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.

Mark Setaro, Esquire856.779.6010

msetaro@wglaw.com