New Jersey Administrative Code

(a) An employee shall not be entitled to any benefits from the Fund with respect to any period of disability commencing while he or she is covered under a private plan. (b) An employee shall not be paid any benefits for disability during unemployment (N.J.S.A. 43:21-3, 4) for any…

(a) As provided in the Act, a private plan shall be discontinued when the Division withdraws its approval thereof upon being furnished satisfactory evidence that a majority of the covered employees have made election in writing to discontinue such plan. (b) An employer may discon…

(a) The employer shall be liable for the deduction of workers' contributions and payment of workers' and employer's contributions, as required by N.J.S.A. 43:21-7, with respect to wages paid for employment subsequent to the effective date of withdrawal or revocation of the certif…

(a) A policy of insurance providing for the payment of benefits under a private plan shall provide that the insurer shall remain liable for the payment of benefits to any employee covered by the policy and the private plan for any period of disability commencing, during the conti…

Each contract of insurance providing for the payment of benefits under a private plan shall contain a clause or clauses guaranteeing that the benefits meet the requirements of N.J.A.C. 12:18-2.9, Minimum plan requirements. Notes N.J. Admin. Code § 12:18-2.23 Amended by R.1998 d.1…

(a) The security required by the Division from an employer whose private plan does not provide for the assumption of the liability to pay benefits by an insurer, duly authorized and admitted to do business in this State, shall be in the form of a cash deposit, a bond of an admitt…

(a) Exemption from the requirement of N.J.A.C. 12:18-2.2 4, Security required, shall be granted to any employer who:1. Is exempt from insuring the employer's workers' compensation liability, as provided by law; or 2. Satisfies the Division as to the employer's financial responsib…

(a) The security provided for in this subchapter should be applied by the Division to the payment of any unpaid obligations under the private plan. Upon termination of a private plan, which does not provide for the assumption by an admitted insurer of the liability to pay benefit…

(a) If an employee's weekly benefit amount, determined under the benefit provisions of an employer's private plan, with respect to any period of disability, is less than the maximum weekly benefit amount payable under the State plan, and such weekly benefit amount has been comput…

Within 10 days after the mailing of a request for information with respect to a period of disability, each employer having a private plan shall furnish the Division with any information requested or known to the employer which may bear upon the eligibility of the claimant. Notes …

(a) For the six month periods ending June 30 and December 31 of each calendar year during which a self-insured private plan is in effect, each employer shall, on a form prescribed by the Division, file a statement, on or before the 30th day following the end of the respective six…

Notice, in a form approved by the Director, of the benefits provided by the private plan shall be furnished to the covered employees either by individual certificates or other direct notification at the time of coverage, or by conspicuous and continuing posting at the place of em…

(a) For the six month periods ending June 30 and December 31 of each calendar year, each union, association of employees, nominee, trustee or organization which has assumed the liability to pay the disability benefits required under one or more private plans (which benefits are n…

(a) For the six month periods ending June 30 and December 31 of each calendar year, each insurance company which has assumed the liability to pay the disability benefits required under one or more private plans shall, on a form prescribed by the Division, file a report, on or bef…

On or before the 30th day following the close of each calendar half-year, each employer having two or more approved private plans in effect during such calendar half-year or any portion thereof shall, on a form prescribed by the Division, file a report showing the amount of taxab…

(a) The term "unemployment disability account deficit" means any negative balance between the credits and debits of the account as determined by the Act. (b) If the accumulated deficit at the end of any calendar year after interest and other earnings have been credited in accorda…

Any assessment under the provisions of N.J.S.A. 43:21-48 shall be collected under the provisions of N.J.S.A. 43:21-14, except that interest shall not accrue on any such assessment until 30 days after the date of notice of such assessment. Notes N.J. Admin. Code § 12:18-2.34…

(a) The portion of the aggregate amount of refunds to workers during any calendar year pursuant to N.J.S.A. 43:21-7(d)(3) to be assessed against private plans shall be determined by multiplying the aggregate amount of such refunds by the ratio of taxable wages involved in such re…

Any employer who acquires the organization, trade, assets or business, in whole or in part, whether by merger, consolidation, sale, transfer, descent or otherwise, from an employer liable for any assessment made under N.J.S.A. 43:21-7(d)(3), N.J.S.A. N.J.S.A. 43:21-46 and N.J.S.A…

(a) If there is a change in the employer and the successor employer assumes the obligations and liability of the predecessor under the plan, the plan shall be transferred to the successor, if: 1. The workers to be covered by the plan immediately after the succession are not requi…

(a) Notice, in a form approved by the Director, of the benefits provided by the private plan shall be furnished to the covered employees by the employer by a conspicuous posting at the place of employment and by personal notice to each employee at the time of the establishment of…

(a) An employee covered under a private plan shall have the right to choose his or her own attending licensed medical practitioner, but he or she may be required to submit, not more often than once a week, to an examination by a licensed medical practitioner designated by the emp…

No employer, union or association representing employees and no person acting in behalf of any of the foregoing shall so administer or apply the provisions of a private plan as to derive any profit therefrom. Notes N.J. Admin. Code § 12:18-2.5

(a) The appeal procedures for private plan temporary disability cases are found at N.J.A.C. 1:12A and are appendixed at the end of this chapter. (b) If an employee covered under a private plan is denied benefits by the insurer for any period of disability or he or she disagrees w…

(a) All approved private plans shall be reviewed by the Division during their continuance to insure compliance with the law and regulations thereunder. (b) Where a decision to accept or deny a claim is not made within 45 days of filing of claim, the insurer shall notify the Divis…

(a) An employer desiring to establish a private plan for the payment of benefits to employees, shall file an application on a form and in a manner prescribed by the Director. In requesting the form, the employer shall inform the Division whether the benefits will be provided by a…

(a) Each private plan, in order to secure Division approval, shall provide to the employees covered thereby rights equal at least to those set forth in N.J.S.A. 43:21-37 to N.J.S.A. 43:21-42 inclusive, by assuring that: 1. The private plan shall cover all employees, except as pro…

(a) A claimant shall not be entitled to any benefits from the Fund with respect to any period of disability commencing while he or she is covered under a private plan. (b) A claimant shall not be paid any benefits under N.J.S.A. 43:21-3 and N.J.S.A. 43:21-4 for any period of disa…

§ 12:18-3.10 - Reserved Notes N.J. Admin. Code § 12:18-3.10

(a) Benefits shall be compensable under N.J.S.A. 43:21-29 for any period of disability "resulting in the individual's total inability to perform the duties of employment." Benefits shall also be compensable at a fractional part of the week as provided in N.J.S.A. 43:21-40 in such…

(a) Under the following circumstances, the seven-day waiting period for payment of benefits shall not apply, and, therefore, benefits shall be payable with respect to the first seven days of the period of disability: 1. If the benefits are payable for a period of disability that …

(a) Within 30 days after the commencement of a period of disability, a written notice of disability, on which a claim for State plan benefits is based, shall be furnished to the Division by or on behalf of the person claiming benefits. The notice need not be on any prescribed for…

(a) All claims and other required documents relating thereto may be filed by mail except in those cases where the claimant is notified by the Division that a personal appearance or examination will be required. Filing by mail shall be deemed complete based on the postmark date, o…

(a) The amount of benefits otherwise payable to a claimant under the State plan for any week of disability, or part thereof, shall be reduced by the amount paid concurrently under any governmental or private retirement, pension or permanent disability benefit or allowance program…

(a) A covered individual is deemed to be in "concurrent employment" if he or she is in employment with two or more employers the last calendar day of employment preceding the commencement of a period of disability. The term "concurrent employers" means the covered employers with …

(a) A claimant shall be given written notice of any decision on his or her claim and of the reason for any denial of his or her claim. (b) If the "Employer's Statement" on Form DS-1 has not been completed by an employer or his or her representative, a request for information shal…

(a) Within 10 days after the mailing of a request for information with respect to a period of disability, an employer shall furnish the Division with any information requested or known to him or her which may bear upon the eligibility of the claimant. (b) If any employer or emplo…

Unless the claimant or the employer, within seven calendar days after the delivery of a determination or notification thereof, or within 10 calendar days after such notification was mailed to his or her last-known address, files an appeal from such determination, it shall be fina…

The rules of the Board of Review shall govern appeals in disability benefit cases under the State plan. See appeal rules at N.J.A.C. 12:20. Notes N.J. Admin. Code § 12:18-3.9 Amended by R.1994 d.241, effective 5/16/1994. See: 26 New Jersey Register 1326(a), 26 New Jersey Register…

This Chapter is promulgated to establish reasonable minimum requirements for the construction, operation and maintenance of pits and quarries in the interest of the life, health and safety of employees, as well as protection of property. Notes N.J. Admin. Code § 12:185-1.1

This Chapter is applicable to every quarry, sand pit, gravel pit, clay pit and shale pit in this State. Notes N.J. Admin. Code § 12:185-1.2

In cases of practical difficulty or unnecessary hardship, the Commissioner may grant exceptions from this Chapter provided that a request for such exception has been made in writing. Exceptions can only be granted when it is clearly evident that a satisfactory, safe and sanitary …

Within one month after the abandonment of any quarry the employer shall file with the Commissioner an accurate plan showing the workings of the quarry up to the time of abandonment and the boundaries of the property in which these workings are situated. Notes N.J. Admin. Code § 1…

The plan filed under N.J.A.C. 12:185-10.1 shall be preserved as a permanent record, but no persons except officials of the Department shall be permitted, without the consent of the owner, to see the plans so filed until after a lapse of 10 years of abandonment, except when in the…

The owner, agent or lessee of any abandoned pit or quarry which is dangerous by reason of its depth or other conditions, shall place or cause to be placed guardrails, fences or other approved means, sufficient to prevent any accidental fallings into any abandoned pit or quarry an…

The fence referred to in N.J.A.C. 12:185-10.3 shall be not less than six feet high and signs marked "Danger--Keep Out" shall be placed thereon or in the vicinity of any excavation. Notes N.J. Admin. Code § 12:185-10.4 Amended by R.2006 d.428, effective 12/4/2006. See: 38 N.J.R. 3…

When the Commissioner finds that any fencing or other safeguards are required in order to avoid danger to persons or property, he or she may cause the work to be done and all expenses incurred thereby shall be chargeable to and shall be paid by the owner, agent or lessee. Notes N…