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Medical Providers Win in Supreme Court on Statute of Limitations Issue

By on February 5, 2020 in Court Rulings with 0 Comments

In New Jersey a medical provider dispute arising from a work injury can only be filed in the Division of Workers’ Compensation ever since the 2012 Amendments.  But the 2012 Amendments to the New Jersey Workers’ Compensation Act failed to answer one fundamental question:  how long does the provider have to bring a claim in the name of the injured worker?  Are medical providers bound by the same two-year rule that applies to claimants? The Supreme Court provided the final answer on February 3, 2020 in The Plastic Surgery Center, P.A. v. Malouf Chevrolet- Cadillac, Inc.

The case involved several claim petitions filed by The Plastic Surgery Center more than two years after the employee’s accident.  The Judge of Compensation ruled that the claims were out of time, but the Appellate Division reversed in favor of the medical providers.  The Supreme Court granted certification and heard the arguments last month.   In its decision the Supreme Court adopted the reasoning of the Appellate Division wholesale. 

First the Court observed that before the 2012 Amendments, medical provider claims were governed by the general six-year statute of limitations which applies to contract claims. The Supreme Court agreed with the two main arguments that the medical providers made to the Appellate Division. The 2012 Amendments could not have been intended to restrict claims to two years because the definition of claimant in the New Jersey Workers’ Compensation Act would have to be expanded to include medical providers.

More importantly, the Court said:

Second, the two-year period simply doesn’t fit:  N.J.S.A. 34:15-51 requires that a petition for compensation be filed within two years of ‘the accident,’ but it is likely that an employee might be treated by a medical provider for a period greater than the two-year period following the accident or even not be treated by a particular medical provider until after two years elapsed from the work-related accident. . . . As a result, a provider’s legitimate claim might actually be extinguished before it even accrued.  . . . The appellate court declined to interpret legislative silence to produce such a result.

This represents a significant win for medical providers. The result basically guarantees that the number of medical provider claims will continue to rise sharply in the New Jersey Division of Workers’ Compensation.  New Jersey remains one of the few states without a medical fee schedule in workers’ compensation.  This decision emphasizes the need for employers to work with medical repricing companies which really know the New Jersey market for workers’ compensation treatment in respect to usual and customary charges.

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John H. Geaney

About the Author

About the Author:

John H. Geaney, a shareholder and co-chair of Capehart Scatchard's Workers' Compensation department, began an email newsletter entitled Currents in Workers’ Compensation, ADA and FMLA in 2001 in order to keep clients and readers informed on leading developments in these three areas of law. Since that time he has written over 500 newsletter updates.

Mr. Geaney is the author of Geaney’s New Jersey Workers’ Compensation Manual for Practitioners, Adjusters & Employers. The manual is distributed by the New Jersey Institute for Continuing Legal Education (NJICLE). He also authored an ADA and FMLA manual as distributed by NJICLE. If you are interested in purchasing the manual, please contact NJICLE at 732-214-8500 or visit their website at www.njicle.com.

Mr. Geaney represents employers in the defense of workers’ compensation, ADA and FMLA matters. He is a Fellow of the College of Workers’ Compensation Lawyers of the American Bar Association and is certified by the Supreme Court of New Jersey as a workers’ compensation law attorney. He is one of two firm representatives to the National Workers’ Compensation Defense Network. He has served on the Executive Committee of Capehart Scatchard for over ten (10) years.

A graduate of Holy Cross College summa cum laude, Mr. Geaney obtained his law degree from Boston College Law School. He has been named a “Super Lawyer” by his peers and Law and Politics. He serves as Vice President of the Friends of MEND, the fundraising arm of a local charitable organization devoted to promoting affordable housing.

Capehart Scatchard is a full service law firm with offices in Mt. Laurel and Trenton, New Jersey. The firm represents employers and businesses in a wide variety of areas, including workers’ compensation, civil litigation, labor, environmental, business, estates and governmental affairs.

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