Temporary disability benefits are, by definition, “temporary†in nature. Under the workers’ compensation statute, the maximum period of time temporary disability benefits may be paid is 400 weeks, which is approximately 7 ½ years. If an injured worker is still receiving active medical treatment at that point, and is unable to return to work, he is entitled to receive total permanent disability benefits.
The injured worker must also be under active medical treatment with an authorized physician to be eligible for temporary disability benefits. Once the authorized physician determines that the patient has reached “maximum medical benefit†from treatment, then he is no longer entitled to receive temporary disability benefits, even if the treatment has not completely cured him and he cannot return to his prior occupation. For example, if an electrician injures his hands, and is no longer able to perform electrical work, his temporary disability benefits will be terminated the day his physician determines that he cannot improve with further treatment.
Permanent Benefits
Once the injured worker has been discharged from treatment, the permanent disability phase of the workers’ compensation claim begins. In order to preserve the right to receive permanent disability benefits, a Claim Petition must be filed with the DWC within two years of the date any benefits were paid by the workers’ compensation carrier. Accordingly, the injured worker may file a Claim Petition any time within two years of the last authorized medical visit or temporary/permanent disability benefit.
The filing of the Claim Petition starts an adversarial proceeding in the DWC between the injured worker (known as the “petitioner†in the DWC) and the employer (known as the “respondentâ€). For all practical purposes though, the claim is made against the workers’ compensation insurance carrier, which is served with the Claim Petition by the DWC.
In order to evaluate the degree of permanent disability sustained by the petitioner, both the carrier and petitioner’s attorney will retain medical experts who are familiar with the New Jersey disability schedule. In general, both experts will provide exaggerated estimates of the disability for the purposes of negotiating a settlement of the claim. For example, a respondent’s expert may estimate the disability of an injured workers’ back injury as a 5% permanent partial disability. By contrast, the petitioner’s expert may indicate that the very same injury causes a 40% permanent partial disability. Most claims settle prior to trial, at a percentage of permanent partial disability benefits somewhere between the two expert estimates.
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