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New Jersey Lawyer

Work Injury Statute & Law Archive

 

May 1, 2012

New Jersey personal injury attorneys question whether the negligence of an auto-insurer
in handling a PIP claim provides a basis to reform the policy to increase coverage

The New Jersey Appellate panel overruled the trial court’s decision that the policy of an auto insurer, when they denied a claim due to their own negligence or an “accounting error”, should be reformed to require payment of benefits above the policy amount. An individual was injured in a car crash, and in the course of obtaining treatment received multiple tests, scans and an MRI. The company Open MRI submitted the $1,600 bill to Mercury Insurance, who took longer than the 60 days allowed by law to process the claim, but it was eventually denied. The Insurance Company denied the claim because the individual injured in the accident had exhausted his PIP coverage, although he still had $418.63 in benefits left. Those remaining benefits were paid to another service provider, not Open MRI and the company soon filed suit claiming Mercury’s actions entitled them to $3,900 in payment and fees, which required the policy be reformed.

 The New Jersey Appellate Panel hearing arguments from New Jersey personal injury attorneys, held that reformation of the policy was contrary to the exclusive nature of procedures and remedies of the no-fault insurance law. Additionally, they held that it “would open the door to circumvention of the statutorily mandated alternative dispute resolution procedures provided.” However, the court sent the case back down to the trial level to decide whether Mercury should be required to pay anything on the claim, even the amount of benefits that remained at the time the claim was submitted, and if Open MRI prevails they will be entitled to legal fees.

Legal Quote of the Week:

The hope of all who suffer, The dread of all who wrong”

John Greenleaf Whittier


 

March 18, 2013

New Jersey Workers’ Compensation  reviews whether stroke was
due to work injury and is compensable

 

Petitioner was an employee of Home Instead Senior Care as a live-in caretaker for an elderly woman and was on duty 24 hours a day, seven days a week with every other weekend off. The petitioner, a 51 year old woman, suffered a stroke after about a year of taking care of the elderly woman, and she was not hypertensive or overweight, and never smoked, imbibed alcohol or used drugs. The New Jersey Workers’ Compensation Judge awarded 10 percent of partial total disability, finding Smith’s only permanent limitation from stroke was numbness in her left thumb.

The New Jersey Compensation Judge ordered Home Instead to pay Smith’s counsel fees and medical expenses, and on appeal Home Stead argues Smith failed to prove the injury was a result of traumatic or occupational injury by not showing the elements needed under NJ compensation law. These arguments are premised on the testimony of its expert that Smith suffered an idiopathic injury that was not caused by her work. The Appellate Division upheld the New Jersey Workers’ Compensation judge, as it found no reason to do otherwise.

Legal Quote of the Week:

It took man thousands of years to put words down on paper, and his lawyers still wish he wouldn’t. 

Mignon McLaughlin, Lawyer’s ‘Wit and Wisdom, 1995


 

January 14, 2013

New Jersey Workers Compensation Judge grants reconstructed wage
due to work injury preventing full time job

The New Jersey Appellate Division upheld the ruling of the NJ Compensation judge finding the petitioner permanently disabled and awarding total disability benefits. Calle was injured performed work for Dejana, his employer, and Calle’s injury rendered him unable to perform similar full time work for other employers. The NJ Comp judge found that Calle had other full time work, and the work from Dejana existed only in the winter, as Calle himself supported this finding. He testified that he would make himself available for full time work to other employers when work was unavailable to him at Dejana. The New Jersey Workers Compensation Judge found that under these circumstances “this injury is what is keeping or what kept Calle from full time employment” and that “but for this injury Calle would have been doing full time work and this is what his loss is.”

The NJ workers compensation judge therefore concluded that Calle should be compensated for a 40 hour week at $11 an hour, and reasonably based the reconstructed wage rate on the wage Dejana paid for his part time seasonal labor.The Appellate Court rejected DeJana’s argument that the NJ comp judge reached a decision unsupported by and inconsistent with the law and the credible evidence at trial.

Legal Quote of the Week:

The elaborate argument….does not need an elaborate answer.

Oliver Wendell Holmes, United States v. Wurzbach, 208 U.S. 396, 399 (1930)


 

January 7, 2013

New Jersey Workers’ Compensation Court questions the meaning of intentional wrong

Plaintiff was injured while operating a table saw with the safety guard’s removed, which occurred during the course of his employment. The trial court found that the plaintiff’s personal injury claim against defendant was barred by the New Jersey Workers’ Compensation Act in spite of the arguments on behalf of the Plaintiff by a New Jersey personal injury attorney.   On appeal, the court finding that the defendant-employer did not commit an “intentional wrong”  in that it did not know that its actions were substantially certain to result in an employee’s injury. Additionally, defendant provided the equipment that would have allowed plaintiff to cut the wood in a safe manner, but the plaintiff chose to use the unguarded table aw instead, and that under these circumstances the injury sustained by plaintiff is a “fact of life of industrial employment.”

Under New Jersey Workers’ Compensation, if the employer did not in fact commit an intentional wrong against the employee, then the employee is barred from bringing an action at law against the employer outside of the parameters of the New Jersey Workers Compensation system. 

 

Legal Quote of the Week:

Four score and seven years ago our fathers brought forth on this continent, a new nation, conceived in Liberty, and dedicated to the proposition that all men are created equal.

Abraham Lincoln, Gettysburg Address, November 19, 1863


 

January 1, 2013

New Jersey Personal Injury lawyers assess whether summary judgment was
properly granted where discovery was not yet complete

Trial court granted dismissal on defendants' motion for summary judgment of her action filed after she tripped and fell on a sidewalk panel in front of defendants' residential property, plaintiff appeals the. The appeals panel remanded, holding that where plaintiff does not refute defendants' certification that they did not install the sidewalk where she fell and never engaged in any activity that caused any defect in the sidewalk and that there has been no repair work to the area where plaintiff fell, she failed to present sufficient evidence to show that the alleged dangerous condition of the sidewalk was due to negligent construction or repair by defendants. Additionally, plaintiff has not identified defendants' predecessor in title who allegedly negligently constructed the sidewalk or when the construction occurred, the time for discovery had not run when the court granted summary judgment, and the municipal ordinance requiring homeowners to maintain the sidewalk abutting their properties could not be a basis for liability for the injuries plaintiff allegedly sustained. Therefore, so that discovery can be completed regarding construction of the sidewalk, the panel remands. The motion for summary judgment by defendants may be renewed after completion of discovery.

Legal Quote of the Week:

It is the duty of a judge to enquire not only into the matter but into the circumstances of the matter.

Ovid, Tristia, c. 9-17.


 

October 29, 2012

New Jersey Workers’ Compensation examines whether employer must pay
benefits and attorney’s fees out of state

Division of Workers' Compensation entered judgment granting benefits and attorney's fees to petitioner and respondent-employer appeals.  Rejecting respondent-employer arguments that the Judge of Compensation made errors in his factual findings and conclusions, the appellate panel affirms. The judge also did not err in ruling that Chubb, the insurance carrier, and respondent-employer were responsible for deterioration of petitioner's medical condition and her resultant disability. The panel also found that the judge was not mistaken as a matter of law in holding that an employer is obligated to provide medical services out of state. The Workers' Compensation Act does not contain any geographical limitations on the provision of medical treatment.

Legal Quote of the Week:

“The hole and the patch should be commensurate. The patch should fit the hole.”

Thomas Jefferson (considering damages)


 

October 22, 2012

New Jersey Accident attorneys examine whether plaintiff entitled to PIP benefits even though

she was uninsured because she was driving her employers insured vehicle

Plaintiff was involved in a motor vehicle accident, at which time she was uninsured, while driving an insured vehicle owned by her employer. Based in part on her failure to meet the verbal threshold requirements in the Automobile Insurance Cost Reduction Act (AICRA), the trial court granted summary judgment to defendants and dismissed her complaint with prejudice. The Plaintiff now appeals. Plaintiff countered that, because she was not operating her uninsured vehicle at the time of the accident, she is not subject to AICRA. Alternatively, plaintiff claims she suffered permanent injuries as a result of the accident.

The appellate panel concluded that summary judgment was properly granted by the trial judge. AICRA applies because the plaintiff was the owner of an automobile to which PIP coverage applies, was required to maintain PIP coverage and was an "unlawfully uninsured person." Additionally, the panel concluded that because she provided no objective medical evidence establishing within a reasonable degree of medical probability that she sustained a permanent injury causally related to the accident, the plaintiff failed to meet AICRA's verbal threshold.


 

Legal Quote of the Week:

A house divided against itself cannot stand.  I believe this government cannot endure permanently half-slave and half-free.

Abraham Lincoln, Speech, Republican State Convention, Springfield, Illinois, June 16, 1858

 

October 1, 2012

N.J. Personal Injury Attorneys evaluate the burden of proof

 for non-economic damage claims

 

The No Fault Act creates quite a significant difference between economic and non-economic losses, with noneconomic loss being pain and suffering and economic loss is lost income, medical expenses or other expenses. A person subject to the verbal threshold, or limitation of lawsuit provision under their insurance, cannot r becover for noneconomic loss unless the injuries satisfy one of the six types under the statute, with one being permanent injury. The statute does not limit economic loss recovery even if the claimant is subject to the verbal threshold.

The Superior Court of New Jersey, Appellate Division, in Haywood v. Harris, considered whether an individual with no permanent injury could recover for an economic loss resulting from future lost wages. The plaintiff was injured in an accident with an uninsured driver, and filed a complaint for uninsured motorist’s benefits against NJM, his insurance carrier. The court stated that plaintiff was subject to the verbal threshold because his policy contained the limitation on loss provision. The plaintiff claimed he sustained permanent injury because of a herniated disc; however the jury determined his injuries were not permanent and, therefore, he could not recover for any noneconomic loss. The plaintiff still claimed he was entitled to damages for economic loss that resulted from his future loss of income. He testified he was forced to curtail his activities because he could not lift heavy bricks due to pain, as he was a stone mason, but still had some work with light duty and supervision. The jury returned a verdict of $75,000 for loss of income and impairment of earning capacity, even though actual loss of income from accident to trial was $27,000. The judge modified the award to $27,000, noting plaintiff’s claim for future lost wages would have to be based on his claim of permanent injury. There was no evidential basis for a claim for future loss of income, because the jury determined there was no permanent injury.

The appellate division disagrees with the reasoning but affirmed nonetheless. First, the court stated a plaintiff does not need to satisfy the verbal threshold for economic loss, thus someone with a non-permanent injury could recover for future loss of income for a reasonable period of recovery. However, the court held plaintiff did not present sufficient evidence to permit the jury to award an amount of damages for future lost wages that was not based upon speculation. The jury was provided W-2’s and plaintiff argued they should simply consider the difference in earnings between the years to determine the effect the injury would have on him in the future. The court rejected these proofs and concluded the jury “was never provided with any evidence that plaintiff’s loss of earnings actually continued in 2008, and by implication, beyond.”


 

September 17, 2012

34:15-28.2  Powers of judges of compensation.

If any employer, insurer, claimant, or counsel to the employer, insurer, or claimant, or other party to a claim for compensation, fails to comply with any order of a judge of compensation or with the requirements of any statute or regulation regarding workers’ compensation, a judge of compensation may, in addition to any other remedies provided by law:

a.  Impose costs, simple interest on any moneys due, an additional assessment not to exceed 25% of moneys due for unreasonable payment delay, and reasonable legal fees, to enforce the order, statute or regulation;

b.  Impose additional fines and other penalties on parties or counsel in an amount not exceeding $5,000 for unreasonable delay, with the proceeds of the penalties paid into the Second Injury Fund;

c.  Close proofs, dismiss a claim or suppress a defense as to any party;

d.  Exclude evidence or witnesses;

e.  Hold a separate hearing on any issue of contempt and, upon a finding of contempt by the judge of compensation, the successful party or the judge of compensation may file a motion with the Superior Court for enforcement of those contempt proceedings; and

f.  Take other actions deemed appropriate by the judge of compensation with respect to the claim.


 

September 10, 2012

New Jersey Personal injury attorneys examine whether herniated discs

meet the verbal threshold for permanent injury

 

The No Fault Act, as amended by AICRA, provides that plaintiff’s subject to the verbal threshold must prove they sustained one of six different types of bodily injury, including a permanent injury. To show permanent injury, a plaintiff must introduce credible medical testimony based upon objective clinical evidence, which may include testing, that the injured body has not and will not heal to function normally with further medical treatment.

In Ames v. Gopal, the plaintiff sustained a herniated disc in his lower back after his car was hit in the rear while stopped at a traffic light. He received treatment from a chiropractor and medical doctor, who gave him an epidural injection. Plaintiff was 35 and testified that he could no longer engage in a physically active lifestyle because of the pain. He introduced two medical experts at trial who testified his herniated disc was causally related to the accident. The defendant’s medical expert agreed that the plaintiff had a herniated disc but testified that it was caused by a degenerative disc condition, a normal condition of aging, and was not related to the accident. On cross, the doctor agreed that a herniation is a permanent injury and that the disc would not go back to its original position, but that the disc would probably return to “functional normalcy.”

The trial court charged the jury that the plaintiff must prove that he sustained a permanent injury, a body part that had not and will not heal to functional normalcy. The jury must determine whether the herniated disc is from the accident, if they do not then plaintiff would not be entitled to damages. The N.J. Superior Court, Appellate Division, reversed and remanded, because the defendant’s doctor drew a distinction between a permanent condition, which he agreed the plaintiff had, and a permanent injury, which one must show, thus presenting a factual question as to whether sustained a permanent injury. They held that the trial court should not have ruled plaintiff’s injury was permanent as a matter of law and distinguished Pardo v. Dominguez (holding existence of herniated disc sufficient to satisfy verbal threshold) by noting Pardo was decided on motion for summary judgment as opposed to a jury trial in this case. The Supreme Court of New Jersey denied certification.

Legal Quote of the Week:

Let the judge answer on the question of law; the jury on the question of fact.

Latin legal phrase W. Gurney Benham,

Putnam’s Complete Book of Quotations, Proverbs and Household Words, 1927


 

September 3, 2012

34:15-28.2  Powers of judges of compensation.

If any employer, insurer, claimant, or counsel to the employer, insurer, or claimant, or other party to a claim for compensation, fails to comply with any order of a judge of compensation or with the requirements of any statute or regulation regarding workers’ compensation, a judge of compensation may, in addition to any other remedies provided by law:

a.  Impose costs, simple interest on any moneys due, an additional assessment not to exceed 25% of moneys due for unreasonable payment delay, and reasonable legal fees, to enforce the order, statute or regulation;

b.  Impose additional fines and other penalties on parties or counsel in an amount not exceeding $5,000 for unreasonable delay, with the proceeds of the penalties paid into the Second Injury Fund;

c.  Close proofs, dismiss a claim or suppress a defense as to any party;

d.  Exclude evidence or witnesses;

e.  Hold a separate hearing on any issue of contempt and, upon a finding of contempt by the judge of compensation, the successful party or the judge of compensation may file a motion with the Superior Court for enforcement of those contempt proceedings; and

f.  Take other actions deemed appropriate by the judge of compensation with respect to the claim.


 

March 26, 2012

34:15-12.  Schedule of payments.  Following is a schedule of compensation:

            a. For injury producing temporary disability, 70% of the worker’s weekly wages received at the time of the injury, subject to a maximum compensation of 75% of the average weekly wages earned by all employees covered by the “unemployment compensation law” (R.S. 43:21-1 et seq.) and a minimum of 20% of such average weekly wages a week. This compensation shall be paid during the period of such disability, not however, beyond 400 weeks. The amount of the maximum compensation shall be computed, determined, rounded out to the nearest dollar, and promulgated by the Commissioner of Labor on or before September 1 in each year based on said average weekly wages as of the calendar year preceding, and shall be effective as to injuries occurring in the calendar year following such promulgation. In any year in which the maximum benefit rate based upon said computation would not be increased or decreased beyond $1.00 in amount, the rate promulgated theretofore shall continue.


March 12, 2012

34:15-14.  Waiting period.  Except as provided pursuant to R.S. 34:15-75, no compensation other than medical aid shall accrue and be payable until the employee has been disabled 7 days, whether the days of disability immediately follow the accident, or whether they be consecutive or not. These days shall be termed the waiting period. The day that the employee is unable to continue at work by reason of his accident, whether it be the day of the accident or later, shall count as one whole day of the waiting period. Should the total period of disability extend beyond 7 days, additional compensation shall at once become payable covering the above prescribed waiting period.


 

March 5, 2012

34:15-7.1.  Horseplay or skylarking on part of fellow employees. An accident to an employee causing his injury or death, suffered while engaged in his employment but resulting from horseplay or skylarking on the part of a fellow employee, not instigated or taken part in by the employee who suffers the accident, shall be construed to have arisen out of and in the course of the employment of such employee and shall be compensable under the act hereby supplemented[1] accordingly.

[1] Compensation for personal injuries to, or death of employee, by accident arising out of and in course of employment, see § 34:15-7


February 27, 2012

34:15-57.4. Workers’ compensation fraud; criminal and civil penalties. 1.a. A person shall be guilty of a crime of the fourth degree if the person purposely or knowingly:

(1) Makes, when making a claim for benefits pursuant to R.S. 34:15-1 et seq., a false or misleading statement, representation or submission concerning any fact that is material to that claim for the purpose of wrongfully obtaining the benefits;

(2) Makes a false or misleading statement, representation or submission, including a misclassification of employees, or engages in a deceptive leasing practice, for the purpose of evading the full payment of benefits or premiums pursuant to R.S. 34:15-1 et seq.; or

(3) Coerces, solicits or encourages, or employs or contracts with a person to coerce, solicit or encourage, any individual to make a false or misleading statement, representation or submission concerning any fact that is material to a claim for benefits or the payment of benefits or premiums, pursuant to R.S. 34:15-1 et seq. for the purpose of wrongfully obtaining the benefits or of evading the full payment of the benefits or premiums.

            b. Any person who wrongfully obtains benefits or evades the full payment of benefits or premiums by means of a violation of the provisions of subsection a. of this section shall be civilly liable to any person injured by the violation for damages and all reasonable costs and attorney fees of the injured person.

            c. (1) If a person purposely or knowingly makes, when making a claim for benefits pursuant to R.S. 34:15-1 et seq., a false or misleading statement, representation or submission concerning any fact which is material to that claim for the purpose of obtaining the benefits, the division may order the immediate termination or denial of benefits with respect to the claim and a forfeiture of all rights of compensation or payments sought with respect to the claim.

            (2) Notwithstanding any other provision of law, and in addition to any other remedy available under law, if that person had received benefits pursuant to R.S. 34:15-1 et seq. to which the person is not entitled, he is liable to repay the sum plus simple interest deducted from future benefits payable to that person, and the division shall issue an order providing for the repayment or deduction.

            (3) Notwithstanding any other provision of law, and in addition to any other remedy available under law, a person who evades the full payment of premiums pursuant to R.S. 34:15-1 et seq. or improperly denies or delays benefits pursuant to R.S. 34:15-1 et seq. is liable to pay the sum due and owing plus simple interest.

            d. Nothing in this section shall preclude, if the evidence so warrants, indictment and conviction for a violation of any provision of chapter 20, 21 or 28 of Title 2C of the New Jersey Statutes or any other law. For the purpose of this section, “purposely,” “knowingly” and “purposely or knowingly” have the same meaning as is provided in chapter 2 of Title 2C of the New Jersey Statutes.

2. This act shall take effect immediately.


February 20, 2012

34:15-10. Employment of minors; extra compensation when illegally employed; exceptions. 

          In the employment of minors, this article shall be presumed to apply unless the notice be given by or to the parent or guardian of the minor. If the injured employee at the time of the accident or compensable occupational disease is a minor under 14 years of age employed in violation of the labor law or a minor between 14 and 18 years of age employed, permitted or suffered to work without an employment certificate or special permit if required by law or at an occupation prohibited at the minor’s age by law, a compensation or death benefit shall be payable to the employee or his dependents which shall be double the amount payable under the schedules provided in R.S. 34:15-12 and R.S. 34:15-13.

            The possession of such duly issued employment certificate shall be conclusive evidence for an employer that the minor has reached the age certified to therein and no extra compensation shall be payable to any minor engaged in an employment allowed by the law for the age and sex certified to in such certificate. If the certificate presented by the employee as one issued to that person shall have been really issued to another child and the real age of the employee shall be such that employment in any capacity or in the particular capacity the employee was employed by the employer was prohibited and if the employer shall show to the satisfaction of the Division of Workers’ Compensation that the employer accepted the certificate in good faith as having been issued to the employee and could not have, despite reasonable diligence, discovered the fraud, in such event no extra compensation shall be paid to the employee illegally employed.

            The employer alone and not the insurance carrier shall be liable for the extra compensation or death benefit which is over and above the amount of the compensation or death benefit provided under R.S. 34:15-12 or R.S. 34:15-13. Any provision in an insurance policy undertaking to relieve an employer from the liability for the extra compensation or extra death benefit shall be void.

            Nothing in this chapter contained shall deprive an infant under the age of 18 years of the right or rights now existing to recover damages in a common law or other appropriate action or proceeding for injuries received by reason of the negligence of his or her master.

            Nothing in this section regarding the payment of a compensation or death benefit in double the amount payable under the schedules provided in R.S. 34:15-12 and R.S. 34:15-13 shall apply to: members of a junior firemen’s auxiliary established pursuant to N.J.S.A. 40A:14-95; employees, of the age of 18 years or under, employed in summer camps operated by the Boy Scouts of America, the Girl Scouts of America, the Knights of Columbus, the Young Men’s Christian Association, the Young Women’s Christian Association, the Young Men’s Hebrew Association, or any domestic corporation organized solely for religious or charitable purposes; student-learners employed in a cooperative vocational education program approved by the State Board of Education; persons, 18 years of age or younger, participating, under the supervision of the Palisades Interstate Park Commission, in volunteer programs in that part of the Palisades Interstate Park located in New Jersey; or persons, 18 years of age or younger, doing volunteer work for the Division of Parks and Forestry, the Division of Fish, Game and Wildlife, the New Jersey Natural Lands Trust or the New Jersey Historic Trust, as authorized by the Commissioner of Environmental Protection.


February 13, 2012

Cooper v. Barnickel Enterprises Inc., 411 N.J. Super. 343 (App. Div. 2010)

Holding: Injuries resulting from an accident that occurred while an off-site employee was driving for a  cup of coffee in the employer’s vehicle on his coffee break was compensable under the workers’ compensation law.

Barnickel Enterprises appealed from a judgment of the Division of Workers' Compensation awarding a “100% disability for residuals of multiple compound comminuted fractures of both legs and left arm” suffered during an automobile accident in February 2003. As respondent employer Barnickel's master plumber and foreman, petitioner was authorized to use its truck to drive to and from home, and between job sites. On Saturday, February 8, 2003, after going to a job site, he went to the union hall in Winslow Township to discuss the plans for a new job, which was to start the following Monday, with one of two union instructors and to obtain a copy of a code referred to in the plans. Upon arriving at the union hall at approximately 11:15 A.M., petitioner discovered that the instructor he was looking for was teaching a class and talking with students. Petitioner felt he could not interrupt the instructor, and decided to take a coffee break and to return to the union hall at lunch time to talk to the instructor. Petitioner was driving his employer Barnickel's truck to a delicatessen about five miles away from the union hall when the accident occurred. The critical issue on appeal was whether the accident arose “in the course of” employment under N.J.S.A. 34:15-7.

An employee is entitled to compensation for an accidental injury under the Workers' Compensation Act if the injury “ar [ose] out of and in the course of employment.” The test of whether a minor deviation is compensable depends on “whether that employee has embarked on a personal errand that would have been compensable if carried out by an on-premises employee.” Here, the judge of compensation found that petitioner was an “off-site” employee who, facing an extended wait to consult with an expert concerning a work-related issue, was injured while driving for a cup of coffee. It cannot be expected that he would stand like a statue or remain at the union hall with nothing to do for such a period, particularly when there was no coffee available at the site. The court could not conclude “in these circumstances that the injuries were not compensable merely because petitioner chose to take his authorized “coffee break” other than at the closest location.” The distance of the coffee shop from respondent's off-site jobsite was reasonable given the rural nature of the community in Winslow Township and the time petitioner had to wait to seek the counsel he sought. The judge found petitioner to be credible, and accidents occurring during coffee breaks for off-site employees, which are equivalent to those of on-site workers, are minor deviations from employment which permit recovery of workers' compensation benefits.


February 6, 2012

International School Services, Inc. v. New Jersey Department of Labor and Workforce Development, 408 N.J. Super. 198 (App. Div. 2009)

Holding: An order declaring that plaintiff was obligated to provide workers’ compensation coverage for its overseas employees is reversed and the matter is remanded for further discovery respecting the employees’ contacts with New Jersey and for reconsideration under Connolly.

International Schools Services (ISS) is a non-profit organization headquartered in Princeton, New Jersey. It employs 163 teachers in overseas schools under annual renewable contracts, which are often renewed for several years at a time. The overseas employees work entirely overseas and not in New Jersey. Of these employees, 108 were United States citizens, and 55 were foreign nationals. None of the United States citizens are New Jersey residents. In its contracts with foreign schools, plaintiff agrees to maintain all insurance required by law, including workers' compensation insurance for its overseas employees. Plaintiff passes the costs of such insurance onto the schools it serves. Beginning in 2003, Plaintiff was unable to find an insurance carrier in the voluntary market that would provide workers' compensation insurance for all of its overseas employees. Plaintiff filed a verified complaint in the Law Division seeking a declaratory judgment that its overseas employees were not covered by the Workers’ Compensation Act. The trial court found that the Act requires that a “New Jersey Company” provide workers' compensation insurance for all of its employees, wherever they work.

Under the Act, employers are required to provide for payment of obligations arising from workplace injuries through insurance coverage. The Act broadly defines an “employee” as one who performs services for an employer for financial consideration. In Connolly v. Port Auth. of New York and New Jersey, 317 N.J.Super. 315 (App.Div.1998), the court noted that the following factors traditionally trigger jurisdiction in the New Jersey compensation court: (1) the injury occurred in New Jersey; (2) New Jersey is the place of the employment contract or hiring; (3) the employee lives in New Jersey and there were at least some employment contacts in New Jersey; and (4) “where there exists neither location of the injury, location of the employment contract or hiring, or residency of the employee in New Jersey, jurisdiction may still arise where the ‘composite employment incidents present a[n] ... identification of the employment relationship with this State.’ ” The location of the employer, however, is never, by itself, sufficient to confer jurisdiction over out-of-state injuries. In reviewing the record, the found that the trial court did not consider the appropriate factors in making its determination as to whether the plaintiff was required to provide coverage under the Act to its overseas employees. The trial court should have taken the Connolly factors into account. The court held that the record did not allow it to make a generalization as to whether the Act applied to any of the plaintiff’s overseas employees, and thus the case was reversed and remanded for expansion of the record to clearly ascertain whether any of the plaintiff’s employees came within the Connolly analysis. If plaintiff could demonstrate that none of its overseas employees had sufficient contacts with New Jersey to support a workers' compensation claim, plaintiff was not obligated to maintain such coverage.


January 30, 2012

NEW JERSEY WORK ACCIDENT LAWYERS CONSIDER MEDICAL BENEFITS PROVISION OF THE NEW JERSEY WORKERS COMPENSATION ACT TO PROVIDE NECESSARY AND REASONABLE MEDICAL TREATMENT FOR INJURED EMPLOYEES COVERED BY THE ACT.

According to N.J.S.A. 34:15-15: “an employer shall furnish such medical, surgical and other treatment and hospital service as shall be necessary to cure and relieve the worker of the effects of the injury and to restore the functions of the injured member or organ where such restoration is possible.”   As such, New Jersey work injury employees who cannot medically have the reduced function of the member or organ restored are entitled to permanency benefits. 

According to the New Jersey statute, if the employer refuses or neglects to provide medical treatment, the work injury employee may secure such treatment and the employer will become liable for the payment, provided that the employee requested the employer to furnish the treatment and the employer refused or neglected to do so, or, unless notification is impossible due to the nature of the injury or the circumstances where so peculiar as to justify.  

Case law interpreting the statute has held that as long as there is competent medical evidence and the treatment is reasonably necessary to cure or relieve the effects of the injury, there may be the necessity for continuing medical treatment if the function of the member or organ is thereby increased. 

Legal Quote of the Week:

No law perfectly suits the convenience of every member of the community: the only consideration is, whether upon the whole it be profitable to the greater part.

Livy, History of Rome, c. 10 b.c.

 

Certified as a criminal trial attorney by the Supreme Court of New Jersey.