Public income support programs supplement income through direct cash payments. Several of the programs described below are designed to insure workers against a loss of income due to a disabling physical or mental health condition. Other programs are not designed specifically for people with disabilities; however, a large percentage of individuals who receive program benefits have disabilities or have a child with a disability so we include them here.
Supplemental Security Income (SSI). Under the Federal Supplemental Security Income (SSI) Program, persons age 65 years and older, or those who are blind or disabled (including children), receive maintenance payments and supportive services, including emergency assistance and payment for burial. The services are administered by county welfare agencies. For eligible individuals, a state supplement is provided, increasing the net countable income up to the state standard for the respective living arrangement.
The Department of Policy and Standards in the New Jersey Division of Family Development administers the SSI program statewide. The Social Security Administration charges each state a fee for processing the state supplement to the SSI payment. This charge has increased gradually over the past few years, and is expected to continue to rise annually. Therefore, the state is pursuing the possibility of direct administration of the supplement.70
Social Security Disability Insurance (DI). The DI program provides cash payments to individuals with work histories who have a medically determined disability expected to last at least 12 months or result in death, and who are unable to engage in substantial gainful activity (SGA). SGA is currently defined as the equivalent of working with earnings above $740 a month.71 The payment amount for a worker is based on his or her lifetime average earnings covered by Social Security. DI benefits replace a portion of the worker's prior earnings. DI beneficiaries with earnings above the SGA level are subject to a loss of their DI cash benefits, and after an extended period of work activity above the SGA level, a loss of the Medicare eligibility.72
Temporary Disability Insurance. The New Jersey Department of Labor's Temporary Disability Insurance Program provides cash benefits to almost all workers covered under the Unemployment Compensation Law to ensure against wage loss when an individual is unable to work because of sickness and injury not caused by his or her job. New Jersey is one of five states that provides compulsory temporary disability insurance for workers.
The following three programs are included in New Jersey's Temporary Disability Benefits Law:
The State Plan. An individual who becomes disabled while employed or within 14 days of the last day of work in covered employment may be entitled to benefits under the State Plan. The maximum amount of benefits payable for each period of disability is one-third of the total wages in New Jersey covered employment paid to the claimant during the base year, or 26 times the weekly benefit amount, whichever is less. An individual must file his or her claim for benefits within 30 days of the state of the disability or risk losing some or all of the benefits.
The Private Plan. The Temporary Disability Benefits Law also permits employers to provide coverage through an approved Private Plan. The Plan may be insured by an insurance company, by the employer, union welfare, or labor-management welfare fund. A Private Plan must be at least equal to the State Plan in benefit amounts, eligibility requirements and duration of payments. Some Plans are more liberal than others. All Private Plans must be approved by the Division of Temporary Disability Insurance. The Private Plan insurer determines eligibility.
Disability During Unemployment. The State Plan and Private Plan provide coverage for individuals who become disabled while employed or within two weeks of the last day of work in covered employment. Additionally, there is a third program for those whose disabilities begin more than 14 days after the last day of work. This program is called "Disability During Unemployment" and is administered under the provisions of the Unemployment Compensation Law and the Temporary Disability Benefits Law. Individuals who claim benefits under this program must meet all the eligibility requirement of the Unemployment Compensation Law, excluding the ability to work.73
Workers' Compensation. The director of the Division of Worker's Compensation is responsible for the administration of worker's compensation. An employee or their dependents are eligible to receive workers' compensation benefits for an injury or death arising out of and in the course of employment. The employer or their insurance carrier pays for necessary and reasonable medical treatment, loss of wages during the period of rehabilitation and benefits for permanent disability. The Division of Workers' Compensation provides an impartial forum to mediate and adjudicate disputes when parties are unable to amiably resolve their differences over entitlement to workers' compensation benefits. The Division's judicial and administrative staff executes this function.74
Medical Benefits. All necessary and reasonable medical treatment, including hospitalization services and prescriptions related to the work injury are paid by the employer's insurance carrier or directly by the employer if they are self-insured.
Temporary Total Disability Benefits. If an injured worker is disabled for longer than seven days, the individual will be eligible to receive temporary total benefits at the rate of 70 percent their average weekly wage, not to exceed 75 percent of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20 percent of the SAWW. These benefits are provided during the period when the worker is unable to work and is receiving medical care.
Benefits are typically terminated when the worker is authorized the return to work or if the individual has reached maximum medical improvement (MMI). Once the worker has reached MMI, additional treatment will no longer improve the medical condition of the injured worker. In some cases, the worker may be left with either partial permanent injuries or total permanent injuries.
Permanent Partial Benefits. Injured workers who suffer a job-related injury or illness that results in a partial permanent disability are eligible to receive benefits, and the amount of the benefit payments are determined by the nature of the disability. Losses are identified as either "scheduled" (i.e., loss of arms, hands, fingers, legs, feet, toes, eyes, ears or teeth) or "non-scheduled" (i.e., any area or system of the body not specifically identified in the schedule, such as the back, the heart, the lungs). Scheduled and non-scheduled losses pay varying benefits.
Permanent Total Benefits. A worker may be entitled to permanent total benefits when a work injury or illness prevents the worker from returning to any type of gainful employment. These weekly benefits are provided initially for a period of 450 weeks. Provided the injured worker is able to show that he or she remains unable to earn wages, these benefits may continue beyond the initial 450 weeks. Wages earned after 450 weeks offset the weekly computation in proportion to the income at the time of the injury. Permanent Total benefits are paid weekly and are based upon 70 percent of the average weekly wage, not to exceed 75 percent of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20 percent of the SAWW. Permanent Total Disability is considered presumptive when the worker has lost two major members or a combination of members of the body such as eyes, arms, hands, legs or feet. Permanent total disability can also be the result of a combination of injuries that render the worker unemployable.75
Department of Veterans Affairs Programs. Disability compensation is available to veterans who are discharged honorably and who have experienced or aggravated a disabling injury or disease during active military service. Veterans who have non-service related disabilities, or who are age 65 or older, are also eligible to receive a veteran's pension. Veteran's disability compensation is paid regardless of work activity.76