In some worker’s compensation cases, an injured worker will have a pre-existing injury and the combination of the two injuries causes the person to become permanently disabled. Is this worker entitled to workers’ compensation benefits? Fortunately, the answer may be yes, and the employee could also receive benefits from the New Jersey Secondary Injury Fund.
What Is New Jersey’s Secondary Injury Fund?
The Secondary Injury Fund was created in 1923 to encourage employers to hire returning veterans who came back from the war with disabilities, such as amputations, internal injuries, and other medical conditions. Employers pay a surcharge under their workers’ compensation insurance policies that funds this benefit. Only workers who are totally disabled as a result of a prior injury or illness in combination with the current injury can receive payments from the Fund. The Fund only pays wage loss benefits. To be eligible for benefits, an employee must show:
- That he is totally disabled
- That the event that caused the worker to become disabled was a valid compensable workplace injury
- That a pre-existing injury or illness contributed to the worker’s disability
When Does the Secondary Injury Fund Make Payments?
When a worker is eligible for Secondary Injury Fund payments, his employer would first be responsible for paying a certain amount before he can receive benefits from the Fund. Both are only responsible for payment of the portion of the worker’s disability that was caused by the workplace accident. For example, an employer would be responsible for 50 percent of a worker's benefits if the workplace accident accounted for half the reason that the worker became permanently disabled.
The employer will be responsible for paying workers’ compensation wage loss benefits for a certain time agreed upon by the employer and Secondary Injury Fund not to exceed 450 weeks. The Secondary Injury Fund does not start making payments until the employer’s obligation to do so ends. Once the Fund begins making payments, it will pay benefits to the employee as long as he remains permanently disabled—sometimes for the rest of his life. However, the benefits would end upon the worker’s death.
The employer is still responsible for paying the employee’s future medical expenses. However, the payments would only be for treatment related to the injury that occurred in the workplace accident.
How to Apply for Secondary Injury Fund Payments
An injured worker must apply for benefits by filing a Secondary Injury Fund Verified Petition. In order to prove his right to benefits, an employee should collect documentation to support his claim. Some of these documents could be helpful:
- Medical reports. An injured worker should obtain a medical report that states that he is totally disabled and addresses the injury caused by the accident at work and the preexisting illness or injury. This report is usually prepared by a medical expert retained by the worker’s attorney.
- Medical records. The employee will need copies of his medical records for his current injury and his pre-existing injury that in combination has caused him to become disabled.
- Social security disability. If the worker receives social security disability payments, he will need to obtain documentation of the date of his disability, which is usually found on the Social Security Disability Determination, and a completed Average Current Earnings form provided by the Division of Workers’ Compensation.
- Pension. When a worker receives a pension because of his disability, he should obtain documentation of the date of the onset of his disability for pension eligibility purposes and what disability the pension was awarded for.
- Unpaid medical bills. Documentation of any unpaid medical bills should be collected to be provided if necessary.
- Third party claims. The injured worker’s attorney should be able to provide information regarding any third party claims that the worker has filed due to his injuries or the name of the attorney who is handling these claims.
Did you suffer a workplace injury that makes you eligible for Secondary Injury Fund payments? You need the assistance of an experienced workers’ compensation attorney to file and prove your claim. Start an online chat or call our office today to schedule your free consultation to learn more about your rights to these workers’ compensation benefits.