New Jersey Administrative Code

(a) The Commission shall conduct an initial review upon receipt of a written complaint or report, which is not obviously unfounded or frivolous, or related solely to the subject of an appeal and which, if true, would constitute a violation of this subchapter. (b) Prior to any mee…

(a) When the Commission conducts an evidentiary review, the Commission shall: 1. Require the filing of a verified complaint or report; 2. Notify the judge of the nature of the complaint or report and the name of the person making the complaint or report, provide a copy of the com…

(a) Upon completion of the initial review, the Commission may take any of the following actions which may be accepted, rejected, or modified by the Director: 1. The Commission may recommend that the Director dismiss the charges and notify the parties of the action taken. If the m…

When requested by the judge, a final hearing in major discipline shall be conducted by an independent hearing officer under procedures set by the hearing officer. The hearing officer will make a recommendation to the Commissioner. As feasible and as permitted by law, the hearing …

(a) Every employer subject to N.J.S.A. 34:15-96 shall file a first notice of accidental injury or occupational disease under the procedures set forth in (b) below when:1. The injury causes a loss of time from regular duties beyond the working day or shift on which the accident oc…

(a) Not more than 26 weeks after the insurance carrier, third party administrator, self-insured employer or statutory non-insured employer learns that an employee has recovered so as to resume work or has reached maximum medical improvement prior to resumption of work, the insura…

(a) Every employer, insurer, third party administrator or other person who fails to comply with the terms of this subchapter shall be liable for a penalty of $ 10.00 for the first offense, $ 25.00 for the second offense and $ 50.00 for the third and subsequent offenses. Violation…

(a) The purpose of this subchapter is to establish surcharge collection procedures to fund the Uninsured Employers' Fund and the Second Injury Fund. (b) The surcharges shall be levied against all workers' compensation and employer's liability insurance policyholders and self-insu…

The following words and terms, when used in this subchapter, shall have the following meanings unless the context clearly indicates otherwise. "Department" means the New Jersey Department of Labor. "Director" means the Director/Chief Judge of the Division of Workers' Compensation…

(a) Report forms for the reporting of compensation paid shall be mailed by the Department to the respective insurers or self-insured employers by June 15 of each calendar year. (b) Insurers and self-insured employers shall file the report of compensation paid for the calendar per…

(a) Insurers shall include the surcharge percentages as provided by the Department of Insurance, for both the Second Injury Fund and the Uninsured Employer's Fund, respectively, on each policyholder's premium notice. (b) The surcharge amounts shall be calculated by multiplying th…

(a) The Department shall provide each insurer and self-insured employer with the appropriate form for calculating the surcharge remittance. The form shall contain express instructions for the completion of the items pertaining to the calculation of the surcharge remittance.1. For…

(a) Insurers and self-insured employers shall submit a quarterly detailed report that supports the amount of credits, supplemental benefits and special adjustment payments claimed on the quarterly remittance. 1. The form and manner of completion shall be as directed by the Direct…

Until calendar year 1999, insurers are required to notify the Department of Banking and Insurance of the amount of standard earned premiums for the period of January 1 to December 31 of each calendar year by August 31 of the immediately following year. Starting with calendar year…

Forms referred to in this subchapter are available from the Department, and may be requested in writing from: Division of Accounting New Jersey Department of Labor PO Box 078 Trenton, New Jersey 08625-0078 Notes N.J. Admin. Code § 12:235-12.8 Amended by R.1997 d.110, effective 3/…

(a) Any insurer or self-insured employer who fails to submit a completed report of compensation paid by July 31 of any calendar year shall be subject to a penalty of $ 100.00 for each 30 day period that the report is delinquent, up to a maximum of $ 500.00. (b) Any insurer or sel…

The Director/Chief Judge or his or her designee may, upon finding that an employer has failed for a period of not less then 10 consecutive days to make provision for payment of compensation as required by N.J.S.A. 34:15-71 and 34:15-72, and subsequent to notice and demand for pro…

In the event the Division determines that a business entity is or may be operating as an employer in the State of New Jersey without the required workers' compensation coverage, the Division shall issue a notice, by regular and certified mail, to the business entity. Notice shall…

(a) In response to a notice issued pursuant to N.J.A.C. 12:235-13.2, acceptable preliminary proof of the required workers' compensation insurance coverage shall include a copy of a current certificate of insurance issued by a mutual association or stock company authorized to writ…

Where the business entity fails to respond to either the initial or second notice and demand for proof of coverage within the period allowed, the amount of assessment stated in the last notice issued to the business entity shall become the final administrative order with respect …

(a) A hearing will be conducted by the Director/Chief Judge or designee if requested pursuant to N.J.A.C. 12:235-13.2. (b) The employer shall have the opportunity to present any and all relevant evidence but the Director/Chief Judge or designee conducting the hearing shall not be…

(a) All penalties shall be paid in compliance with the final administrative order. Failure to pay such penalties when due shall result in a judgment being obtained in a court of competent jurisdiction. (b) All sums shall be made payable to the "Uninsured Employers Fund" in the fo…

(a) Besides any other penalties, remedies or sanctions as provided by statute or regulation, an employer who knowingly fails to provide workers' compensation coverage, who knowingly misrepresents one or more employees as independent contractors or who knowingly provides false, in…

(a) Listed below are the titles and numerical designations of the standard forms utilized for workers' compensation:1. Employee Claim Petition, WC 365; 2. Dependency Claim Petition, WC 366; 3. Application for Review or Modification of Formal Award, WC 368; 4. Notice of Motion for…

Samples of the standard forms listed in N.J.A.C. 12:235-14.1 follow: OFFICE OF ADMINISTRATIVE LAW NOTE: The Division of Workers' Compensation submitted 29 sample forms as part of R.1997 d.110. These forms are not reproduced herein but may be inspected at: Office of Administrative…

The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise: "Act" means Workers' Compensation Law, N.J.S.A. 34:15-7 et seq. "Chief Judge" means the Director/Chief Judge of the Division. "Commissioner…

(a) Claim petitions shall be subject to the following: 1. The claim petition may be filed electronically or on paper. 2. Claim petitions filed on paper shall be verified by the claimant and include the date of the signature and verification. The formal hearing process shall be in…

(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 …

(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 a…

(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 tri…

(a) A settlement agreement reached pursuant to N.J.S.A. 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 de…

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 N.J.S.A. 2:5-1. Notes N.J. Admin. Code § 12:235-3.14 The following annotations apply to N.J.A.C. 12:235-3.14 prior to its repeal…

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 inter…

(a) A party may, by written motion pursuant to N.J.A.C. 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 worker…

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. Notes N.J. Admin. Code § 12:235-3.17 New Rule, R.2002 d.340, effective 10/21/2002. See: 34 N.J.R. 2257(a), 34 N.J.R. 2549(a), 34 N.J.R. 3641(d). Recodified from …

(a) Administrative procedures for avoiding duplication of benefits in cases where claimants have pursued temporary disability benefits under both the Temporary Disability Benefits Law, N.J.S.A. 43:21-25 et seq. (hereinafter referred to in this section as the "TDBL") and the Worke…

(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…

(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 servic…

(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 N.J.A.C. 12:235-3.1 for claim petition filing and assignment). (b) The notice of motion f…

(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 ha…

(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 f…

(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…

(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…

(a) Interrogatories shall be allowed without motion in dependency cases. (b) Interrogatories shall be allowed without motion where the injured worker is treated by the employer's physician and where medical information is not available to the worker. (c) The employer shall be req…

(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…

(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…

(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. Notes N.J. Admin…