Many injured public employees in New Jersey retire on disability pensions (ordinary or accidental). An accidental disability pension must be for a work injury. An ordinary disability pension can be for non-work health issues, or work injuries or both. This blog will focus on some of the key provisions which employers, third party administrators and practitioners need to know about ordinary and accidental disability pensions in the context of workers’ compensation cases.
Ordinary Disability Pensions for PFRS
To obtain an ordinary disability pension (hereinafter ODP) for a member of the Police and Firefighter Retirement System (hereinafter PFRS), one must be a member in service at the time the application is filed with the New Jersey Division of Pensions and Benefits (hereinafter NJDPB). The applicant must have four or more years of service in the pension system and must prove he or she is totally and permanently disabled. That means he or she cannot perform the normal assigned job duties or any other position that the employer may assign.
The benefit is equal to 40% of the Final Compensation or 1.5% of the Final Compensation for each year of service credit (whichever is higher). Final Compensation will depend on which Tier the employee occupies. Tier 1 is for those enrolled on or before May 21, 2010; Tier 2 is for those enrolled after May 21, 2010 and before January 28, 2011; and Tier 3 members are enrolled after January 28, 2011.
Ordinary disability retirement benefits are subject to federal tax but not NJ State income tax until age 65.
Ordinary Disability Pensions for PERS and TPAF
For members of the Public Employees Retirement System (hereinafter PERS) and Teachers’ Pension and Annuity Fund (hereinafter TPAF), ordinary disability pensions are only available for those employees enrolled on or before May 21, 2010.
Unlike the PFRS, 10 years or more of New Jersey service credit are required for members of PERS and TPAF. The annual benefit is equal to 43.6 percent of Final Average Salary or 1.64% of Final Average Salary for each year of service credit, whichever provides the higher benefit.
Workers’ Compensation Offsets
It is very important to understand that under workers’ compensation law in New Jersey, employers may receive an offset against ordinary disability pensions. I will discuss the change in the law eliminating offsets for accidental disability pensions later in this article.
New Jersey employers may be entitled to an offset in a workers’ compensation case for an ODP if part of the reason for the employee’s ODP is a workers’ compensation injury. Many ODP awards are filed by employees who have non-work-related conditions together with work-related conditions. The offset, however, only applies to the work-related condition. So, if the Division of Pensions and Benefits awards someone an ordinary disability for a work-related back surgery along with non-work-related respiratory and heart problems, only the back surgery will be considered for purposes of an offset.
Another important point to emphasize is that there is never an offset for monies that the employee puts into his or her retirement pension. Those monies are called the annuity portion. Any available offset is limited to the pension portion of the ordinary disability, which is usually most of the benefit.
Let’s consider two simple examples of offsets, and in both examples we will assume that the ODP was granted entirely for the workers’ compensation claim. The first example is from the very important Rosales case.
The permanency rate was $329.15 per week
The ODP was $673.95 per month
The annuity portion was $79.38 per month
The pension portion was $594.57 per month.
First, the $79.38 amount must be deducted as it represents the annuity portion, which cannot be offset. All that you need to do is convert the monthly pension figure of $594.57 to a weekly figure (multiply by 12 and then divide by 52 or 52.14 which is used by the Second Injury Fund). That leads to a pension offset figure of $137.20 per week if you divide by 52.
Comp rate $329.19 per week
Offset amount $137.20 per week
Amount due petitioner $191.99 per week
So in the Rosales case, the workers’ compensation award was reduced by $137.20 per week as an offset against the ODP, and the public employer paid the award at a reduced rate of $191.99 per week.
Now let’s consider another case where we have a high-wage employee who receives a workers’ compensation award of 60% permanent partial disability or 360 weeks at $927 per week or $333,730.
In this case, assume the ODP is $43,000 per year. The annuity portion is $5,000 per year, so that must be subtracted, leaving a potential offset of $38,000 per year.
To compute the offset, you convert the $38,000 per year figure into a weekly rate which comes to $730.76 per week.
Comp rate $927.00 per week
Offset amount $730.76 per week
Amount due petitioner $197.00 per week
You can see in this second example that offsets can make a huge difference in exposure for the public sector employer. The public employer in the second example is saving about 80% of the award on account of the ODP. Failing to consider the offset for the ordinary disability pension would cost the public employer over $265,000!
These examples are simple ones because we assumed that the ODP was entirely due to a workers’ compensation injury. But often that is not the case. Many public employees get an ODP for non-work-related conditions together with work-related conditions. The parties must first attempt to gather medical records that may have been submitted to the Division of Pensions and Benefits. Respondent will need the petitioner’s application to the Division of Pensions and Benefits. Then the parties must attempt to negotiate what percentage of the ODP is related to just the work accident. If only one third of the ODP is related to the work accident, then the public employer is only going to be able to consider one third of the ODP for purposes of potential offset. When the parties cannot agree, the Judge of Compensation will make recommendations or may require testimony to decide what portion of the ODP is work related.
Accidental Disability Pensions for PFRS
An accidental disability pension (hereinafter ADP) is very different from an ODP. First of all, there is no apportionment between non-work conditions and work conditions. The accidental disability pension must be from a work injury, namely a traumatic event as defined by case law and regulations. Benefits are higher than they are for an ODP. There is no service requirement. One could be injured seriously in the first month of employment and obtain an accidental disability pension if the proofs suffice.
As in an ODP, the public employee must prove that he or she is totally and permanent disabled from the work accident to obtain an ADP. For PFRS, the benefit is equal to two thirds of the annual compensation on which pension contributions were being made at the time of retirement or at the date of the traumatic event, whichever provides the higher benefit.
Accidental disability pensions are not only more generous in payments but also treated better by the IRS. Unlike an ODP, the member who receives an ADP is exempt from paying federal tax on the pension amount. No state income tax is due until age 65.
Until 2022, public employers were settling workers’ compensation cases where the employee received an ADP with medical monitoring orders. What that meant is the public employer was not paying any permanent partial disability benefits but only causally related medical benefits. That practice, which continued for many years, ended more than three years ago. New Jersey Administrative Code 12:235-3.19 became effective March 7, 2022. This regulation eliminated the practice of settling a workers’ compensation case involving an ADP by a medical monitoring order, with one exception discussed below. The regulation provides as follows:
- 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.
- Except at (a)3 below, the approval by a Judge of Compensation of a continuing medical monitoring settlement shall be prohibited and the worker’s compensation petition shall result in one of the following outcomes:
The award by a Judge of Compensation of a monetary judgment after trial;
The approval by a Judge of Compensation of a settlement agreement reached pursuant to N.J.S.A. 34:15-20 (Section 20 settlement)
The approval by a Judge of Compensation of a settlement agreement reached pursuant to N.J.S.A. 34:15-22 (Section 22 settlement)
The dismissal by a Judge of Compensation of petitioner’s claim after trial for failure of petitioner to meet their burden; or
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.
These changes were designed to require the public employer to pay whatever workers’ compensation awards are entered, thereby avoiding situations created by medical monitoring orders where the Division of Pensions and Benefits would keep paying the public employee without receiving an offset.
The regulation permits one exception under (a)3. “Where the workers’ compensation claim 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…” In this practitioner’s experience, the NJDPB seldom awards accidental disability pensions in occupational cases.
Despite the fact that these changes were enacted in 2022, the statute itself still provides that “No former employee who has been retired on pension by reason of injury or disability shall be entitled under this section to compensation for such injury or disability; provided, however, that such employee, despite retirement, shall, nevertheless, be entitled to the medical, surgical and other treatment and hospital services as set forth in RS. 34:15-15.” This language, which remains unchanged, established the rationale for medical monitoring awards.
So where are we today? The new regulation that became effective in March 2022 remains in conflict with N.J.S.A. 34:15-43 since the statute provides that public employers do not have an obligation to pay a permanency award when the public employee receives an accidental disability pension. It is unclear why this conflict was not resolved in 2022.
It is also important to understand that the policy in New Jersey militates against double recovery to the public employee who receives workers’ compensation benefits and an accidental disability pension. After all, taxpayers fund public sector workers’ compensation claims and taxpayers also fund state pensions, so it makes sense that one cannot receive both. Under procedures since 2022, when an award is entered in the Division of Workers’ Compensation for someone who has received an ADP, the workers’ compensation payment is not really going to the public employee. Rather the payment serves to reimburse the Division of Pensions and Benefits. How is this accomplished? The NJDPB simply takes a dollar for dollar offset for every dollar that the employee receives in workers’ compensation. There is generally no financial benefit to the public employee in pursuing a workers’ compensation case when he or she receives an accidental disability pension. One exception, however, occurs when there is a gap period between the end of temporary disability benefits and the start date of the ADP for which permanent partial disability would be paid without offset.
Accidental Disability Pensions for TPAF and PERS
The accidental disability retirement benefit for TPAF and PERS is actually higher than the two thirds benefit under PFRS. For TPAF and PERS, the amount is equal to 72.7% of the base salary at the time of the traumatic event. As with PFRS, the application must be filed within five years of the date of the traumatic event. Most of the other provisions in accidental disability pensions for PFRS apply to PERS and TPAF.
If one applies for an ADP and is found by the Board of Trustees to be permanently and totally disabled, but not because of a traumatic event or the traumatic event was not the primary cause of disability, then an ODP will be granted but only for those who have 10 years of New Jersey service in the retirement system.
The definition of an accident that is a direct result of a traumatic event has been addressed by courts:
- The event must be identifiable as to time and place;
- The event must be undesigned and unexpected;
- The event must be caused by a circumstance external to the member (not the result of pre-existing disease that is aggravated or accelerated by the work);
- The event must occur during and as a result of the member’s regular or assigned duties;
- The event cannot be the result of willful negligence of the public employee;
- The event must result in the member’s permanent and total incapacitation from performing his or her usual or any other duty.
There are other kinds of disability pensions which this article does not focus on. Readers can contact the undersigned for further information. There are provisions in all three pension systems for Accidental Disability for World Trade Center Responders, Involuntary Disability Retirement (where the employer applies on behalf of the recipient), and Special Disability Retirement. There are also rules for possible adjustments in benefits due to employment of the member after retirement.