06
Nov
Caught in the New Jersey Temporary Disability Benefits Gap - Volunteer Firemen
On average, a Workers’ Compensation Judge in the State of New Jersey has approximately fifty to sixty cases listed before them each day. Of these, Judges are asked to conference various disputes, take testimony in either trials or motions for Medical and Temporary benefits, and, hopefully, review the fairness and reasonableness of settlements. Compared to other attorneys, I generally bring the most cases to Court with me each day. However, some days, I have to wait for other attorneys to finish with the Judge. While this gives me more last minute time to prepare my arguments, it does give me the opportunity to listen to the stories of other attorneys, and the problems that they are having in their cases.
A few days ago, an attorney asked me for some advice. He has a client that was injured as a volunteer fireman. He works another job, full-time. Under N.J.S.A. 34:15-43, volunteer firemen are full Workers’ Compensation benefits if injured in the line of duty, including treatment, temporary disability, and permanency benefits. The insurance carrier for the volunteer fire department has indicated that he can return to working for the volunteer fire department on light duty, and the fire department indicated that they had light duty available. Accordingly, per statute, the insurance company stopped paying temporary disability benefits. However, the Petitioner was not capable of returning to his full-time job, and was not receiving any money.
This is a horrible situation, which fortunately, does not happen very often. In order to receive temporary disability benefits from a Respondent in the State of New Jersey when their injury arises from the course of their employment, an injured worker must be temporarily totally disabled and under active medical treatment. By virtue of being released to light duty, he was not totally disabled regardless of his ability to return to his full-time job, and this Petitioner was caught in a very rare gap in New Jersey’s Workers’ Compensation system.
The only solution that I could recommend is that the Petitioner apply for Temporary Disability Benefits from the State of New Jersey, which provides similar benefits to those of the insurance carrier. The State has a lien against all Workers’ Compensation claims and should be repaid by the carrier if they carrier should have been paying temporary disability benefits.
In this situation, the Petitioner should indicate on the application for State benefits that this injury did not arise out his employment with his full-time job, and that he does not have a Workers’ Compensation claim pending against them. He will also need a doctor to sign the form to indicate that he can not return to his full-time job. As the Workers’ Compensation carrier has provided him treatment all along, it is doubtful that the doctor for the carrier will want to get involved, and the Petitioner may have to find another doctor to review him at his own expense, but at least he will start getting a temporary income until he is capable of fully working.
Listening to the stories of other attorneys, and learning from them is an essential part of my Court experience, so if you are ever injured during the course of your employment, I can properly advise you of what your next step should be.