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Are There Any Lost Wage Benefits Available After Workers’ Compensation Stops Payment Of Temporary Disability Benefits?

Yes, there is an alternate source for you to obtain some financial relief if your workers’ compensation temporary disability benefits are terminated and you are medically unable to return to work. Your employer may have purchased a disability plan through a private insurance company, or you may be qualified to receive benefits through the State of New Jersey. You should ask your company’s human resources department whether the company’s disability insurance is through a “state plan” or a “private plan.”

If your company purchased a private plan, you must apply for benefits through that insurance company. Keep in mind that most private disability plans contain a provision in the insurance policy which provides for a “dollar for dollar” offset for any benefits you receive through workers’ compensation. Accordingly, you may need to repay the private disability benefits you receive out of the proceeds of your workers’ compensation permanent disability settlement award.

If your employer is covered by a state plan, you may qualify for state temporary disability insurance benefits [hereinafter referred to as “TDI”], if you have earned the threshold amount of wages in New Jersey for covered employment during the 52 weeks immediately preceding the date your disability began. You must have earned at least $168 per week in the last 20 weeks, OR earned at least $8,400 during the year in which the disability occurred to qualify for benefits.

You may apply for TDI benefits while you are waiting for the Division of Workers’ Compensation to hear the Motion for Temporary Disability Benefits which your attorney filed on your behalf. Please note that filing a Motion for Temporary Disability Benefits is not a prerequisite for obtaining TDI benefits. However, it is advisable to file a Motion to increase the chances of forcing the workers’ compensation carrier to pay the lien which will ultimately be placed on your workers’ compensation case by the State of New Jersey, for the benefits it paid to you.

The quickest way to obtain TDI benefits is to file an online application at the following web address: Division of Temporary Disability And Family Leave Insurance.

If you do not have internet access, you may obtain a copy of an application form from your attorney or by calling the Division of Temporary Disability at (609) 292-7060. The completed application should either be faxed to 609-984-4138 or mailed to the following address: Division of Temporary Disability Insurance / P.O. Box 387 / Trenton, NJ 08625-0387. Your application should either by mailed or faxed, but avoid submitting it both ways, which could confuse the claims examiners and slow down the process.

The current Application for State TDI benefits contains three parts. You must complete Part A of the Application. Your physician must complete the Certification found in Part B. You should ask your employer to complete Part C of the Application, which lists your wages in the ten (10) week period immediately before your disability began. If your employer refuses to complete its portion of the Application you may write “Employer Uncooperative” on Part C, and instead, attach a copy of your paystubs over the last ten (10) weeks.

The New Jersey Division of Temporary Disability Insurance provides lost wage benefits for qualified individuals who are unable to work due to non-occupational causes. Accordingly, if your disability is related to a work injury your application for TDI benefits will initially be denied. Do not be alarmed. Upon receipt of a denial, you must simply complete a “Certification of Contested Workers’ Compensation Claim” form. To qualify for TDI benefits, your attorney must first file a Claim Petition in the Division of Workers’ Compensation, and provide you with the Claim Petition number which must be noted in the Certification form. The State will then assert a lien for any benefits it paid on your behalf, to be paid out of the proceeds of any award you obtain in the Division of Workers’ Compensation.

State TDI pays qualified applicants two-thirds (2/3) of their average wage, up to a maximum benefit rate which changes annually. The maximum weekly benefit rate is $633 for disabilities which begin on or after January 1, 2017. There is a seven (7) day waiting period before you will be eligible to receive benefits, and TDI benefits are available for up to six months, as long as a physician continues to certify that you are unable to work.

Pezzano Mickey & Bornstein, LLP

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(908) 923-0020