Workers' Compensation
As your employer, Eleos is obligated to maintain workers' compensation insurance. This measure is designed to safeguard staff members' rights to pursue compensation for work-related injuries or illnesses without the fear of retribution. Staff Members are entitled to file a workers' compensation claim if they sustain a work-related injury or illness. Additionally, staff members have the right to be protected from discrimination or retaliation for asserting this right, and they may report any instances of misconduct to management or state authorities.
We hope to provide you with the information you need to understand the process and your right's benefits and responsibilities.
It is imperative that all job-related injuries are reported immediately.
What is Workers' Compensation?
Workers’ compensation is a “no fault” insurance program that provides medical treatment, wage replacement, and permanent disability compensation to staff members who suffer job-related injuries or illnesses. It also provides death benefits to dependents of workers who have died due to their employment. An injured staff will receive benefits regardless of who was at fault.
What are the Benefits?
- Medical Benefits: Necessary and reasonable medical treatment, prescriptions, and hospital services related to the work injury are paid by the employer’s insurance carrier or directly by the employer if self-insured. The employer and/or their insurance carrier have the right to designate medical providers for all work-related injuries.
- Temporary Total Benefits: If an injured worker is disabled for a period of more than seven days, he or she will be eligible to receive temporary total benefit, retroactive to the first day of lost time. The benefit will be paid at a rate of 70% of their average weekly wage, not to exceed the statutory maximum rate or fall below the statutory minimum rate established annually by the Commissioner of Labor and Workforce Development. These benefits are provided until the worker has returned to work or has reached maximum medical improvement.
- Permanent Partial Benefits: When a job-related injury or illness results in a permanent bodily impairment, benefits are based on the individual’s functional loss. These benefits are paid weekly and are due after the date temporary disability ends.
- Permanent Total Benefits: When a work injury or illness prevents a worker from returning to any type of gainful employment, he or she may be entitled to receive permanent total disability benefits. These weekly benefits are provided initially for a period of 450 weeks. Benefits continue beyond the initial 450 weeks provided that the injured worker is able to show that he or she remains totally disabled. The benefits are paid weekly and are based upon 70% of the average weekly wage, not to exceed the statutory maximum or fall below the statutory minimum.
- Death Benefits: Dependents of a worker who dies due to a work-related injury or illness may be eligible to receive death benefits and funeral expenses up to $3,500. The weekly benefits are 70% of the wage of the deceased worker, not to exceed the statutory maximum or fall below the statutory minimum.
Staff Rights
- Disputes: In cases of dispute over entitlement to benefits, a worker may file either a formal Claim Petition or an Application for an Informal Hearing with the Division of Workers' Compensation (New Jersey). Issues may include compensability of the claim, the type and extent of medical treatment, and/or the payment of temporary and permanent disability benefits.
- Discrimination Complaint: It is against the law for an employer to discharge or discriminate against a staff member because the staff member claimed or attempted to claim Workers' Compensation benefits or because the staff member testified or is about to testify in a Workers' Investigation.
If a staff member would like to file a discrimination complaint through the administrative course of action as mentioned above, download and complete the form here.
- Internal Investigation: Eleos Management will launch an investigation into actual or alleged discrimination or retaliation by any staff member against another staff member who has claimed or attempted to claim Workers’ Compensation Benefits.
- Americans with Disabilities Act: If the employer's actions are not believed to be based upon the efforts of a staff member to secure Workers' Compensation benefits for themselves or others, but because of the disabling condition, the staff member would not have a claim for discrimination in Workers' Compensation; they may have a claim for violation of the Americans with Disabilities Act (ADA). Information concerning the ADA or the filing of complaints under the act may be obtained by writing or calling the Equal Employment Opportunity Commission at 1801 L. Street. NW., Washington, D.C. 20507; (202) 663-4900 (phone); (202) 663-4912 (fax).
- Provider Participation: Staff members access the AmTrust website to and utilize the provider search tool through Tailspoint to verify if the treating provider is in the Horizon network.
Staff Responsibilities
- Report Injuries Promptly: Staff must report all work-related injuries or illnesses to their supervisor or management as soon as possible.
- Injured Staff and/or Management must complete, sign and submit our Workers’ Compensation Claims Submission Form.
If Management completes, signs and submits a form on behalf of a staff member, an email copy of the form will be sent to the staff member’s email on file. - Seek Immediate Medical Attention: For serious injuries and severe symptoms, staff members should seek immediate medical assistance by calling 9-1-1 or if able to safely go to the nearest ER if you are able to do so safely. Inform the Doctor or Nurse that you were injured while on the job.
- Cooperate with Investigations: Staff members must cooperate with investigations of their injuries, including timely responses to requests from Human Resources and Claims Adjuster.
- Follow Medical Advice: Staff Members must follow the medical advice provided by their treating physician.
- Provide Information: Staff Members must provide accurate information about their injury and medical history.
- Advise Workers' Compensation Provider: Staff Members must advise the approved workers' compensation provider during the initial visit that the injury/occupational illness is work related.
Staff Member Violations
- Fraudulent Claims: Making false or misleading statements in a workers' compensation claim is a crime of the fourth degree.
- Penalties: Staff members who commit fraud may face incarceration in state prison and hefty fines.
- Working While Receiving Benefits: If a staff member is collecting workers' compensation benefits while performing similar work, they may face fraud charges and penalties.
- Civil Liability: Anyone who wrongfully obtains benefits or evades payment is civilly liable for damages and attorney fees.
"I was injured while on the job." What should I do?
Call your direct supervisor immediately to report the incident and your injury.
You may also report your injury by completing, submitting and signing our Workers Compensation Claim Submission Form.
New Jersey Notices & Guidance
New Jersey's Workers' Guide to Workers' Compensation: This pamphlet is published for general information only and does not have the status of law or regulation. For specific wording of the law see the New Jersey Workers’ Compensation Act (NJSA 34:15-1 et seq.) or consult your attorney.
Click the button below to view the pamphlet.
For more information on Workers' Compensation in New Jersey, click below.
Florida Notices & Guidance
Florida "Broken Arm" Poster
Florida Anti-Fraud Reward Poster
Florida Employee Brochure
For more information on Workers' Compensation in Florida, click below.
Questions?
If you have questions or concerns related to Workers' Compensation please contact our Human Resources Director mariangela.rodriguez@eleosfamilyservices.com or our Compliance Manager marquis.johnson@eleosfamilyservices.com
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