A Capehart Scatchard Blog

Controlling Costs

Pro or Con: Reducing Pay While Employee Is On Light Duty?

I received an excellent question today from a reader of this blog.  The question was this:  “I’m looking for some information on whether it is acceptable to bring an employee back for light duty at a wage that is lower than their pre-accident wage provided that they are paid at least at the temporary total […]

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Workers’ Comp Lien Applies Even if PIP Benefits Are Not Recoverable Against Tortfeasor

On January 13, 2011, Paulette Dorflaufer was hit by a car while working as a part-time crossing guard for Livingston Township.  She filed a workers’ compensation claim and filed a negligence law suit against the tortfeasor.  She settled that case for $95,000 for pain and suffering.  PMA Management Corporation put plaintiff on notice of its […]

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Workers’ Comp Lien Applies to Medical Payments That Could Have Been Paid Through Plaintiff’s PIP Carrier

Ever since the decision in Dever v. New Jersey Mfrs. Ins. Co., No. A-3102-11T2, (App. Div. Oct. 23, 2013), plaintiffs’ counsel have been arguing that respondents do not have a lien for medical bills paid in workers’ compensation from a work-related car accident where the plaintiff had PIP coverage.  But civil courts have not been […]

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Judge of Compensation Rejects Medical Reimbursement Claim and Adopts Paid Fees as Being Most Reliable Measure of Reasonable and Necessary Care

The New Jersey Division of Workers’ Compensation has thousands of medical reimbursement claims in various stages of negotiation and litigation.  Few cases actually get tried because most medical providers do not want to come to court to defend their charges. The vast majority of cases get settled through negotiations.  One recent case, however, involved testimony […]

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When Should an Employer Order a Fitness-For-Duty or Functional Capacity Exam?

This is the second article devoted to fitness-for-duty examinations and Functional Capacity Exams (FCE) in workers’ compensation. The first segment focused on how such examinations can lead to significant cost savings for employers and common mistakes that are made by employers.  This segment will focus on when to order a fitness exam or FCE and […]

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Fitness-For-Duty and Functional Capacity Exams: Important Tools in Reducing Workers’ Compensation Costs

We have all seen this situation: an employee with a physical job has major surgery and is given restrictions by the treating doctor, who issues an MMI note (maximum medical improvement).  When temporary disability benefits are stopped, the employee immediately calls to see about returning to work.  The employer indicates that it cannot take the […]

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Past Medical History Remains the Key to Controlling Costs in Workers’ Compensation

Those who do not remember the past are doomed to repeat it, wrote George Santayana.  In workers’ compensation, those who do not know the past are doomed to pay for it.  Winning in workers’ compensation in almost every state comes down to developing past information about injuries, car accidents, chiropractic care, sports activities, second jobs, […]

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CDC Releases Guideline for Prescribing Opioids for Chronic Pain

Pain management has become a major health issue and cost driver in most state workers’ compensation programs with the proliferation of prescription opiates and consequential addictions arising from workers’ compensation injuries.  One of the central problems that practitioners face in file handling and in court is the absence of any clear standards to decide whether […]

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Appellate Court Explains How an Employer Can Protect Its Lien Rights by Filing Suit in the Name of the Injured Worker

Employers are aware that if the claimant has not pursued his or her third party civil action within a year of the injury, the employer can provide a 10-day notice and then sue in the name of the injured worker.  But what happens if the injured worker will not cooperate with the law suit?  Can […]

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Appellate Court Affirms Some Sanctions Against Employer and Reverses Other Sanctions

Sanctions against an employer in workers’ compensation are rather rare, and the case of Pschunder-Haaf v. Synergy Home Care of South Jersey, A-3138-13T3, (App. Div. May 12, 2015) provides some guidance on conduct that may lead to such sanctions. The petitioner, Pschunder-Haaf, a home health aide, injured her low back when a patient fell on […]

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Appellete Division Holds That Costs of Suit Under Subrogation Provision in New Jersey are Limited to $750

By on September 25, 2012 in Controlling Costs, NJ Workers' Comp with 1 Comment

From time to time, plaintiff’s counsel takes the position that respondent’s lien is applied to the net proceeds after deduction for plaintiff’s total costs of suit.  In Greater New York Mutual Insurance Company v. Calcagno & Associates, A-0900-11T4 (App. Div. September 20, 2012), that very issue was decided. John Phillips was injured arising from work, […]

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Appellate Division Allows Medical Reimbursement Claim To Proceed In Civil Court While Comp Case Is Pending

Legal actions for reimbursement by medical providers have become very common in the New Jersey Division of Workers’ Compensation.  Now they are even more complex following the decision in The Valley Hospital v. LQ Management LLC, A-0831-10T1 (App. Div. August 8, 2011). The facts are straightforward.  An employee of LQ Management, LLC, was treated for […]

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Liens and Subrogation – Kuhnel v. CNA Ins. Cos.

In Kuhnel v. CNA Ins. Cos., 322 N.J. Super. 568 (App. Div. 1999), certif. denied, 163 N.J. 12, cert. denied, 531 U.S. 819 (2000) the Appellate Division held that a lien under N.J.S.A. 34:15-40 shall not include expenses for rehabilitation nursing services as a medical cost unless respondent can prove that the services primarily benefited […]

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Liens and Subrogation – Errickson v. Supermarkets General Corp.

New Jersey has a powerful subrogation provision under N.J.S.A. 34:15-40.  Respondent is entitled to two thirds of its payment if the recovery exceeds the total workers’ compensation expenses.  The employer must properly reserve lien rights. The case of Errickson v. Supermarkets General Corp., 246 N.J. Super. 457 (App. Div. 1991) points out how failure to […]

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