On large construction projects the main general contractor may obtain a workers’ compensation insurance policy to cover all workers on a the job site – this policy is called a “wrap-up” policy. A wrap-up policy has an expiration date that coincides with the planned completion date of the project.
Disability stemming from any disease within the course of employment may entitle the employee to compensation, if the disease is found to be occupational in nature. Di Nicola v. Crucible Steel, Inc., 83 A.D.2d 735, 736, 442 N.Y.S.2d 582, 584 (3d Dept. 1981); see also Rodriguez v. Atlantic Gummed Paper Corp., 61 A.D.2d 873, 402 N.Y.S.2d 238, 239 (3d Dept. 1978). To be considered an occupational disease, the disease must be the “result of a distinctive feature of the kind of work performed by claimant and others similarly employed, not an ailment caused by the peculiar place in which the particular claimant happens to work … or caused by ordinary contact with a fellow employee ….” Paider v. Park East Movers, 19 N.Y.2d 373, 380, 280 N.Y.S.2d 140, 144, 227 N.E.2d 40, 43 (1967) (citations omitted). In order to obtain workers’ compensation benefits based upon an occupational disease, the claimant must “establish a ‘recognizable link’ between his condition and a distinctive feature of his occupation.” Engler v UPS, 767 NYS2d 496, 498 . Therefore, the foundation of determining if a disability resulted from an occupational disease is whether a distinctive feature of employment caused the disability.
A recent decision serves as a reminder that when cases are bifurcated for trial, the ruling may only be limited to the issue before the Court. In Moran v. Cosmetic Essence, the Judge of Compensation issued a ruling on temporary disability following a bifurcated trial regarding the compensability of an alleged work-related injury. On March 14, 2018, the Appellate Division of the Superior Court of New Jersey remanded the matter finding that the workers’ compensation judge should not have ruled to award temporary disability benefits following a bifurcated trial on compensability.
The facts in Moran.
The petitioner, Nestor Moran, filed a Claim Petition alleging that he was injured on January 28, 2016 while lifting a heavy box. Respondent filed an Answer denying compensability and alleging that no accident occurred while working. Petitioner then filed a Motion for Temporary and Medical Benefits. However, due to the fact that the Respondent denied a work-related accident occurred, it was agreed that they would bifurcate the trial limited to whether a work-related injury occurred and if such an injury did not occur, whether the petitioner committed fraud by pursuing the matter. Continue reading Practical Advice for Bifurcated Trials in New Jersey→
This video from our March 19, 2018 webinar presentation is designed to answer the following questions:
“What are the most common causes for penalties in New York?” and
“How do we avoid case-level penalties?” and
“What can we do to mitigate or resolve a penalty issue?”
Presenter Greg Lois has years of experience representing employers and carriers before the Board. At the end of the presentation, the attendees will have a basic understanding of the common penalties, tactics to avoid penalties, and the potential to mitigate or resolve some penalties.