Claims Kit
New Jersey
State Compliance Information
Penalties for Late Reporting 34:15-101
Every employer, insurer or other person failing to comply with this statute, will be liable to a penalty of not less than $10 nor more than $50.
Physician Selection 34:15-15
The employer has the right to designate the authorized treating physician for all work related injuries. Only in the situations where the employer inappropriately refuses to provide medical treatment or if an emergency exists, may the injured worker choose the treating physician. In the case of the latter, the injured worker should notify the employer as soon as possible concerning the treatment being received.
Posting Requirements 34:15-80
New Jersey law requires every employer to post and maintain, in a conspicuous place or places in and about the worksite, a form prescribed by the Commissioner of the Department of Banking and Insurance, stating that the employer has secured workers' compensation insurance coverage or has qualified with the Department of Banking and Insurance as a self-insured employer.
For insured employers, the notice must include the name of the insurance carrier and other items as required by the Department of Banking and Insurance.
The form of notice is prescribed by the Commissioner of Insurance and shall be clearly printed on a minimum of 90# index, 8 1/2" by 11" in size.
Form 16 NJ A
Reporting of Claim by Employer 34:15-96
The employer must, upon the happening of any accident or the occurrence of any compensable occupational disease in its establishment, promptly report to the insurance carrier, or the third party administrator.
Posters & Brochures
Documents Provided by CopperPoint
Portal User Help
Pharmacy First Fill - ENG/SPA
Change of Address
Witness Statement - ENG/SPA
Accident Report - ENG/SPA
Gramm-Leach-Bliley Act (GLBA) Privacy Notice
Return To Work
Return To Work Transitional Employment Offer Template - ENG/SPA
Return To Work Policy Guide
Documents Provided by CopperPoint
Portal User Help
Pharmacy First Fill - ENG/SPA
Change of Address
Witness Statement - ENG/SPA
Accident Report - ENG/SPA
Gramm-Leach-Bliley Act (GLBA) Privacy Notice
Return To Work
Return To Work Transitional Employment Offer Template - ENG/SPA
Return To Work Policy Guide
Injured Worker Guide
The worker's compensation system can be complicated, and each state has its own laws regarding workers' compensation.
The information contained in your state's guide provides a general guide for workers injured or made ill on the job.
This state-issued publication will assist you in navigating the workers' compensation system and serve as a resource for basic legal rights as well as steps to take to initiate workers' compensation benefits, deadlines and who to contact for additional assistance.
If you have questions about the workers' compensation process, this guide will provide the contact information for the regulatory agency for your state. In addition, many states have an ombudsman to oversee and assist all interested parties in the workers' compensation system.
Publications
Need help?
Phone: 800.231.1363
For Claim Reporting, please complete your First Notice of Loss and email to reportaclaim@copperpoint.com