Tag: workers’ compensation
Private Sector EMTs and Paramedics Are Now Covered Under New Legislation Signed by New Jersey Governor Creating a High Rebuttable Presumption in Favor of Compensability of Strokes or Heart Attacks
The recent passage of A5909 has generated many questions from hospitals and private sector ambulance companies which provide EMT and paramedic services. The questions focus on the recently passed legislative overhaul of N.J.S.A. 34:15.7.3. That original 1988 law is entitled, “Cardiovascular or cerebrovascular injury or death of police, fire or emergency personnel in response to […]
Respondent Defeats Alleged Claim of Aggravation and Motion for Medical and Temporary Disability Benefits Seeking Payment for Five Spinal Surgeries
Cases involving aggravation of preexisting conditions are quite common in workers’ compensation and are often complex. Adequately addressing such claims requires obtaining the pre-accident medical treatment records and obtaining expert opinion on whether the work accident aggravated the prior condition. Donald Smith v. H & H Transportation, Inc., No. A-3568-21 (App. Div. December 20, 2023) […]
Appellate Division Holds Employee Who Worked and Attended School Is Eligible for Temporary Disability Benefits After Unemployment Benefits Terminated
There are not many cases involving eligibility for temporary disability benefits while attending school. The case of Soto v. Hoosier Care, Inc., No. A-0507-22 (App. Div. December 11, 2023) discusses this issue directly. The facts in the opinion are threadbare, and the reader will have many more questions than answers after reading this decision. The […]
Medical Provider Cannot Sue Workers’ Comp Carrier for Breach of Contract to Get Around New Jersey’s Exclusive Remedy for Medical Disputes
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 […]
The “Silk City”
It is a city conceived and created by one of the most famous Americans in history. He is perhaps even more well known today than ever following the success of the eponymous Broadway show “Hamilton” created by Lin-Manuel Miranda. Yet it is a city that surprisingly few New Jersey residents know much about. The city […]
A Practitioner’s Guide to Prior Injuries and Credits
Practical Advice in New Jersey Workers’ Compensation Pursuant to N.J.S.A. 34:15-12(d), “if previous loss of function to the body, head, a member or an organ is established by competent evidence, and subsequently an injury or occupational disease arising out of and in the course of an employment occurs to that part of the body, head, […]
Supreme Court Finds Non-Waivable Duty on the Part of Insurance Brokers to Provide Notice of Available Coverage for LLC Members
When coverage is denied under a workers’ compensation policy for an LLC, one can be almost certain that a finger will be pointed, rightly or wrongly, at the insurance broker. The more severe the injury, the more likely the potential for a civil suit. This was the situation in Holm v. Purdy, New Jersey Supreme […]
A Practitioner’s Guide to “Arising Out of Employment and Occurring In the Course of Employment”
Practical Advice in New Jersey Workers’ Compensation Practitioners and employers will often hear the phrase, “arising out of and in the scope of (or course of) employment.” This phrase encompasses two separate concepts: 1. Occurring in the course of employment, which refers to when the injury occurred and if it occurred at work; and 2. […]
Appellate Division Vacates Penalties and Fees Against Employer Pending New Hearing
In Saiti v. Garden Homes, No. A-1328-20 (App. Div. October 11, 2022), the petitioner received an award for $66,074 on September 3, 2020. The terms of the settlement were memorialized in an order signed by the Judge of Compensation and both parties. Petitioner’s attorney made numerous phone calls in the ensuing 60 days regarding non-payment […]
Advice to Employers In Dealing With Potential Fraud
Practical Advice in New Jersey Workers’ Compensation N.J.S.A. 34:15-57.4 (commonly known as the Workers’ Compensation Fraud Act) states in pertinent part: “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 […]
Advice to Employers in Dealing With Dependency Issues, Dependency Benefits, and Lifetime Benefits
Practical Advice in New Jersey Workers’ Compensation What happens if an employee dies during the pendency of the open and ongoing workers’ compensation claim? The answer to this depends on a few factors. The first consideration is when the petitioner died (during treatment/ before permanency exams, after permanency exams, or after an Order Approving Settlement […]
How to Properly Cancel a Workers’ Compensation Policy
Coverage Issues in Workers’ Compensation Often cases are referred to this insurance defense attorney where the policy was cancelled prior to the alleged date of loss. The claimant-petitioner has retained an attorney and has filed a Claim Petition in the Division of Workers’ Compensation. The petitioner’s counsel has reviewed the New Jersey Compensation Rating and […]
Advice To Employers In Dealing With Complex TTD Scenarios
Practical Advice in New Jersey Workers’ Compensation The general rule is that an injured worker is entitled to TTD for the time frame that the authorized treating doctor placed the employee out of work. Pursuant to Monaco v. Albert Maund, Inc., 17 N.J. Super. 425 (App. Div.), 21 N.J. Super. 443 (App. Div. 1952), generally, […]
Book Review Of “Workers’ Compensation Emerging Issues Analysis”
For those readers who are interested in learning about current issues in workers’ compensation, I highly recommend the 2021 LexisNexis book entitled “Workers Compensation Emerging Issues Analysis.” I was asked to review this book and found it to be chock full of cutting-edge articles written for attorneys, employers, physicians, adjusters, carriers and third party administrators. […]
UBER Style Business Found To Be Employer of Driver
Julio Pendola fractured his ankle in 2014 picking up a customer and filed a petition in the Division of Workers’ Compensation. He asserted that he worked exclusively as a driver for Classic, which had over 100 cars. He purchased his own car after consulting with Classic. The company required Pendola to paint the car silver […]
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