reglab/statecodes huggingface dataset:
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 3 - FORMAL CLAIMS › Section 12:235-3.2 - General motions for temporary disability and/or medical benefits

Current through Register Vol. 56, No. 14, July 15, 2024
(a) In all motions by the petitioner for temporary disability or medical benefits, the original notice of motion shall be filed with the district office to which the case is assigned and a copy of the notice of motion and claim petition served by certified mail or personal service on the attorneys of record. If the attorney of record is unknown, then service shall be made by certified mail on the respondent(s) and its carrier(s). If it is a new claim petition and it is a claim petition filed on paper, then the notice of motion shall also be filed with the central office. Motions for temporary disability and/or medical benefits shall evidence that petitioner is currently temporarily totally disabled and/or in need of current medical treatment. Where only past periods of temporary total disability and/or medical expenses are claimed by petitioner, such issues should be presented at pretrial for resolution or trial and not by motion under this section.
(b) The notice of motion for temporary disability or medical benefits shall be on a form prescribed by the Division and shall contain:
1. A detailed account of compensable lost time claimed by the petitioner, indicating any period paid by the respondent;
2. Affidavits or certifications made in personal knowledge by the petitioner or the petitioner's attorney, as well as the report(s) of a physician(s) stating the medical diagnosis and the specific type of diagnostic study, referral to specialist, or treatment being sought, and, if available, an itemized bill and report of the treating physicians or institutions or both for which services past, present and future, petitioner is seeking payment and such other evidence as shall relate to the petitioner's claim for temporary disability and/or medical treatment; and
3. If the petitioner, having received treatment, cannot secure a report of the medical provider authorized by the respondent, it shall be set forth in the affidavit in lieu of the physician's report.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 3 - FORMAL CLAIMS › Section 12:235-3.3 - Motions for emergent medical care pursuant to N.J.S.A 34:15-15.3

Current through Register Vol. 56, No. 14, July 15, 2024
(a) With or after the filing of a claim petition, a petitioner may file a motion for emergent medical care directly with the district office to which the petition is or will be assigned (See 12:235-3.1 for claim petition filing and assignment).
(b) The notice of motion for emergent medical care shall be on a form prescribed by the Division and shall contain or be accompanied by the following:
1. A statement by the petitioner or the petitioner's attorney of the specific request(s) for medical treatment made by the petitioner or the petitioner's attorney to the employer and/or the employer's insurance carrier, including the name of the person(s) to whom the request(s) was/were made;
2. Medical documentation, including a statement by a physician indicating that the petitioner is in need of emergent medical care, that the delay in treatment will result in irreparable harm or damage to the petitioner and the specific nature of the irreparable harm or damage;
3. All medical records relating to the requested medical care, which are in the possession of the petitioner or the petitioner's attorney;
4. Copies of the claim petition and answer.
i. If no answer to the claim petition has been filed, the notice of motion shall include the following information if known by the petitioner: the telephone number and the fax number of the employer, the name of the employer's workers' compensation insurance carrier and the insurance carrier or self-insured employer contact person's telephone number and fax number, as required to be maintained under 12:235-3.4; and
5. Proof of service under (c), (d) and (e) below.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 3 - FORMAL CLAIMS › Section 12:235-3.4 - Insurance carrier or self-insured employer contact person procedures pursuant to N.J.S.A 34:15-15.4

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Every insurance carrier providing workers' compensation insurance and every workers' compensation self-insured employer shall designate a contact person who is responsible for responding to issues concerning medical and temporary disability benefits where no claim petition has been filed or where a claim petition has not been answered.
(b) The contact person referred to in (a) above shall also receive notice of motions for emergent medical care under 12:235-3.3.
(c) The full name, telephone number, mailing address, e-mail address and fax number of the contact person referred to in (a) above shall be submitted to the Division utilizing the Division's contact person form in the manner instructed on the form.
(d) The Division's contact person form shall be made available on the Division's website and at the Division's district offices.
(e) Any changes of contact person or in information about the contact person shall be immediately submitted to the Division using the Division's contact person form.
(f) After an answer to a claim petition has been filed, the attorney of record for the respondent shall be the point of contact for issues concerning temporary disability and/or medical benefits.
(g) A contact person roster using the information provided under (c) above will be available on the Division's website.
(h) Failure to comply with the requirements of 34:15-15.4 or this section shall result in a fine of $ 2,500 for each day of noncompliance, which fine shall be payable to the Second Injury Fund.
1. The Division shall send notice of noncompliance and of the fine amount by certified mail, return receipt requested, to the business address of the insurance carrier or self-insured employer.
2. The insurance carrier or self-insured employer shall have 30 calendar days to pay the fine or to contest the fine.
3. Where the insurance carrier or self-insured employer contests the fine, the Division shall hold a conference in an attempt to resolve the dispute.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 3 - FORMAL CLAIMS › Section 12:235-3.5 - Other motions

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All other motions shall be in the form of a notice of motion, the original of which shall be filed with the district office to which the case is assigned with copies served on petitioner(s), respondent(s), carrier(s), or attorney(s). Every notice of motion shall include the factual and legal basis for the relief requested and a proposed form of order in triplicate.
(b) If the notice of motion or responsive pleading relies on facts not of record, it shall be supported by affidavit made on personal knowledge setting forth facts which are admissible in evidence to which the affiant is competent to testify. The notice of motion shall be considered uncontested unless responsive papers are filed and served within 14 days of the service of the notice of motion.
(c) Motions to dismiss for lack of prosecution pursuant to 34:15-54 and motions to suppress defenses shall be listed for hearing. All other motions shall be disposed of on the papers, unless a Judge of Compensation directs oral argument or further proceedings, in which event a hearing shall be scheduled within 30 days from the filing of the last papers contemplated by this section. At the conclusion of any such hearing the Judge of Compensation shall render a decision and enter an appropriate order within 30 days.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 3 - FORMAL CLAIMS › Section 12:235-3.6 - Third-party joinder by respondent

Current through Register Vol. 56, No. 14, July 15, 2024
(a) A respondent who alleges that another employer or insurance carrier may be liable for all or part of the benefits claimed by the petitioner may move to join such employer or insurance carrier as a responding party to the original claim petition by notice of motion which shall be supported by a definitive statement setting forth the factual and legal basis for the relief sought.
(b) A copy of the motion and supporting statement with a copy of the original claim petition shall be served upon the party sought to be joined and all other parties.
(c) It shall be the responsibility of the moving party to give notice of any hearing of the motion to the party sought to be impleaded.
(d) Such motion shall be granted only where the moving party has satisfied the Judge of Compensation that there exists a substantial likelihood that the party to be joined is or may be liable for compensation benefits to the petitioner.
(e) If the order sought is granted, the order shall be served upon the party joined forthwith who shall file an answer within 30 days of the date of service of the order.
(f) In cases where it appears that the only issue involved is which carrier or employer is liable to the petitioner for the benefits sought, the Judge of Compensation may order the moving party to pay the benefits in whole or in part as a condition of joinder subject to an order for reimbursement, if another party is held to be liable for such benefits.
(g) If a respondent knowingly files an incomplete, inaccurate or frivolous motion for third party joinder, such circumstances may be considered in the apportionment of any counsel fee awarded, in addition to a counsel fee not to exceed $ 200.00 to each opposing counsel of each party sought to be joined.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 3 - FORMAL CLAIMS › Section 12:235-3.7 - Conditions allowable for discovery

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Discovery, except a deposition for preservation of testimony, may be allowed in those contested cases where there are issues in dispute in addition to the nature and extent of petitioner's temporary or permanent disability.
(b) All discovery shall be concluded within 180 days from the filing of respondent's answer or from petitioner's last authorized medical treatment, whichever date is later. A Judge of Compensation may extend or reopen discovery on his or her own motion or on application of a party for good cause appearing.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 3 - FORMAL CLAIMS › Section 12:235-3.9 - Testimony of injured or ill petitioner by depositions

Current through Register Vol. 56, No. 14, July 15, 2024
(a) A petitioner seeking compensation who is in such a physical condition that it is imperative that his or her testimony be taken by deposition, in order to preserve the person's rights or those of his or her estate or dependents, may give a deposition.
(b) The deposition may be ordered by a Judge of Compensation upon notice to the adverse party and taken before a certified shorthand reporter.
(c) The appearance by an attorney for the respondent shall not constitute a waiver of any of the rights of the respondent or its insurance carrier.
(d) A report from a physician shall be attached to the application to take depositions stating the medical basis upon which the deposition is sought.
(e) A deposition for this purpose may also be taken by consent of all parties, provided there is a report from a physician stating the medical basis upon which the deposition is sought.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 3 - FORMAL CLAIMS › Section 12:235-3.10 - Certification of pre-existing conditions

Current through Register Vol. 56, No. 14, July 15, 2024
(a) In all cases in which the petitioner claims total and permanent disability, the petitioner or petitioner's attorney shall, prior to the first hearing date, furnish to all other parties a written certification as to the existence of any condition pre-existing the last claimed compensable episode.
(b) The certification shall include the names and addresses of physicians and institutions furnishing treatment or examinations for any such pre-existing conditions.
(c) The petitioner may in lieu of furnishing actual records or reports, furnish executed authorizations for the records and reports of each such physician and institution.
(d) Copies of all records and reports so obtained by the respondent shall be furnished to the petitioner or petitioner's attorney within 10 days of receipt.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 3 - FORMAL CLAIMS › Section 12:235-3.11 - Pre-trial conference

Current through Register Vol. 56, No. 14, July 15, 2024
(a) In any formal proceeding, the Division shall schedule a pre-trial conference where the following shall be accomplished:
1. All medical reports shall be exchanged;
2. The Judge and the attorneys shall agree upon the type of examination(s) required by each party;
3. The Judge and the attorneys shall make a sincere effort to limit issues; and
4. A pre-trial memorandum on a form prescribed by the Division shall be executed.
i. Any party that intends to utilize videos or other electronic media, including surveillance tapes, must indicate that such media will be utilized at trial and identify the witness who will authenticate and testify concerning the materials to be presented in the "Other Witness" section of the pre-trial memorandum or as an addendum to the pre-trial memorandum. A party is not required to provide or exhibit electronic information, including surveillance tapes, to another party prior to the other party's testimony under oath.
ii. A party may move to amend the pre-trial memorandum to include any necessary changes including the introduction of electronic materials obtained subsequent to the pre-trial; or
5. There shall be an adjournment upon good cause shown.
i. "Good cause" for an adjournment shall not include that the injury or illness upon which the subject claim before the Division of Workers' Compensation is based is also the basis for a pending application to a pension fund administered by the Division of Pensions and Benefits within the Department of the Treasury, including, but not limited to, the Public Employees' Retirement System (PERS), the Police and Firemen's Retirement System (PFRS), and the Teachers' Pension and Annuity Fund (TPAF), for an accidental disability pension allowance.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 3 - FORMAL CLAIMS › Section 12:235-3.12 - Conduct of formal hearings

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The following concern appearances:
1. Only an attorney at law licensed to practice in the State of New Jersey shall act as attorney of record.
i. A substitution of attorney is permitted by filing a Substitution of Attorney (WC-10) form any time up to the commencement of a trial when another attorney is being substituted to represent a party. At or after the commencement of trial, a substitution of attorney must be approved by a Judge of Compensation.
ii. An attorney who has entered an appearance for a party must file a motion to be relieved as counsel when another attorney is not being substituted. Notice of such motion, including the date of the hearing, shall be given to the client to afford an opportunity to be heard on the motion.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 3 - FORMAL CLAIMS › Section 12:235-3.13 - Orders approving settlement reached pursuant to N.J.S.A 34:15-20

Current through Register Vol. 56, No. 14, July 15, 2024
(a) A settlement agreement reached pursuant to 34:15-20 ("Section 20 settlement") may be approved by a judge of compensation when:
1. The petitioner is represented by counsel;
2. The case involves contested issues of jurisdiction, liability, causal relationship and/or dependency; and
3. The settlement is determined to be fair and just under the circumstances.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 3 - FORMAL CLAIMS › Section 12:235-3.14 - Notice of appeal

Current through Register Vol. 56, No. 14, July 15, 2024
Copies of a notice of appeal of any order or judgment shall be provided to the Division and the judge who decided the matter. See New Jersey Court Rule 2:5-1.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 3 - FORMAL CLAIMS › Section 12:235-3.15 - Interpreters

Current through Register Vol. 56, No. 14, July 15, 2024
In any proceeding for which the services of an interpreter are required, a professional interpreter shall be utilized unless the Judge of Compensation, with the consent of the parties, determines otherwise. An interpreter shall be sworn or make affirmation or declaration to interpret accurately.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 3 - FORMAL CLAIMS › Section 12:235-3.16 - Enforcement

Current through Register Vol. 56, No. 14, July 15, 2024
(a) A party may, by written motion pursuant to 12:235-3.5(a) and (b), move against an employer, insurance carrier, petitioner, case attorney or any other party to a claim petition for enforcement of any court order or for the enforcement of the requirements of the workers' compensation statute or rules.
(b) The motion under (a) above shall identify the order, statute or regulation sought to be enforced.
(c) The party against whom the motion has been brought shall file a written response to the motion within 14 calendar days of the notice of motion.
(d) The response under (c) above shall include the reasons for any noncompliance and the manner and time period to ensure compliance.
(e) Any time after the 14-day period to respond under (c) above has elapsed and on notice to the parties, the judge shall hold a hearing on the motion.
(f) A judge on his or her own motion may at any time, upon notice to the affected parties, move to enforce a court order or to enforce the requirements of the workers' compensation statute or rules.
(g) Prior to ruling on a motion under (f) above, the judge shall provide the parties an opportunity to respond to the motion and to be heard on the record.
(h) Upon a finding by a judge of noncompliance with a court order or the workers' compensation statute or rules, the judge, in addition to any other remedy provided by law, may take any or all of the following actions:
1. Impose costs and simple interest on any monies due.
i. The judge may impose an additional assessment not to exceed 25 percent on any moneys due if the judge finds the payment delay to be unreasonable;
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 3 - FORMAL CLAIMS › Section 12:235-3.17 - Hearing to request a stay of the order or judgment

Current through Register Vol. 56, No. 14, July 15, 2024
A request for a stay of an order or judgment shall be heard on the record when a party requests a hearing on the stay.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 3 - FORMAL CLAIMS › Section 12:235-3.19 - Pension offset; public employees; accidental disability retirement

Current through Register Vol. 56, No. 14, July 15, 2024
(a) When the injury or illness upon which the subject claim before the Division of Workers' Compensation is based is also the basis for a pending accidental disability pension application to a fund administered by the Division of Pensions and Benefits within the Department of the Treasury, including, but not limited to, the Public Employees' Retirement System (PERS), the Police and Firemen's Retirement System (PFRS), and the Teachers' Pension and Annuity Fund (TPAF), the following shall occur:
1. Both the workers' compensation petitioner and the workers' compensation respondent shall immediately notify the Division of Pensions and Benefits of the filing of the claim petition with the Division of Workers' Compensation;
2. Except at (a)3 below, the approval by a Judge of Compensation of a continuing medical monitoring settlement shall be prohibited and the workers' compensation claim petition shall result in one of the following outcomes:
i. The award by a Judge of Compensation of a monetary judgment after trial;
ii. The approval by a Judge of Compensation of a settlement agreement reached pursuant to N.J.S.A. 34:15-20(Section 20 settlement);
iii. The approval by a Judge of Compensation of a settlement agreement reached pursuant to N.J.S.A. 34:15-22(Section 22 settlement);
iv. The dismissal by a Judge of Compensation of petitioner's claim after trial for failure of petitioner to meet their burden; or
v. The dismissal by a Judge of Compensation of petitioner's claim petition pursuant to N.J.S.A. 34:15-54 for lack of prosecution;
3. Where the workers' compensation claim petition is for an occupational disease (for example, asbestosis), under appropriate circumstances based on the facts presented, and when not used in a way to avoid a pension offset, a Judge of Compensation may approve a continuing medical monitoring settlement; and
4. Upon a Judge of Compensation granting a judgment, approving a settlement award, or dismissing petitioner's claim before the Division of Workers' Compensation, both the workers' compensation petitioner and the workers' compensation respondent shall immediately provide a copy of the award, order approving settlement, or order of dismissal, as the case may be, to the Division of Pensions and Benefits, within the Department of the Treasury.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 4 - INFORMAL HEARINGS › Section 12:235-4.1 - Purpose of informal hearings

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The informal hearing process is a service provided by the Division to effectuate the amicable adjustment of controversies between injured workers and their employers involving their respective rights under the Act.
(b) The informal hearing procedure is not expressly contained within the provisions of the Act.
(c) The filing of an application for an informal hearing will not toll the time limitation periods for the filing of a formal claim petition or a dependency claim petition as provided by the Act.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 4 - INFORMAL HEARINGS › Section 12:235-4.2 - Filing of an application for an informal hearing

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The informal process is initiated by the filing of an application in duplicate with the Division.
(b) The filing for informal hearing may be made by any party of interest including the injured worker, petitioner's attorney, the employer, the employer's representative or insurance carrier, or the Division.
(c) The application shall be filed within the time periods prescribed for the filing of a formal claim petition.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 4 - INFORMAL HEARINGS › Section 12:235-4.3 - Contents of the application

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The application for an informal hearing shall contain:
1. The worker's name, address, age, and social security number;
2. The employer's name and address;
3. The name of the employer's insurance carrier, if any;
4. The date of the accident;
5. A brief description of how the accident occurred;
6. A brief description of the injury.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 4 - INFORMAL HEARINGS › Section 12:235-4.4 - Scheduling of informal hearings

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Upon receipt of the completed application the Division shall schedule the matter as soon as practicable.
(b) The Division shall give written notice of the time, place and name of the assigned Judge of Compensation to all parties involved in the controversy. In addition, the Division shall include, with the notice to the worker that is the subject of the proceeding, an informational brochure explaining the nature of the proceedings and the rights of the parties involved. The form brochure shall be as set forth in 12:235-14.1.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 4 - INFORMAL HEARINGS › Section 12:235-4.5 - Attendance at hearing

Current through Register Vol. 56, No. 14, July 15, 2024
The worker's attorney, employer, insurance carrier, or self-insured shall provide sufficient personnel to insure prompt attendance at the scheduled time and place of the hearing to expeditiously handle all listed cases.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 4 - INFORMAL HEARINGS › Section 12:235-4.6 - Representative of employer or carrier

Current through Register Vol. 56, No. 14, July 15, 2024
An employer or carrier shall be represented by an individual expressly empowered with authority to act on its behalf to agree or disagree with the recommendations made by the Judge of Compensation at the time of the hearing.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 4 - INFORMAL HEARINGS › Section 12:235-4.7 - Registration of representatives for employers or carriers

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Each employer, carrier, or self-insured shall submit to the Director for distribution to all Judges of Compensation a list of each individual who will represent them at informal hearings.
(b) Each employer, carrier, or self-insured shall indicate that such individuals shall have the authority to represent and agree to settle on behalf of the respondent at informal proceedings.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 4 - INFORMAL HEARINGS › Section 12:235-4.8 - Representation of claimant

Current through Register Vol. 56, No. 14, July 15, 2024
Only an attorney at law licensed to practice in the State of New Jersey shall act as an attorney for a worker in any informal hearing.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 4 - INFORMAL HEARINGS › Section 12:235-4.9 - Procedure where employer has no insurance

Current through Register Vol. 56, No. 14, July 15, 2024
Where it is brought to the attention of the Judge of Compensation that the employer has failed to comply with 34:15-71, written notice of such violation shall be given to the Director for appropriate action.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 4 - INFORMAL HEARINGS › Section 12:235-4.10 - Allowance of attorney fees

Current through Register Vol. 56, No. 14, July 15, 2024
(a) A Judge of Compensation conducting informal hearings may allow counsel a fee, where warranted, for services rendered on behalf of the worker, in an amount not to exceed 10 percent of the worker's award.
(b) The fee in (a) above shall be payable by the worker.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 4 - INFORMAL HEARINGS › Section 12:235-4.11 - Commencement of informal hearings

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Hearings shall be conducted by a Judge of Compensation designated by the Director.
(b) Hearings shall commence promptly at the time and place designated in the notice of informal hearing by a call of the daily court to ascertain the presence of all parties to the controversy and to identify those cases ready for disposition.
(c) Upon completion of the daily call, the Judge of Compensation shall inform all parties present of the order for hearing the ready cases and commence hearings, excusing those persons whose presence will not be required and granting those adjournments the Judge feels are warranted.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 4 - INFORMAL HEARINGS › Section 12:235-4.12 - Determination of issues

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Upon a review of the application for the informal hearing and any supporting documents, the Judge of Compensation shall ascertain the areas of dispute and make recommendations to the parties to resolve any controversy as to unpaid temporary disability benefits and/or medical expenses.
(b) After a review of medical records or evaluation reports or both submitted by the parties and having personally inquired of the worker as to all present complaints, the Judge of Compensation shall make recommendations regarding permanent disability.
(c) In cases where there is insufficient factual or medical information upon which a recommendation can be made, the Judge of Compensation shall require either party to provide such information and shall adjourn the hearing until such time as the information is available.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 4 - INFORMAL HEARINGS › Section 12:235-4.13 - Acceptance of settlement recommendations and entry of informal award

Current through Register Vol. 56, No. 14, July 15, 2024
(a) When agreement has been reached by all parties and approved by the Judge of Compensation, the terms of such settlement shall be entered in the "Statement of Award," on a form prescribed by the Division.
(b) The claimant shall be fully advised of all rights under the Act and as more particularly described in the brochure as prescribed at 12:235-14.1.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 4 - INFORMAL HEARINGS › Section 12:235-4.14 - Fee for service of physician

Current through Register Vol. 56, No. 14, July 15, 2024
A Judge of Compensation conducting an informal hearing may allow a fee to a physician for medical services rendered to a claimant for the term of a compensable injury, unless such treatment was not ordered or authorized by the employer or carrier.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 4 - INFORMAL HEARINGS › Section 12:235-4.15 - Denial of compensability or refusal to accept findings of informal hearings

Current through Register Vol. 56, No. 14, July 15, 2024
In cases where the employer or the representative denies compensability under the Act or where either party refuses to accept the recommendations made by the Judge of Compensation, the claimant shall be made aware of all statutory rights, including the right to obtain counsel, to file a formal claim petition, and the applicable time period within which a claim petition must be filed.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 4 - INFORMAL HEARINGS › Section 12:235-4.16 - Failure of employer or carrier to appear

Current through Register Vol. 56, No. 14, July 15, 2024
(a) If a worker is present and the employer or its carrier fails to appear, the Judge of Compensation shall inform the worker of:
1. The procedure and time limit relating to rescheduling for a rehearing;
2. The approximate date of rescheduling; and
3. The worker's statutory rights as stated at 12:235-4.1 5.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 4 - INFORMAL HEARINGS › Section 12:235-4.17 - Adjournment

Current through Register Vol. 56, No. 14, July 15, 2024
When it appears that certain cases cannot be resolved at the first hearing, due to lack of notice or knowledge of any injury, incomplete reports, or for any good cause, the Judge of Compensation shall be promptly informed so that the Judge may have an opportunity to notify the parties and arrange for rescheduling.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 5 - SECOND INJURY FUND CASES › Section 12:235-5.1 - General procedure

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Upon the filing of a verified petition for Second Injury Fund (Fund) benefits a settlement conference shall be scheduled before a Judge of Compensation where representatives of the employee, employer(s) and the Fund are noticed to attend.
1. The settlement conference may be adjourned by a Judge of Compensation for good cause.
2. If a settlement cannot be effectuated at the settlement conference, the matter may be bifurcated and listed for trial on a day when the probable responsible respondent is regularly scheduled to appear.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 5 - SECOND INJURY FUND CASES › Section 12:235-5.2 - Payment of benefits

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Upon approval of an application for benefits from the Fund, the Judge of Compensation shall enter an order requiring payment from the Fund from the date when the final payment of compensation by the employer is or was payable for the last compensable injury following which the employee became totally and permanently disabled. No payment from the Fund shall be made for any period prior to the date of filing the verified petition for Fund benefits.
1. If the employer has paid in excess of the amount for which it is responsible, the employer shall be reimbursed by the Fund.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 5 - SECOND INJURY FUND CASES › Section 12:235-5.3 - Filing

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The verified petition for benefits shall be filed in accordance with 34:15-95.1 and shall include a succinct and accurate description of all medical, legal and factual basis upon which the petitioner alleges eligibility for Fund benefits pursuant to 34:15-95. The verified petition shall be under oath or affirmation and be accompanied by all physician's reports in possession of the applicant or the applicant's attorney.
(b) The verified petition shall also include the following:
1. Name and address of petitioner;
2. Social security number of petitioner;
3. Age and date of birth of petitioner;
4. Marital status and educational background of petitioner;
5. A summary of petitioner's employment history;
6. A description of disabilities which existed prior to the date of the last compensable injury, and the date of onset of each;
7. The last compensable injury, indicating the date and a description of the occurrence; a description of the injury; brief description of the medical treatment for the injury; a description of permanent injury; name and address of employer and its insurance carrier; petitioner's wages and compensation rate; and a listing of all compensation paid to date for this injury;
8. An indication as to whether a third party tort claim has been made as to the last compensable injury, stating the name and address of the third party and the status of the claim;
9. A copy of all reports which are in the possession or control of the party filing the applications from all proposed expert witnesses and all treating physicians;
10. A description of all wage replacements presently being received by the petitioner;
11. References to all prior allowances and awards in workers' compensation matters concerning the petitioner, including the date of the accident and the extent of the allowance or award.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 6 - COMMUTATION OF AWARD › Section 12:235-6.1 - Application for commutation

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All applications for commutation of compensation payments pursuant to 34:15-25 shall be filed with the Director.
(b) Applications for commutation of compensation shall be made only after the entry of an award.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 6 - COMMUTATION OF AWARD › Section 12:235-6.2 - Application form for commutation

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The application for commutation shall be made on a form prescribed by the Division which shall include:
1. The applicant's name, address, and social security number;
2. The name and address of the employer;
3. The name, address, and file number of the employer's insurance carrier;
4. The date of award;
5. The Judge of Compensation and the place wherein the award was rendered;
6. The amount of the award;
7. The amount of balance due on the award;
8. The amount requested for commutation; applicant's marital, employment, and economic status;
9. The purpose(s) for which commutation is being requested; and
10. Such other information as prescribed by the Director.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 6 - COMMUTATION OF AWARD › Section 12:235-6.3 - Approval or disapproval of application for commutation

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Upon receipt of the application for commutation, the matter shall be forwarded for hearing to the Judge of Compensation who entered the award which is sought to be commuted.
1. If that Judge is not available, then any Judge in the vicinage may hear the application.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 7 - UNINSURED EMPLOYER'S FUND › Section 12:235-7.1 - Purpose; scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The Uninsured Employer's Fund (UEF) has been established pursuant to 34:15-120.1 to provide for the payment of certain awards of medical and temporary benefits entered against uninsured defaulting employers. This subchapter sets forth the procedures by which the UEF will be operated.
(b) Benefits for temporary disability and medical costs shall be provided in accordance with 34:15-120.1 et seq.
(c) The UEF shall be a party to proceedings under this subchapter. However, no judgment or order for the payment of benefits shall be entered against the UEF.
(d) The UEF may relax or dispense with requirements under the subchapter where appropriate and with the consent of the judge hearing the case.
(e) A petitioner may move to relax or dispense with requirements under this subchapter.
1. After a hearing on the motion to relax or dispense with requirements under this subchapter, the judge may grant the motion upon a finding that the subject requirements under the particular facts of the case are unduly burdensome and that grant of the motion would not adversely affect the UEF.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 7 - UNINSURED EMPLOYER'S FUND › Section 12:235-7.2 - Filing notice of an uninsured claim; personal service; subpoena duces tecum; third party joinder

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Petitioner or petitioner's attorney shall contact the Compensation Rating and Inspection Bureau for coverage information in writing within 30 days after the petitioner or the petitioner's attorney knew or should have known that the employer was uninsured or has received confirmation that the employer was uninsured on the date of the accident or occupational exposure alleged in the claim petition. A copy of the Rating Bureau's response shall be included in the motion to join the UEF.
(b) If benefits may be sought from the UEF, the petitioner or petitioner's attorney shall notify the UEF in writing within 30 days after the petitioner or petitioner's attorney knew or should have known that the employer was uninsured on the date of the accident or occupational exposure or has received information from the Compensation Rating and Inspection Bureau showing that the employer was uninsured on the date alleged.
(c) In order to secure reimbursement of a petitioner's temporary disability benefits from the Uninsured Employers Fund, the petitioner shall file a motion to join the UEF in an action brought against the uninsured employer.
1. When filing a motion to join the UEF, the petitioner's attorney or petitioner shall attach a copy of the inquiry and response of the Compensation Rating and Inspection Bureau.
2. The motion to join the UEF shall be filed in the vicinage in which the case is assigned.
3. A copy of the motion to join the UEF shall be served upon the Fund in the Office of Special Compensation Funds, PO Box 399, Trenton, New Jersey 08625-0399.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 7 - UNINSURED EMPLOYER'S FUND › Section 12:235-7.3 - Certification

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Petitioner shall submit a certification when filing a motion for an uninsured claim. The certification shall be specific, and shall contain the following information if known or available to the petitioner and should be supplemented as such information becomes known or available to the petitioner:
1. The date of hire immediately preceding the date of the accident, injury or occupational exposure;
2. The length of employment: If not continuous, list all dates of employment;
3. Copies of petitioner's W-2 forms for all dates of employment during the year in which the accident occurred;
4. Pay stubs for or other documentation in support of all wages received from respondent for the six months immediately preceding the date of the accident or occupational exposure;
5. The total wagers received from respondent for 12 months immediately preceding the accident, which includes salary, gratuities, services, in lieu of wages, meals or lodging;
6. The name, address (business and personal) and phone number of the respondent and any corporate officer or manager of the company;
7. Any documents relating to the employer/employee relationship or lack thereof;
8. A statement of facts which establish the employer-employee relationship;
9. The name, address and phone number of all persons with knowledge of the existence of an employer/employee relationship between petitioner and respondent;
10. The address and/or other identifying information about where the injury occurred, including the name of the owner of the property and the reason why the employee was at the location where the injury occurred;
11. The name, address and phone number of all witnesses to the accident, and whereabouts of respondent when the accident occurred;
12. The name, address and phone number of all persons with any knowledge of the accident;
13. The date on which a medical provider was first contacted concerning injuries sustained in the accident or occupational condition;
14. The name and address of all treating physicians and the name and address of any hospital, laboratory or other facility where treatment was received;
15. Copies of all medical reports from the hospitals and treating physicians;
16. Medical insurance coverage for employee and/or spouse, and if available, the name and address of the company and the policy number;
17. A detailed listing of medical expenses which have been paid, the dates the medical services were provided, the names of individuals and entities providing such services, and the sources and amounts of such payments; and
18. Whether or not the petitioner is receiving or has applied for Social Security, unemployment compensation, temporary disability insurance, disability insurance, pensions or any other wage-related benefits.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 7 - UNINSURED EMPLOYER'S FUND › Section 12:235-7.4 - Medical bills; physician's examination

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Any medical bills or charges for which petitioner seeks payment from the UEF must be timely submitted by the petitioner to the UEF and be supported by the following:
1. Related treating records, itemized bills and a physician's report, which reflects that the bills and charges were reasonable, necessary and causally related to the work accident or occupational exposure alleged in the claim petition; and
2. Other necessary medical documentation or information required by the UEF.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 7 - UNINSURED EMPLOYER'S FUND › Section 12:235-7.5 - Assignment of cases; schedules

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The Director shall sign the UEF cases for hearing.
(b) The Director shall establish the vicinages in which the cases shall be heard.
(c) The Director shall establish the hearing dates and schedules for all uninsured employer cases.
New Jersey Administrative Code › Title 12 - LABOR AND WORKFORCE DEVELOPMENT › Chapter 235 - RULES OF THE DIVISION OF WORKERS' COMPENSATION › Subchapter 7 - UNINSURED EMPLOYER'S FUND › Section 12:235-7.6 - Payments from the UEF

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Payments from the UEF shall be made only in accordance with 34:15-120.4.
1. The UEF shall not reimburse governmental agencies for benefits paid to or on behalf of the petitioner except for benefits or expenses conditionally paid under the New Jersey Temporary Disability Benefits Law (43:21-25 et seq.), New Jersey Medicaid reimbursement statute (30:4D-7.1 ), and the Federal Medicare Secondary Provider Statute ( 42 U.S.C. §
											1395y ). Such reimbursements for medical expenses are subject to the limitations set forth in 12:235-7.4(e).
2. Payments under (a)1 above can be made only after a Judge of Compensation has ordered the uninsured employer to reimburse the agency or agencies making the conditional payments and the uninsured employer has defaulted on making such reimbursements within the time period set forth by 34:15-120.3 and 34:15-120.4.