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Claims

Medical Provider Cannot Sue Workers’ Comp Carrier for Breach of Contract to Get Around New Jersey’s Exclusive Remedy for Medical Disputes

By on November 20, 2023 in Claims, NJ Workers' Comp with 0 Comments

Medical claim petitions comprise an increasingly large percentage of New Jersey workers’ compensation claims with over 5,000 being filed in 2023 alone.  One of the problem areas remains jurisdictional issues when a New York or Pennsylvania workers’ compensation case is referred to New Jersey just for a one-time medical procedure. The recent case of Hudson […]

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What Does The Rebuttable Presumption Mean In A COVID-19 Claim?

By on May 5, 2022 in Claims, NJ Workers' Comp with 0 Comments

The concept of legal presumptions in workers’ compensation is not new in New Jersey.  The first presumption legislation in New Jersey was passed in 1964 concerning volunteer firefighters who contract respiratory disease in certain circumstances. The second presumption legislation was passed in 1988 in regarding to firefighters with cardiovascular or cerebrovascular injuries or death in […]

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Respondent Prevails Where First MRI Post-Accident Showed No Abnormalities In Knee

By on June 25, 2021 in Claims, NJ Workers' Comp with 1 Comment

What happens when an injured worker gets a normal MRI study after a work injury but later on a second MRI shows an operable tear? Can the findings on the second MRI be related back to the original injury?  The Appellate Division addressed that issue in Costanzo v. Meridian Rehab, A-5547-18 (App. Div. June 17, […]

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Appellate Division Holds That Public Employee Injured In Shared Parking Lot With Employees And The Public Is Not Covered For Workers’ Compensation Purposes And Can Sue Her Employer

By on March 26, 2021 in Claims, NJ Workers' Comp with 2 Comments

When an employee is injured on the employer’s premises, including a parking lot owned and controlled by the employer, it is fundamental that such a claim is work related.  If this injury is caused by the actions of another employee, it is also fundamental that the two employees cannot sue each other or their employer […]

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Appellate Division Affirms Dismissal of Occupational Tinnitus Claim

By on January 15, 2021 in Claims, NJ Workers' Comp with 0 Comments

There are not many Appellate Division decisions on occupational hearing loss and tinnitus, which is why the decision is of interest in Donzella v. SG Performance Plastics Corp., A-2408-19T3 (App. Div. January 12, 2021).  The case involved an employee of SG Performance who worked at its manufacturing warehouse in August 2015.  He and 30 other […]

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Respondents Can Reopen Cases Too

By on August 7, 2020 in Claims, NJ Workers' Comp with 0 Comments

Employers and workers’ compensation professionals are very familiar with reopener petitions or applications for modification of awards.  A reopener may be filed by the petitioner within two years of the last payment of indemnity benefits or the last authorized treatment date, but not many workers’ compensation professionals realize that employers can also apply for modification […]

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Jurisdictional Issue in Med Mal Decision In New Jersey May Presage Likely Dismissal of MCP Cases Arising from New York Injuries and New York Employment

By on December 27, 2019 in Claims, NJ Workers' Comp with 1 Comment

In 2020 we will likely get a published Appellate Division decision that resolves whether a medical provider can bring a medical claim petition in New Jersey where virtually all contacts are in New York State except for where the surgery occurs and sometimes where the claimant lives.  One hint of how the Appellate Division may […]

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Respondent’s Counsel’s Failure to Comply with Rules Governing Motions for Med and Temp Leads to Court Order in Favor of Petitioner

By on November 1, 2019 in Claims, NJ Workers' Comp with 0 Comments

Motions for medical and temporary disability benefits are urgent matters that are treated as such by Judges of Compensation.  Because injured workers are not receiving benefits, motions for medical and temporary disability benefits require all parties to work swiftly to prepare for court hearings.  In the case of Capel v. Township of Randolph, A-1315-18T1 (App. […]

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Handling Scar Injury Cases Effectively In New Jersey

By on September 6, 2019 in Claims, NJ Workers' Comp with 0 Comments

There are a large number of petitions for permanent partial disability benefits filed each year in New Jersey for scars and serious lacerations.  It is important for practitioners to understand that injuries due to scars are subject to completely different proofs from all other physical injury claims in New Jersey.  The main difference between a […]

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Can A Dependent Settle A Dependency Claim By Section 20 And Then Sue The Uninsured Employer?

By on August 23, 2019 in Claims, NJ Workers' Comp with 0 Comments

The case of Kaur v. Garden State Fuels, Inc., A-2135-17T1 (App. Div. April 12, 2019) presents some interesting legal issues.  The facts begin with the tragic death of Surinder Singh, who was shot and killed during the course of his employment at Woodbury Gulf LLC.  In 2014 Singh’s widow, Kirandeep Kaur, filed a dependency claim […]

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Counsel Fees in Dependent Spouse Claims May Be Based On The Life Expectancy Of The Dependent Spouse, Not 450 Weeks

By on August 7, 2019 in Claims, NJ Workers' Comp with 0 Comments

In an important reported decision, and one of first impression at the Appellate level, the Court in Collas v. Raritan River Garage, A-3103-17T4, (App. Div. July 19, 2019), held that the Judge of Compensation was correct in basing the counsel fee of petitioner on petitioner’s life expectancy, not limited to 450 weeks, as has been […]

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Petitioner Failed To Show Her Worsened Disability On Reopener Related Back to Her 1999 Work-Related Motor Vehicle Accident with Sprint PCS

By on July 3, 2019 in Claims, NJ Workers' Comp with 0 Comments

Reopener petitions abound in New Jersey, but seldom does an injured worker seek on reopener to move an award of 30% permanent partial disability to total and permanent disability benefits.  That was the issue in Camarena v. Sprint PCS, A-2205-17T2 (App. Div. June 24, 2019).  Ms. Camarena obtained an award of 30% permanent partial disability […]

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Petitioner Proved Work Exposures Materially Caused or Contributed To His Colorectal Cancer

By on May 24, 2019 in Claims, NJ Workers' Comp with 0 Comments

It can be challenging to prove that a fairly common cancer occurring frequently in the general population is work related.  The case of Proscia v. Advanced Biotech, A-3017-17T2 (App. Div. April 26, 2019) offers interesting guidance on how an injured worker can prove such a case.   Frank Proscia worked for Advanced Biotech (AB) from […]

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The Perez Trio of Cases and Proof of Permanent Partial Disability

By on March 15, 2019 in Claims, NJ Workers' Comp with 0 Comments

It is a remarkable coincidence that the three cases that best explain entitlement to permanent partial disability benefits in New Jersey all involve claimants with the last name of Perez.  The most important of the three Perez cases is Perez v. Pantasote, 95 N.J. 105 (1984). This case addressed the key statutory definition in N.J.S.A. […]

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Medical Providers Have Six Years To File Claims in Division of Workers’ Compensation

By on January 24, 2019 in Claims, NJ Workers' Comp with 0 Comments

The New Jersey Appellate Division decided an important case on January 17, 2019 entitled The Plastic Surgery Center, PA. v. Malouf Chevrolet-Cadillac, Inc,.  The case centered on how long a medical provider has to file a claim petition in the Division, namely whether providers have two years, like claimants, or six years.  The case has […]

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