For those unfamiliar with New Jersey’s workers’ compensation program, the benefits may seem unnecessary or even redundant. After all, you likely have health care coverage through your employer. You may even carry short-term and long-term disability insurance through a private company or through your employer.
However, those personal policies do not replace workers’ compensation as a critical asset to working adults in New Jersey. In fact, the workers’ compensation program is ideal for injured workers, even if they have other insurance. It offers wage replacement and medical coverage, as well as survival benefits in the event of a fatal workplace injury or illness.
Understanding workers’ compensation medical coverage
If you already have a relatively solid insurance plan through your employer, you may find yourself wondering why you would need the medical benefits that come from a workers’ compensation claim. There are a couple of different answers to that question. The first is subrogation.
If your medical insurance company learns that your injury is the result of a workplace accident, they may expect to subrogate the claim to the workers’ compensation insurance policy. In other words, your medical plan will bill your employer’s workers’ compensation policy for the coverage they provide. Even if that won’t be the case, you still get better coverage through workers’ compensation than you do through almost any private insurance policy.
Workers’ compensation offers 100% coverage. That means no deductible, no copay and no co-insurance. People have to pay thousands of dollars out-of-pocket before they reach their deductible and their insurance starts covering things. Even then, they may have to continue to pay $20 or $40 per appointment and prescription in co-pay costs.
Then, they will also receive bills for a certain percentage of the total cost of their medical care, known as coinsurance. Workers’ compensation doesn’t require that you pay any of those. Instead, they fully cover the medical costs directly associated with the recovery from your workplace injury or illness.
Wage replacement can help you close the financial gaps after an accident
When an injury leaves you unable to work, your family may struggle to make ends meet. You may think that tightening your budget will offset the lost income, but you shouldn’t have to do without financial help just because of a workplace injury.
Although the wage replacement offered through temporary and permanent disability coverage under New Jersey workers’ compensation does not replace your full wage, it does provide you with a steady source of income until your medical issues resolve enough to allow you to return to work.
If you worry about how to file your workers’ compensation claim or don’t understand what benefits you could receive, you might want to sit down with an attorney who can guide you through the entire process, from filing an initial claim, to appealing any denial of benefits.