.e. six months, 26 weeks, or another set period of time specified in the long term disability policy.
The Workers’ Compensation Board does not have jurisdiction over private long term disability benefit plans. As there is no jurisdiction, the Board has no legal authority to direct reimbursement for a duplication of benefits. Therefore, a claimant can receive both workers’ compensation indemnity benefits and benefits from their long term disability policy at the same time and even receive more from the two than their normal weekly wage while working. However, most long term disability policies contain provisions that require reimbursement to the long term disability carrier or take an offset for any workers’ compensation benefits. These reimbursements and offsets are to be determined in accordance with the terms of the long term disability policy. Continue reading How an Award of Workers’ Compensation Benefits Impacts Other Disability Benefits→
Social Security Disability Insurance (SSDI) provides protection for injured people who need to return to work without compromising
their rights to other federal and/or state benefits. According to the Social Security Administration, someone is “disabled” if they are not able to work as the result of an illness or injury that will last for at least twelve (12) months.
Many claimants in the workers’ compensation (WC) system are either receiving Social Security Disability (SSD) benefits or applying for SSD benefits. It is important to have some knowledge of how Social Security Disability benefits can affect the WC claim and how a person’s application/eligibility for SSD can affect the WC claim.
The Meaning of Disability
In New York, a WC claimant must produce medical evidence of a causally related degree of disability in order to receive ongoing indemnity benefits for lost time from work. A claimant can receive indemnity benefits if they are totally disabled (100%), or have any degree (1% or more) of casually related degree of disability. The claimant’s weekly disability benefit rate is affected by the ongoing degree of disability. Continue reading The Overlap Between Social Security Disability and New York Workers’ Compensation→