Deciding employment status is an issue that can be resolved either before the Division of Workers’ Compensation [DWC] or before Superior Court in a civil action.
Showing posts with label Jurisdiction. Show all posts
Showing posts with label Jurisdiction. Show all posts
Monday, February 28, 2022
Wednesday, February 3, 2021
Navigable Waterway Confers Jurisdiction
The Third Circuit Court of Appeals has ruled that workers compensation benefits are payable under The Longshore and Harbor Workers Compensation Act (LHWCA) if the worker injured on “navigable water.” There is no need to prove that the waterway “is capable of sustaining ‘commonly used large commercial ships” or if there is evidence of ‘present commercial use.’”
Tuesday, July 23, 2019
Employment Relationship Essential Criteria for Jurisdiction
Petitioner, a New Jersey resident, sought benefits under the Workers' Compensation Act (WCA), N.J.S.A. 34:15-1 to -128, alleging injuries both as the result of a specific incident, and occupational injuries "while performing repetitive duties" as an aircraft technician while employed by United Airlines at the airport in Philadelphia. The judge of compensation dismissed both petitions for lack of jurisdiction.
Thursday, March 8, 2018
Federal Court Invokes the Abstention Doctrine in a Workers' Compensation Matter
A Federal Court decided that it would defer to a New Jersey Judge of Compensation to resolve an underlying issue of compensability in a contractor/sub-contractor claim. In abstaining, the Federal Court imposed the “Burford Abstention Doctrine” and dismiss the Federal action with the right to reopen the matter at the conclusion of the state workers’ compensation case.
Saturday, April 22, 2017
The Internet Redefines Jurisdiction
The Internet has resulted in widespread changes in workers’ compensation including what defines a contract of employment. In determining the applicable law governing a claim, the NJ Appellate Division, in a unanimous reported decision, went back to basics in reaching the conclusion that NJ had jurisdiction.
Wednesday, June 17, 2015
NJ Supreme Court: Superior Court has jurisdiction to determine employment status
The NJ Supreme Court ruled that the NJ Division of Workers' Compensation does not have exclusive jurisdiction in determining employment status. In reversing the decision of the Appellate Decision, the NJ Supreme Court held that when a claim petition is not filed with the NJ Division of Workers' Compensation, the Superior Court has exclusive jurisdiction over who is an employee versus independent contractor.
"We conclude that when, as here, there is a genuine dispute regarding the worker's employment status, and the plaintiff elects to file a complaint only in the Law Division of the Superior Court, the Superior Court has concurrent jurisdiction to resolve the dispute."
Wednesday, May 27, 2015
Pending Before the NJ Supreme Court
A-89-13 Estate of Myroslava Kotsovska v. Saul Liebman (073861)
Should the trial court have transferred this wrongful death and survival action to the Division of Workers' Compensation for a determination of the decedent's employment status where defendant raised the workers' compensation bar as an affirmative defense?
Certification granted: 5/19/14
Posted: 5/20/14
Argued: 3/16/15
Case below:
Should the trial court have transferred this wrongful death and survival action to the Division of Workers' Compensation for a determination of the decedent's employment status where defendant raised the workers' compensation bar as an affirmative defense?
Certification granted: 5/19/14
Posted: 5/20/14
Argued: 3/16/15
Case below:
Argued March 20, 2013. Decided Dec. 26, 2013.
Background: Estate of driver's home health aid filed wrongful death action against driver, stemming from accident in which driver accelerated vehicle while parking, hitting home health aid. Following jury trial, the Superior Court, Law Division, Union County, 2012 WL 3965151, determined home health aid was independent contractor, found in favor of estate, and denied driver's motion for new trial. Driver appealed.
Holdings: The Superior Court, Appellate Division, Accurso, J.A.D., held that:
(1) Division of Workers' Compensation was proper forum for resolution of whether home health aid was driver's employee;
(2) jury instruction as to whether home health aid was employee or independent contractor did not adequately convey the law;
(3) taking judicial notice that person would suffer pain if leg was traumatically amputated while conscious was harmless error; and
(4) damages would be preserved pending remand.
Affirmed in part, reversed in part, and remanded.
Tuesday, June 24, 2014
Court of Compensation Does Not Have Jurisdiction for Restitution
A Court of Compensation is not the place for an insurance carrier to seek reimbursement from a responsible entity if it has paid a judgment in error. The NJ Court of Appeals, in affirming a trial decision, ruled that a workers' compensation carrier who erroneously appeared and had entered into a settlement of a workers' compensation claim could not, after payment of the award, could not modify the award to have its name removed as the responsible party.
"Travelers, however, did not present sufficient cause to reopen the settlement to change the identity of the settling entity. If Travelers is entitled to reimbursement for a settlement it mistakenly entered into, it must seek such reimbursement from the liable entity in another court. As Travelers acknowledges, petitioner is not at blame nor should petitioner be involved in litigation seeking to modify the settlement. Workers' Compensation Court is not the proper forum for litigation between two insurers after a judgment has been entered and payment of that judgment made to petitioner."
"Travelers, however, did not present sufficient cause to reopen the settlement to change the identity of the settling entity. If Travelers is entitled to reimbursement for a settlement it mistakenly entered into, it must seek such reimbursement from the liable entity in another court. As Travelers acknowledges, petitioner is not at blame nor should petitioner be involved in litigation seeking to modify the settlement. Workers' Compensation Court is not the proper forum for litigation between two insurers after a judgment has been entered and payment of that judgment made to petitioner."
Not Reported in A.3d, 2014 WL 2807529 (N.J.Super.A.D.)
Related articles
Saturday, May 18, 2013
NJ Bayonne Medical Center - Highest Priced Medicine in the Nation
While workers' compensation insurance carriers may set approved fees or contract with providers, hospitals have huge disparities in the cost for medical care provided. Additionally, there appears to be no difference in the ultimate outcome based on cost for medical service provided.
Compromising fees for medical services has become a big business in the US. Regulatory agencies provide a forum for the re-evaluation and determination of the cost for medical service. Many companies have emerged that provide representation in assisting in compromising fee. NJ Workers' Compensation have been mandated with the jurisdiction to evaluate the need and reasonableness of medical care provided to injured workers and establish the reimbursable value of the medical services rendered.
The highest priced medicine does not yield the best result according to published data released by the US Government. The NY Times has analyzed data and found that the NJ Bayonne Medical Center was the highest priced hospital in the nation.
"Until a recent ruling by the Internal Revenue Service, for instance, a hospital could use the higher prices when calculating the amount of charity care it was providing, said Gerard Anderson, director of the Center for Hospital Finance and Management at Johns Hopkins. “There is a method to the madness, though it is still madness,” Mr. Anderson said."
Compromising fees for medical services has become a big business in the US. Regulatory agencies provide a forum for the re-evaluation and determination of the cost for medical service. Many companies have emerged that provide representation in assisting in compromising fee. NJ Workers' Compensation have been mandated with the jurisdiction to evaluate the need and reasonableness of medical care provided to injured workers and establish the reimbursable value of the medical services rendered.The highest priced medicine does not yield the best result according to published data released by the US Government. The NY Times has analyzed data and found that the NJ Bayonne Medical Center was the highest priced hospital in the nation.
"Until a recent ruling by the Internal Revenue Service, for instance, a hospital could use the higher prices when calculating the amount of charity care it was providing, said Gerard Anderson, director of the Center for Hospital Finance and Management at Johns Hopkins. “There is a method to the madness, though it is still madness,” Mr. Anderson said."
Wednesday, January 16, 2013
NFL, Like M.D.'s, Was Slow to Recognize Concussion Risk =Orentlicher & David
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| Professor George W. Conk |
He states, "Brain injury in the NFL has gained the attention of public health authorities who have documented that NFL players die of neurodegenerative disorders at a rate triple the national average. The NFL finds itself and the game on the defensive."
Click here to read the complete blog post: NFL, Like M.D.'s, Was Slow to Recognize Concussion Risk =Orentlicher & David
Read more about "brain concussions" and football
Dec 19, 2012
Football Concussions – An Epidemic Failure of Safety. Story after story is now emerging of the tragedy of head concussions incurred during the sport of football. While the a battle is brewing over jurisdictional issues involving ...
Apr 19, 2010
He remarked that former football players have donated their brains for pathological research concerning CTE and its association with multiple concussions playing the sport. It has been alleged that CTE results in early ...
Friday, May 11, 2012
Law to Ban Medical Expense Claims Proposed
Legislation (A-2652) [introduced May 10, 2012] has been proposed in NJ that would ban charging workers’ compensation claimants for medical expenses and gives the Division of Workers’ Compensation sole jurisdiction over work-related medical claims. The law would be a positive initiative for all parties as it will subject medical provider claims to an exclusive remedy and consolidate the claims before a single administrative agency for resolution.
The legislation will be the subject of consideration by the NJ Assembly Labor Committee on Monday, May 14, 2012.
Click here to read: Clearing the Workers' Compensation Benefit Highway of Medical Expense Land Mines
The legislation will be the subject of consideration by the NJ Assembly Labor Committee on Monday, May 14, 2012.
Click here to read: Clearing the Workers' Compensation Benefit Highway of Medical Expense Land Mines
By John H. Geaney and Jon L. Gelman
"Medical expenses in contested workers’ compensation cases are now a significant and troublesome issue resulting in uncertainty, delay and potential future liability. Th recent NJ Supreme Court decision, University of Mass. Memorial Hospital v. Christodoulou, 180 N.J. 334 (2004) has left the question of how to adjudicate medical benefits that were conditionally paid or paid in error. Presently there is no exclusively defined procedure to determine the allocation, apportionment of primary responsibility for unauthorized medical expenses and reimbursement."
Statement of the Bill
"This bill prohibits the charging of workers’ compensation
claimants for medical expenses that have been authorized by the
employer or its carrier or its third party administrator, that have
been paid by the employer, its carrier or third party administrator
pursuant to pursuant to the workers’ compensation law, or which
been determined by the Division of Workers’ Compensation to
be the responsibility of the employer, its carrier or third party
administrator. The bill gives the division sole jurisdiction over
disputed work-related medical claims, and directs the division to
provide procedures to resolve those disputes, including procedural
requirements for medical providers or any other party to the
dispute. Finally, the bill provides that the treatment of an injured
worker or dependent of an injured or deceased worker shall not be
delayed because of a claim by a medical provider. "
Further Reference:
NJ Task Force Report on Medical Provider Claims
"During our meetings, it came to the attention of the Task Force that “balance billing” is a
problem. This is the practice wherein authorized medical providers accept fees paid by the
carrier and then issue a bill to the petitioner for any remaining balance. In an effort to eradicate
this practice, the Task Force recommends an amendment to N.J.S.A. 34:15-15. Section 15 of the
Act requires that employers furnish and pay for physicians, surgeons and hospital services for the
injured worker. Having reviewed the statute and the case law, the Task Force believes that there
is a need to clarify that balance billing in the workers’ compensation setting is inappropriate.
Accordingly, the Task Force recommends the following amendment to N.J.S.A. 34:15-15 which
we would propose would appear as a paragraph between the final two paragraphs of that section.
This additional language would read as follows:
“Fees for treatments that have been authorized by the employer or
its carrier or its third party administrator, or which have been
determined by the court to be the responsibility of the employer, its
carrier or third party administrator, shall not be charged against or
collectible from the injured worker. Sole jurisdiction for any
disputed medical charge arising from a workers’ compensation
claim shall be vested in the Division of Workers’ Compensation.”
"Medical expenses in contested workers’ compensation cases are now a significant and troublesome issue resulting in uncertainty, delay and potential future liability. Th recent NJ Supreme Court decision, University of Mass. Memorial Hospital v. Christodoulou, 180 N.J. 334 (2004) has left the question of how to adjudicate medical benefits that were conditionally paid or paid in error. Presently there is no exclusively defined procedure to determine the allocation, apportionment of primary responsibility for unauthorized medical expenses and reimbursement."
Statement of the Bill
"This bill prohibits the charging of workers’ compensation
claimants for medical expenses that have been authorized by the
employer or its carrier or its third party administrator, that have
been paid by the employer, its carrier or third party administrator
pursuant to pursuant to the workers’ compensation law, or which
been determined by the Division of Workers’ Compensation to
be the responsibility of the employer, its carrier or third party
administrator. The bill gives the division sole jurisdiction over
disputed work-related medical claims, and directs the division to
provide procedures to resolve those disputes, including procedural
requirements for medical providers or any other party to the
dispute. Finally, the bill provides that the treatment of an injured
worker or the payment of workers’ compensation to an injured
worker or dependent of an injured or deceased worker shall not be
delayed because of a claim by a medical provider. "
Further Reference:
NJ Task Force Report on Medical Provider Claims
"During our meetings, it came to the attention of the Task Force that “balance billing” is a
problem. This is the practice wherein authorized medical providers accept fees paid by the
carrier and then issue a bill to the petitioner for any remaining balance. In an effort to eradicate
this practice, the Task Force recommends an amendment to N.J.S.A. 34:15-15. Section 15 of the
Act requires that employers furnish and pay for physicians, surgeons and hospital services for the
injured worker. Having reviewed the statute and the case law, the Task Force believes that there
is a need to clarify that balance billing in the workers’ compensation setting is inappropriate.
Accordingly, the Task Force recommends the following amendment to N.J.S.A. 34:15-15 which
we would propose would appear as a paragraph between the final two paragraphs of that section.
This additional language would read as follows:
“Fees for treatments that have been authorized by the employer or
its carrier or its third party administrator, or which have been
determined by the court to be the responsibility of the employer, its
carrier or third party administrator, shall not be charged against or
collectible from the injured worker. Sole jurisdiction for any
disputed medical charge arising from a workers’ compensation
claim shall be vested in the Division of Workers’ Compensation.”
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