Governor Murphy Announces Intention to Nominate Rachel Wainer Apter to Serve on the New Jersey Supreme Court

At Ruth Bader Ginsburg Hall at Rutgers–Newark, Governor Phil Murphy today announced his intention to nominate Rachel Wainer Apter to the New Jersey Supreme Court to fill the seat of Associate Justice Jaynee LaVecchia, who will retire at the end of the current Court term on August 31, 2021. The appointment will first be sent to the New Jersey State Bar Association’s Judicial and Prosecutorial Appointments Committee. With the Committee’s approval, the Governor will proceed with a formal nomination, subject to advice and consent in the Senate.

Pending NJ Supreme Court Cases of Interest

Pending NJ Supreme Court Cases of Interest

Top NJ Workers' Compensation Decisions of 2019

It has been an active 2019 for workers’ compensation decisions in New Jersey. There have been two NJ Supreme Court opinions and three reported Appellate Court opinions that are noteworthy. From a review of the pending docket the NJ Supreme Court will be reviewing at least 3 very significant issues in 2020 invoking workers’ compensation issues.

NJ Supreme Court to Review Application of Exclusivity Rule Between Social Remedial Legislation Acts

The NJ Supreme Court will review two social remedial legislative acts to determine whether the Exclusivity Rule is applicable. The workplace legislation is the Law Against Discrimination [LAD] and the Workers’ Compensation Act [WCA]. The Court will determine whether a LAD claim is barred by the exclusive remedy of the WCA. Mary Richter, Plaintiff-Respondent, v. Oakland Board of Education, C-234 Sept.Term 2019, 2019 WL 5847242, Petition for Certification Granted NOVEMBER 4, 2019

Pending NJ Supreme Court Workers' Compensation Appeals

A-78/79/80-18 The Plastic Surgery Center, PA v. Malouf Chevrolet-Cadillac, Inc. (082502)
Does the two-year statute of limitations, applicable to claims under the Workers’ Compensation Act, apply to claims by medical providers for the payment of services rendered to injured employees?
Certification granted: 05/14/2019
Posted: 05/15/2019
Argued:
Decided:

A-68-18 New Jersey Transit Corporation v. Sandra Sanchez and Chad Smith (082292)
Can plaintiff, a workers’ compensation carrier, obtain reimbursement of medical expenses and wage loss benefits it paid from defendants (more specifically, the tortfeasors who negligently caused injuries to plaintiff’s employee in a work-related motor vehicle accident), if the employee would be barred from recovering non-economic damages from defendants because he did not suffer a permanent injury?
Certification granted: 04/04/2019
Posted: 04/05/2019
Argued: 09/24/2019
Decided:

Download the Oral Argument Video for A-68-18

Updated: 09/30/2019

…. 

Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thomson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thomson-Reuters). For over 4 decades the Law Offices of Jon L Gelman 1.973.696.7900jon@gelmans.com has been representing injured workers and their families who have suffered occupational accidents and illnesses.

Medical Treatment is an Exclusive Remedy Not a Reasonable Accommodation

The NJ Supreme Court has held that the provision of medical treatment does not equate to a "reasonable accommodation", therefore an employee cannot claim under the Law Against Discrimination [LAD] that failure to provide medical care was actionable. The provision of medical treatment is an exclusive remedy of the Workers’ Compensation Act.

Just Published: 2018 Update - Gelman on Workers' Compensation Law

Jon Gelman’s newly revised and updated 2018 treatise on Workers’ Compensation Law is now available from by West Group of Egan, MN within the next few weeks. The treatise is the most complete work available on NJ Workers’ Compensation law and integrated with WESTLAW™, the "most preferred online legal research service.'"

NJ Supreme Voids Agreements Not To Sue Third-Parties

In a landmark decision, the NJ Supreme Court has ruled that agreements between employers and employees not to file a lawsuit against an employer's customers are unenforceable. The Court held that such disclaimers are against public policy.

Guidelines for Medical Provider Claims - A Valuable Approach

While the vast majority of jurisdictions in the US have the guidance of mandatory workers' compensation medical fee schedules, New Jersey remains one of the very few with no such structure. As I reported earlier, this generates multiple issues in the claims process and creates costly delays in the adjudication of disputes.

NJ Supreme Court Hears Argument on Employer's Duty to Household Contact

An employer's duty to a employee's household contact was the focus of an oral argument recently before the NJ Supreme Court. The NJ Supreme Court reviewed the question, that was certified by the US Third Circuit Court of Appeals, to define the duty and its scope. The household contact, the fiance, subsequently spouse, suffered beryllium related disease causally related to the employee's toxic exposure.

The Security of Metadata in Workers' Compensation Claims

Metadata Ethics Opinions Around the U.S.
Source: aba.org

Confidentiality is a crucial element in workers' compensation matters and the removal of metadata in electronically transmitted documents are a critical factor in the process of maintaining the level of security embraced by the system. Metadata is all hidden data in a PDF file, including text, metadata, annotations, form fields, attachments, and bookmarks.

NJ Supreme Court to Review An Increase of Partial Disability Award in Total Disability Claim

One of the basic tenants of workers' compensation is that awards maybe reviewed and modified where the medical status has changed.1 The NJ Supreme Court on March 14, 2016 granted Certification to review a favorable Appellate Court ruling that permitted a totally and permanently disabled injured worker to receive an increase of a prior (2006 injury) partial disability award, even though the worker had been declared to be totally and permanently disability from a subsequent (2008 injury) injury.

NJ Supreme Court Bars Expansion of Injured Workers Remedies

Additional tort claim disallowed against insurance companies for intentional failure to comply with court of compensation's, an administrative agency, order to provide provide benefits.

Wade Stancil v. ACE USA (067640)
Argued 3/26/12 Decided 8/1/12 see http://tinyurl.com/d4pycqw

SYLLABUS 

(This syllabus is not part of the opinion of the Court.  It has been prepared by the Office of the Clerk for the 

convenience of the reader.  It has been neither reviewed nor approved by the Supreme Court.  Please note that, in the 

interests of brevity, portions of any opinion may not have been summarized.) 

Wade Stancil v. ACE USA (A-112-10) (067640) 

Argued March 26, 2012 -- Decided August 1, 2012

HOENS, J., writing for a majority of the Court.

The Court considers whether an injured employee may sue his employer’s compensation carrier for pain and suffering caused by the carrier’s delay in paying for medical treatment, prescriptions, and other services. Plaintiff Wade Stancil was injured in 1995 while employed by Orient Originals.  He received workers’ compensation benefits from his employer’s compensation carrier, defendant ACE USA (ACE).  In 2006, following a  trial, the court of compensation determined that Stancil was totally disabled.  In 2007, Stancil filed a motion in the compensation court seeking an order compelling ACE to pay outstanding medical bills.  

During a hearing on the motion, the compensation judge commented that ACE had a history of failing to make payments when ordered to do so.  On September 12, 2007, the compensation judge granted Stancil’s motion, warned ACE against any further violation of the order to pay, and awarded Stancil counsel fees.  On October 29, 2007, the parties returned to the compensation court for a further proceeding relating to the disputed bills.  After finding that the bills identified in the September 12 order remained unpaid and that ACE’s failure to make payment was a willful and intentional violation of the order, the court issued another order compelling ACE to make immediate payment and again awarding counsel fees.  

The court commented on its limited ability to ensure that carriers would comply with orders, noted that it lacked the authority to enforce orders through contempt proceedings, found that Stancil had exhausted his administrative remedies, and suggested that he seek further relief in the Superior Court.  In 2008, Stancil underwent additional surgery and psychiatric treatment.  Stancil’s physician attributed the need for additional treatment to an earlier treatment delay caused by the carrier’s delay in paying medical providers.  

On April 15, 2009, Stancil filed this lawsuit in the Superior Court.  In his complaint, Stancil claimed that ACE required him to undergo medical examinations by physicians of its own choosing and then rejected the recommendations of those physicians and refused to authorize the recommended medical care.  The complaint stated further that Stancil obtained orders from the compensation court, but ACE failed to comply.  Stancil contended that ACE’s failure to authorize needed treatment caused him unnecessary pain and suffering, a worsening of his medical condition, and expenses that should have been paid by ACE.  ACE responded by filing a motion to dismiss the complaint.  ACE argued that the Workers’ Compensation Act, N.J.S.A. 34:15-1 to -142 (the Act), is the exclusive remedy for the claims pled in the complaint and therefore no damages could be awarded.  The trial court granted ACE’s motion.  The court analyzed the impact of then-recently adopted amendments to the Act and found that the Legislature had foreclosed resort to the Superior Court for the kind of tort-based relief demanded by Stancil.

The Appellate Division affirmed.  418 N.J. Super. 79 (App. Div. 2011).  The panel agreed with the trial court that The Legislature’s amendments to the Act foreclosed Stancil’s claims.  The panel also rejected Stancil’s argument that ACE’s willful disregard of compensation court orders met the Act’s intentional wrong exception to the litigation bar. The Supreme Court granted certification limited to determining whether an employee who suffered a work-related injury has a common-law cause of action for damages against a workers’ compensation carrier for its willful failure to comply with court orders compelling it to provide medical treatment when the delay or denial of treatment causes a worsening of the employee’s medical condition and/or pain and suffering.  207 N.J. 66 (2011).  

HELD:  An injured employee does not have a common law right of action against a workers’ compensation carrier for pain and suffering caused by the carrier’s delay in paying for or authorizing treatment because 1) the workers’ compensation system was designed to provide injured workers with a remedy outside of the ordinary tort or contract remedies cognizable in the Superior Court; 2) in amending the Workers’ Compensation Act in 2008, the Legislature rejected a provision that would have given the compensation courts broader permission to authorize a resort to the Superior Court and adopted a remedy that permits compensation courts to act through a contempt power; and 3) 2allowing a direct common-law cause of action against a carrier would undermine the workers’ compensation system by substituting a cause of action that would become the preferred manner of securing relief.

CHIEF JUSTICE RABNER, JUSTICE LaVECCHIA, and JUDGE WEFING (temporarily assigned) join  in JUSTICE HOENS’s opinion. JUSTICE ALBIN filed a separate, dissenting opinion. JUSTICE  PATTERSON did not participate.

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Workers' Compensation: Bad Faith Claims Maybe Going to the Jury

Aug 05, 2011

The lower court had rejected the case and dismissed it holding that the jurisdiction for bad faith is exclusively within the purview of the Division of Workers' Compensation. Stancil v. ACE USA, 418 N.J. Super. 79, 12 A. 3rd 223...

http://workers-compensation.blogspot.com/

NJ Supreme Court To Rule on Several Critical Issues

Apr 23, 2012

A-112-10 Wade Stancil v. ACE USA (067640). 3. The Exclusivity Rule: Under the circumstances of this case, which include a finding by the federal Occupational Safety and Health Administration that the accident was the result ...

http://workers-compensation.blogspot.com/

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Willful OSHA Violation Alone Not Enough Alone to Circumvent the Exclusivity Doctrine

"New Jersey’s Workers’ Compensation Act (the Act), N.J.S.A. 34:15-1 to -128.5, provides a prompt and efficient remedy for an employee’s claim against an employer for a workplace injury. The Legislature made the statutory workers’ compensation remedy  its preferred mechanism for providing compensation to injured  workers......Based on the strong legislative preference for the workers’ compensation remedy and an intentional-wrong standard that even an employer’s recklessness and gross negligence fails  to satisfy, we hold that this matter falls short of demonstrating that an intentional wrong creating substantial certainty of bodily injury or death occurred. " Justice LaVecchia

A finding of a willful OSHA violation is not conclusive in determining whether the employer committed an intentional wrong for the purposes of the Workers' Compensation Act. Instead, it is one factor among the totality of circumstances to be considered. The issuance of a willful OSHA violation against employer (trench collapse injury) was insufficient to defeat a motion for summary judgment, so the Court examined the totality of the circumstances of the accident and applies the conduct and context prongs of the substantial-certainty standard.

In reviewing the substantial certainty of injury prong of the dual test to determine employer liability beyond workers' compensation, the court distinguished this case from all prior decisions by relying upon the fact that the employer did not intentionally remove a safety device. Noting that the employer's actions in this circumstance, failure to have a proper trench preventing collapse system in place, where the soil was poor in violation of OSHA provisions, did not eliminate the exclusivity of remedy. The court specifically indicated that an employer should not be mearly penalized for actions taken for economic business motivation.

Furthermore, the high threshold of the content prong of the test was not satisfied the court enunciate. "...The type of mistake in judgment by the employer and ensuing employee accident that occurred on this construction site was so far outside the bounds of industrial life has never to become contemplated for inclusion in the Act's exclusively bar," ie. mere violation of an OSHA safety requirements.

Van Dunk v. Reckson Associates Realty Corporation, 2012 WL 2377854 (2012).
 

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NJ Supreme Court To Rule on Several Critical Issues

The NJ Supreme Court has before it three issues of critical importance concerning workers' compensation including: the standard of proof in a fatal heart claim; remedy for the failure of an insurance company to provide medical care, and the "exclusivity rule." These decisions have the potential to be landmark decisions.


1. Standard of Proof in a Fatal Heart Claim: Does the record support this workers' compensation claim under N.J.S.A. 34:15-7.2, which sets the standard of proof governing claims based on injury or death from cardiovascular causes?


Workers' Compensation benefits were awarded for a pulmonary embolism causally related to sedentary work activity. A NJ Appellate Court awarded benefits for the development of a pulmonary embolism precipitated by the inactivity of sitting long hours at a desk job.

Certification granted: 2/14/12

Posted: 2/14/12

A-71-11 James P. Renner v. AT&T (068744)

2.  Remedy for the Failure of the Insurance Company to Provide Medical Care:

May an employee who suffered a work-related injury pursue a common-law cause of action against a workers’ compensation carrier for willful failure to comply with court orders compelling it to provide medical treatment when the delay or denial of treatment causes the employee’s condition to worsen?

The NJ Supreme is going to review the procedure to bring bad faith claims against employers and insurance companies in workers' compensation actions. The Court accepted for review a case holding that workers' compensation bad faith claims are within the exclusive jurisdiction of the workers' compensation hearing official.

Certification granted 6/7/11
Posted 6/10/11
Argued: 3/26/12
A-112-10 Wade Stancil v. ACE USA (067640)

3. The Exclusivity Rule:

Under the circumstances of this case, which include a finding by the federal Occupational Safety and Health Administration that the accident was the result of a “willful violation” of its regulations, did the employer’s action constitute an “intentional wrong” that would preclude immunity under N.J.S.A. 34:15-8 of the workers’ compensation statute?

NJ Courts have held that trench accidents were not a mere fact of industrial life and were beyond intent of Act's immunity provision. A claim was permitted directly against the employer in addition to the workers' compensation action. 

Certification granted 1/27/11

Posted 1/28/11

Argued: 10/12/11

A-69-10 Kenneth Van Dunk, Sr. v. Reckson Associates Realty Corp. (066949)

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• Federal RICO Claim May Not Be Preempted by a State Workers Compensation Act (workers-compensation.blogspot.com)
• The New Non-Subscriber Opt-Out Plan Is Emerging As The Alternative to Traditional Workers' Compensation (workers-compensation.blogspot.com)