The Division Of Workers’ Compensation’s jurisdiction includes medical fee disputes arising from New Jersey workers’ compensation claims.N.J.S.A. 34:15-15 states:
“Exclusive jurisdiction for any disputed medical charge arising from any claim for compensation for a work-related injury or illness shall be vested in the division.”
As evidenced by its situation inside of the New Jersey Workers’ Compensation section of the New Jersey Labor Statute, this provision is meant to apply to all New Jersey Workers’ Compensation claims.
Prior to the November 19, 2012 amendment to the New Jersey Workers Compensation Act (N.J.S.A. 34:15-15), the statue of limitations for fee disputes was set by N.J.S.A. 2A:14-1 as per Medical Diagnostic Assocs. v. Hawryluk, 317 N.J. Super. 338, 349 (App. Div. 1998), cert. denied, 160 N.J. 89 (1999). Under N.J.S.A. 2A:14-1, recovery upon a contractual claim or liability, express or implied, not under seal, or upon an account other than one which concerns the trade or merchandise between merchant and merchant, their factors, agents and servants, shall be commenced within 6 years next after the cause of any such action shall have accrued.” Continue reading The Statute of Limitations in New Jersey Medical Provider Claims
Coverage under the Longshore and Harbor Workers’ Compensation Act requires a master-servant relationship between employer and an employee. Crowell v. Bensen, 285 U.S. 22, 54 (1932). The Act defines employee as “any person engaged in maritime employment, including any longshoreman or other person engaged in longshoring operations, and any harbor-worker including a ship repairman, shipbuilder, and ship-breaker.” 33 U.S.C. § 902(3). The Act also sets out a long list of potential employees who do not fit the criteria: clerical and secretarial workers, marina workers, fishermen, etc.
The issue of employment is usually reached int he context of an alleged independent contractor seeking benefits. Just because an employer has not secured LHWCA coverage for an employee does not mean that that worker is not covered under the Act as an employee. Tanis v. Rainbow Skylights, 19 BRBS 153 (DOL Ben. Rev. Bd. 1986). Continue reading Longshore Employment Defined.
Which workers’ compensation act applies: the Longshore and Harbor Workers’ Compensation Act or the Jones Act? The Jones Act and the LHWCA are mutually exclusive. Thus, when dealing with a “water-based” (as opposed to “land-based”) LHWCA claim, it must be determined if the claim falls within the criteria of LHWCA coverage, or belongs more properly under the Jones Act. Of course, the claim might not belong under either jurisdiction and should be decided under a state workers’ compensation act.
The Jones Act (The Merchant Marine Act, 1920, 46 U.S.C. § 688), in pertinent part, reads as follows:
Any seaman who shall suffer personal injury in the course of his employment may, at his election, maintain an action for damages at law, with the right of trial by jury, ... and in case of the death of any seaman as a result of any such personal injury the personal representative of such seaman may maintain an action for damages at law with the right of trial by jury. ... Jurisdiction in such actions shall be under the court of the district in which the defendant employer resides or in which his principal office is located.
Admiralty jurisdiction and the coverage of the Jones Act depends only on a finding that the injured was “an employee of the vessel, engaged in the course of his employment” at the time of his injury. The fact that a Jones Act petitioner’s injury occurred on land is not material. 46 U.S.C. § 740; Senko v. La Crosse Dredging Corp., 352 U.S. 370, 373 (1957). Continue reading The Jones Act v. Longshore
Workers’ Compensation benefits are analogous to no fault benefits because the employee will be entitled to benefits regardless of whether the employee was negligent in causing the injury or death. By the same token, an employer’s negligence is not considered. Comparative negligence, contributory negligence, or the act of God doctrines are not applicable in determining entitlement to workers’ compensation benefits in New York. Pierce v. Young, 252 N.Y. 520 (1929).
There are some exclusions from compensation. Keep these possible defenses handy when analyzing claims. Continue reading Defenses to New York Workers’ Compensation Claims
The Longshore and Harbor Workers’ Compensation Act provides for medical benefits and disability benefits to an injured worker. An injured employee is entitled to reasonable and necessary medical, surgical, and hospital treatment and other medical supplies and services required by the work-related injury or illness, such as prescription medications, diagnostic tests, physical therapy, prostheses, hearing aids, attendant care, and the cost of travel for such treatment. An injured employee is entitled to select a physician of his/her choice to provide medical treatment for the work injury.
The LHWCA provides for the payment of compensation for the following four types of disability: temporary partial, temporary total, permanent partial, and permanent total. This compensation can not exceed two-thirds of the employee’s average weekly wage during the period of disability, subject to maximums and minimums. 33 U.S.C. § 908 Continue reading Overview of Longshore Benefits
The right to compensation for disability or death is barred unless a claim therefore is filed within one year after the injury or death. 33 U.S.C. § 913. Continue reading The Statute of Limitations in Longshore Claims