Copyright
Sunday, February 12, 2017
FELA: US Supreme Court to Review Personal Jurisdiction Criteria
"Issue: Whether a state court may decline to follow the Supreme Court's decision in Daimler AG v. Bauman, which held that the due process clause forbids a state court from exercising general personal jurisdiction over a defendant that is not at home in the forum state, in a suit against an American defendant under the Federal Employers' Liability Act."
Tuesday, July 23, 2019
Employment Relationship Essential Criteria for Jurisdiction
Monday, April 19, 2010
Football Players File Claims for Brain Damage
At recent discussion on Legal Talk Network reviewing this topic in depth, Christopher Nowinski, President and CEO of the Sports Legacy Institute and former Harvard football player, participated. 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 dementia, early onset of Alzheimer's Disease and multiple other brain disorders. The average football player sustains over 1,000 concussions each game.
Recently claims have been filed by several players against the National Football League in California. Massachusetts attorney, Alan S. Pierce, explains that that the statutory prohibitions make California a fertile jurisdiction for workers compensation claims. In additional to the medical causation issue, it is anticipated that players will be confronted with conflict of laws issues in selecting an appropriate jurisdiction(s) to insure a maximum recovery.
As employment relationships become more geographically complex due to interstate and international relationships, the courts have been confronted with an ever-increasing problem as to what forum's law will apply to specific situations. In most instances, courts have adopted their local law as long as the site of the injury, or the site of the contract, or the site of the employment relationship was within their state. In certain instances, the court must go beyond those factors and assess whether another forum's law would provide the certainty of result which would occur in the their own state. The court looks towards fairness to the employee in selecting the choice of law to be applied. An overwhelming consideration is that public policy demands that the injured employee be cared for adequately within their jurisdiction.
Additionally rates of compensation vary among the states as well as laws defining what constitutes an occupational exposure and the allocation of liability where multiple jurisdiction, employment and events occur.
It is anticipated that these claims will increase and will proliferate in multiple-jurisdictions throughout the country. Since it it is impossible to avoid injuries in a sport designed for body contact sport, the courts and legislatures will be faced ultimately with public policy consideration concerning the sport and continuing to mandate workers' compensation benefits.
Click here to read more about jurisdiction and workers' compensation.
Saturday, April 22, 2017
The Internet Redefines Jurisdiction
Tuesday, January 30, 2024
Long Overdue Public Safety Worker Coverage
Legislation has been reintroduced to provide workers’ compensation benefits for certain public safety workers who developed an occupational illness or injury flowing from the September 11, 2001, terrorist attacks. A closer look at the legislation reveals that it removes defenses such as causal relationship, statute of limitations, and jurisdiction. Complicated statutory and regulatory challenges may ultimately offset the benefits offered.
Monday, February 28, 2022
The Master of the Complaint Retains Jurisdiction
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.
Thursday, March 8, 2018
Federal Court Invokes the Abstention Doctrine in a Workers' Compensation Matter
Thursday, September 5, 2013
9th Circuit Vacates MSP Injunction Against CMS for Medicare Reimbursement
The Court held that it lacked jurisdiction:
"... we conclude that the***
beneficiaries' claim was not adequately presented to the
agency at the administrative level and therefore the district
court lacked subject matter jurisdiction pursuant to 42 U.S.C.§ 405(g) .
" Federal question jurisdiction does not extend to most
claims arising under the Medicare Act. The Medicare Act
incorporates 42 U.S .C. § 405(h) , which provides:
No findings of fact or decision of the
[Secretary] ... shall be reviewed by
any person, tribunal, or governmental
agency except as herein provided.
No action against the United States,
the [Secretary] ..., or any officer or
employee thereof shall be brought
under section 1331 ... of title 28 torecover on any claim arising under this
subchapter.
42 U.S.C. § 405(h) ; 42 U.S.C. § 1395ii .
****
"We decline to adopt the extraordinarily broad reading of***
Eldridge that the beneficiaries invite. We conclude that the
named plaintiffs' reimbursement disputes did not provide an
opportunity for the Secretary to consider the claim that her
interpretation of the secondary payer provisions exceeded
her authority. Their requests for redetermination of their
respective amounts of reimbursement did not constitute
presentment of their policy challenge.
" We conclude that the beneficiaries' claim wasHaro v Sebelius, ___F.3d____, No. 11-16606, 2013 WL 4734032, Decided Sept.4, 2013.
not presented to the agency. Because presentment is a
jurisdictional requirement under § 405(g) , the district court
lacked subject matter jurisdiction over the beneficiaries'
claim.
Read prior posting about this case:
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- Liability Claim Collateral SOurce Payments Subject to MSP (workers-compensation.blogspot.com)
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- The 10 Highest Medical Cost Jurisdictions for Medicare (workers-compensation.blogspot.com)
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Wednesday, June 17, 2015
NJ Supreme Court: Superior Court has jurisdiction to determine employment status
Related articles
- Employee vs. Independent Contractor: Can You Tell the Difference? (workers-compensation.blogspot.com)
- Exclusivity Rule: Court Holds Risk of Death Contemplated by Legislature (workers-compensation.blogspot.com)
- NJ To Consolidate Workers' Compensation Hearing Offices (workers-compensation.blogspot.com)
- Pending Before the NJ Supreme Court (workers-compensation.blogspot.com)
Friday, May 11, 2012
Law to Ban Medical Expense Claims Proposed
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
"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.”
Related articles
- AIG Exits Workers Compensation As Comp Medical Issues Grow (workers-compensation.blogspot.com)
- Facebook, Organ Donations and Medical Privacy of Workers' Compensation (workers-compensation.blogspot.com)
- Trending: Opting-Out of Workers' Compensation (workers-compensation.blogspot.com)
- Sidetracked By Drugs (workers-compensation.blogspot.com)
- Federal RICO Claim May Not Be Preempted by a State Workers Compensation Act (workers-compensation.blogspot.com)
- NJ Supreme Court To Rule on Several Critical Issues (workers-compensation.blogspot.com)
- The Religious Opt-Out Scheme: A New Approach to Eliminate Workers' Compensation (workers-compensation.blogspot.com)
Tuesday, August 18, 2015
NLRB Rejects Northwestern University Football Payers' Bid to Unionize
Saturday, February 10, 2018
Just Published: 2018 Update - Gelman on Workers' Compensation Law
Friday, May 28, 2021
U.S. Equal Employment Opportunity Commission Issues Update On Vaccinations
The following is shared from the U.S. Equal Employment Opportunity Commission eeoc.gov
Saturday, June 20, 2009
US Supreme Court Bars Direct Asbestos Claims Against Travelers Insurance
The US Supreme Court ruled that the direct action claims against Travelers Insurance Company for its conduct in the asbestos conspiracy with Johns-Manville Corporation (Manville) were barred by the 1986 reorganization plan of the Manville.
Sunday, February 8, 2015
An Update on Florida's Constitutional Challenges to Workers' Copensation
A Florida Constitutional Update
It happened again yesterday. An observer from several hundred miles away wrote to me about what has become known as "Padgett." Padgett has a lot of names, officially it isFlorida Workers Advocates v. Florida, but much of the country seemingly just calls it "that constitutionality case down in
David Langham is the Deputy Chief Judge of Compensation Claims for the Florida Office of Judges of Compensation Claims and Division of Administrative Hearings |
There is much happening in Florida workers' compensation right now. I hear a fair amount about it from around the country. Before D-day, Dwight Eisenhower told his troops "the eyes of the world are upon you." This is not of that magnitude, but it is apparent that the eyes of the workers' compensation world are upon Florida.
This spring may bring distractions. There is the legislative proposal on drug and alcohol in New Mexico accidents. There is the discussion of an "Oklahoma Opt-Out" in Tennessee's legislative agenda. There are drug formulary proposals, treatment guideline proposals,Marijuana questions, and even immigration issues. One has no trouble finding "hot topics" in workers' compensation this year.
But, the inquiries keep coming on Padgett/Florida Workers' Advocates v. Florida. It is Florida Circuit Court decision out of Miami. Many people I run into across the country do not appreciate the magnitude of Miami. Nineteen and a half million people live in Florida, we are the third most populous state behind California and Texas. Over two and half million of those Floridians live in Dade County, in which Miami is located. Dade county is more populous than fifteen of the United States.
In Florida, our general jurisdiction trial courts are called Circuit Courts. There are twenty Circuits, most containing multiple counties. But Dade is the only county in the Eleventh Circuit. Other single county Circuits include Hillsborough/Tampa, Palm Beach/West Palm Beach, Broward/Ft. Lauderdale, and Monroe/the Florida Keys.
Wednesday, May 13, 2020
A Federal Heroes Compensation Fund
Saturday, December 14, 2019
Top NJ Workers' Compensation Decisions of 2019
Tuesday, September 30, 2014
Federal Appeals Court Rules State Apportionment Order Not A Bar to Medicare Recovery
The Court of Appeals, Hardiman, Circuit Judge, held that:
(1) recipient's liability settlement from third-party tortfeasor qualified as a “primary plan” within the meaning of the Medicare as a Secondary Payer Act;
(2) recipient's $90,000 settlement with tortfeasor included her medical expenses, and thus recipient had obligation to reimburse Medicare for $10,121.15 in medical
(3) the New Jersey Collateral Source Statute (NJCSS) did not prevent Medicare from recovering medical expenses as part of her damages in tort suit;
(4) state court's order apportioning settlement proceeds did not bar government from seeking reimbursement for medical expenses;
(5) District Court lacked jurisdiction to adjudicate recipient's unexhausted claim pursuant to “equity and good conscience” exception under Act; and
(6) District Court lacked federal question jurisdiction over due process claim.
"As the ALJ correctly found, the Superior Court's apportionment order was not “on the merits,” and need not be recognized by the agency. A court order is “on the merits” when it is “delivered after the court has heard and evaluated the evidence and the parties' substantive arguments.” Black's Law Dictionary 1199 (9th ed.2009); cf. Greene v. Palakovich, 606 F.3d 85, 98 (3d Cir.2010) (finding, in a criminal case, that “on the merits” means the state court “acted on the substance of [the] claim”), aff'd sub nom. Greene v. Fisher, ––– U.S. ––––, 132 S.Ct. 38, 181 L.Ed.2d 336 (2011); Thomas v. Horn, 570 F.3d 105, 115 (3d Cir.2009) (holding that state proceedings occur “on the merits” “when a state court has made a decision that 1) finally resolves the claim, and 2) resolves the claim on the basis of its substance”). Here, the state court did not adjudicate any substantive issue in the primary negligence suit. Indeed, in her motion for the order, Taransky clarified that she sought an apportionment not to resolve any outstanding issue in her suit, but “only to the extent necessary to obtain specified documentation relevant to anticipated administrative proceedings with the federal Centers for Medicare and Medicaid Services.” JA at 267. The state court, in effect, rubber stamped her request. Taransky's motion was uncontested, issued pursuant to a stipulation between Taransky and Larchmont, and prepared and submitted by Taransky's counsel for the judge's signature. This order is the antithesis of one made on the merits."
Related articles
- Liability Claim Collateral SOurce Payments Subject to MSP (workers-compensation.blogspot.com)
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- Court Permits Deduction of Procurement Costs From Medicare Set-Aside in Liability Claim (workers-compensation.blogspot.com)
- NJ Court Approves Medicare Set-Aside Agreement Lacking CMS Review(workers-compensation.blogspot.com)
- US Supreme Court Denies CMS-MSP Case - Hadden (workers-compensation.blogspot.com)
- Medicare Takes Bigger Bite Out California Workers Compensation (workers-compensation.blogspot.com)
Friday, October 5, 2012
NJ Senate Votes Approval to Stop Balance Billing for Workers Compensation Claims
A2652 Bans charging workers' compensation claimants for medical expenses, gives Division of Workers' Compensation sole jurisdiction over work-related medical claims. Passed both Houses |
Eustace, Timothy J. as Primary Sponsor
Singleton, Troy as Primary Sponsor
Egan, Joseph V. as Primary Sponsor
Benson, Daniel R. as Primary Sponsor
Coughlin, Craig J. as Primary Sponsor
Lampitt, Pamela R. as Co-Sponsor
Mosquera, Gabriela M. as Co-Sponsor
Greenstein, Linda R. as Co-Sponsor
Madden, Fred H., Jr. as Co-Sponsor
5/10/2012 Introduced, Referred to Assembly Labor Committee
5/14/2012 Reported out of Assembly Comm. with Amendments, 2nd Reading
5/24/2012 Passed by the Assembly (77-0-0)
5/31/2012 Received in the Senate, Referred to Senate Labor Committee
9/20/2012 Reported from Senate Committee, 2nd Reading
10/4/2012 Substituted for S1926/2022 (SCS)
10/4/2012 Passed Senate (Passed Both Houses) (38-0)
Introduced - 4 pages PDF Format HTML Format
Statement - ALA 5/14/12 - 1 pages PDF Format HTML Format
Statement - SLA 9/20/12 1R - 1 pages PDF Format HTML Format
Committee Voting:
ALA 5/14/2012 - r/Aca - Yes {9} No {0} Not Voting {0} Abstains {0} - Roll Call
SLA 9/20/2012 - r/favorably - Yes {5} No {0} Not Voting {0} Abstains {0} - Roll Call
Session Voting:
Asm. 5/24/2012 - 3RDG FINAL PASSAGE - Yes {77} No {0} Not Voting {3} Abstains {0} - Roll Call
|
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Wednesday, May 28, 2008
5TH ANNUAL THIS YEAR IN WORKERS’ COMP – THE TOP ISSUES & CASES
http://www.njicle.com/seminar.aspx?sid=558
Hear an expert analysis of key cases decided during the past year
Presented in cooperation with the NJSBA Workers’ Compensation Section
Tuesday, July 08, 2008 4:00 PM to 8:00 PMNew Jersey Law Center, New Brunswick / S1485d-14533
This fifth annual program features a panel of some of the most respected Workers' Conmpensation Judges and attorneys, who will review and provide insight on the top issues and cases that have emerged during the past year.
This fast-paced program will be packed with practical pointers that have proven successful in matters ranging from jurisdictional issues through coverage of employment. The program will expand your horizons and broaden your practice potential into expanding in developing areas of the law such as the Longshore Act, Defense Base Act claims, and actions involving New York jurisdiction, including 9/11 claims. Make plans to register today!
PROVEN STRATEGIES FOR DEALING WITH THE TOP ISSUES CONFRONTING TODAY’S WORKERS’ COMPENSATION ATTORNEYS, INCLUDING…
• Proving that a claim arose out of, and occurred in, the course of the employment: Mojica v. The Valley Hospital
• Interpreting the "Going and Coming Rule" to prove your case: Scott v. Foodarama Supermarkets • Determing jurisdiction of the court: Morella v. Grand Union/New Jersey Self-Insurers Guaranty Association 193 N.J. 350 (2008), Kibler v. Roxbury Bd. of Educ. 392 N.J. Super. 45 App. Div. 2007) , Flick v. PMA Ins. Co. and Kathleen Reed, 394 N.J. Super. 605 (App. Div. 2007)• What you need to know about counsel fees: Alvarado v. J & J Snack Foods Corp.
• How to handle a Longshore and/or Defense Base Act Claim
• What you need to know about NJ 911 exposure filing and proof requirements
...and more
http://www.njicle.com/seminar.aspx?sid=558
Moderator:JON L. GELMAN, ESQ.
Speakers include:
STEPHEN C. EMBRY, ESQ.
NANCY J. JOHNSON, ESQ.
EDGAR N. ROMANO, ESQ.
Click here to print paper registration form http://www.njicle.com/ICLEOrderForm.pdf