Category Archives: New Jersey

New Jersey: No Modification to Award 18 Years After Loss

Joe Jones, Esq.
Joe Jones, Esq.
The New Jersey Appellate Division just handed down a decision in Larry D. Batts v. Flag House, a case that although not precedent for other courts to follow (the decision was an unpublished decision under Docket No. A-5616-15T4, January 16, 2018), discusses two important things:

  • A decision by a workers’ compensation Judge supported by substantial credible evidence will be generally upheld as substantial deference is given to their decisions as the trier of fact. This is a common theme in many Appellate decisions but an important one to note when you are making a record in a trial.
  • When an original case settles under an Order Approving Settlement involving more than one body part (arm and back, neck and psych, etc.) and the first re-opener is filed and settled with an increase to one of the original body parts but remains silent as to the other body parts, the second re-opener may include an increase in disability to the other body part that was not increased in the prior re-opener OAS (of course the petitioner still has to prove an increase in permanency!).

In Larry D. Batts v. Flag Ship, petitioner claimed injury to his right foot as well as psychiatric disability for chronic depression and anxiety disorder as a result of an accident that occurred on April 2, 1998 while at work when a forklift ran over his right ankle. The original case settled under an Order Approving Settlement awarding the petitioner 50% of the right foot for orthopedic disability and 10% of partial total for psychiatric disability. Continue reading New Jersey: No Modification to Award 18 Years After Loss

Practical Guide: Understanding “PIP” and Winning Appeals in New Jersey

What is “PIP”?

“PIP” is short for “Personal Injury Injury Protection.” Personal Injury Protection is a mandatory coverage in New Jersey automobile insurance policies. that provides medical expense, income continuation, essential services, an funeral expense benefits for persons injured in automobile accidents. The coverage is available to the insured regardless of who was at fault in the accident. Personal Injury Protection is provided for “private passenger automobiles” as that term is defined in N.J.S.A. 39:6A-2. The definition covers both the type of vehicle and the ownership of the vehicle.

Disputes regarding medical care provided under the Personal Injury Protection coverage are resolved by way of Internal Appeal Procedure mandated by law or, where that fails to resolve the issue, by way of appeal to arbitration forum (Forthright, a provide company providing alternative dispute resolution services). This guide provides a background on PIP and a primer on resolving disputes for lawyers handling these cases. Continue reading Practical Guide: Understanding “PIP” and Winning Appeals in New Jersey

Video: Section 20 Lump Sum Dismissals and Medicare Secondary Payer in New Jersey

Attorney Greg Lois discusses the availability of a lump-sum dismissal settlement in New Jersey Workers’ Compensation cases. The presentation looks at the limitations on this type of compromise in the statute (N.J.S.A. 34:15-20), the rules (N.J.A.C. 12:235-13.1) and the case law. Attorney Lois reviews the barriers to Section 20 settlements and presents practical advice and opinion on obtaining the dismissal in court. The discussion also include an overview of the Medicare Secondary Payer Act as a barrier to full compromise settlements in New Jersey, with practical tips for resolving cases quickly.

Subject: New Jersey, Workers’ Compensation Law, Exposure, Permanency, MMI
Date Presented: January 22, 2018
Presenter: Greg Lois
Run time: 34:34

Continue reading Video: Section 20 Lump Sum Dismissals and Medicare Secondary Payer in New Jersey

Video: Maximizing Recovery via Reimbursement and Subrogation Under New Jersey Section 40

Attorneys Christopher Major and Greg Lois present a webinar on carrier recovery through reimbursement and subrogation under New Jersey’s Section 40 (N.J.S.A. 34:15-40). They discuss the impact of recent cases, such as the December 11, 2017 Supreme Court decision in Vitale v. Schering Plough and the November 22, 2017 Appellate Decision in Pino v. Polanco. The attorneys discuss reimbursement to the carrier/employer from the proceeds of civil actions as well as tactics for maximizing recovery – including practical negotiation tips for dealing with plaintiff’s attorneys who always demand a lien reduction to “1/3rd.”

Subject: New Jersey, Workers’ Compensation Law, Exposure, Permanency, MMI
Date Presented: December 26, 2017
Presenter(s): Christopher Major and Greg Lois
Run time: 29:42

Continue reading Video: Maximizing Recovery via Reimbursement and Subrogation Under New Jersey Section 40

Court Reviews Evidence to Support a Finding that the Petitioner was deemed Permanently and Totally Disabled due Solely to the Last Compensable Accident

Karen Vincent, Esq.
Karen Vincent, Esq.

On October 30, 2017, the Appellate Division of the Superior Court of New Jersey in D’Angelo v. Archdiocese of Newark, N.J. Super. App. Div. (per curiam) (22pp.) issued a written decision affirming a prior compensation judge’s ruling that the petitioner was permanently and totally disabled from the last accident.

The petitioner, Teresa D’Angelo, was employed as a school bus driver for the respondent, Archdiocese of Newark/Christ the King Preparatory Schools at the time of the accident. On November 28, 2011, while driving the school bus, she was hit by a stray bullet from an AK-47. The bullet lodged in to petitioner’s pelvis causing multiple internal injuries. The respondent accepted compensability of the claim and authorized the petitioner to submit to treatment. Petitioner underwent authorized surgery and treatment to the pelvis, hips, abdomen, lumbar spine and PTSD. Continue reading Court Reviews Evidence to Support a Finding that the Petitioner was deemed Permanently and Totally Disabled due Solely to the Last Compensable Accident

Can an Incapacitated New Jersey Beneficiary Receive Dependency Benefits for Life?

Michael Gervolino, Esq.
Michael Gervolino, Esq.
The New Jersey Workers Compensation Act specifies that in the case of total disability, the petitioner is entitled to payments for a period of up until 450 weeks. See N.J.S.A. 34:15-12(b). If the petitioner perishes as a result of his workers compensation injury, the Act provides us with guidance for the petitioner’s dependents at the time of death. For example, in the case of a surviving spouse, the Act directs us to N.J.S.A. 34:15-13(j), which states that the surviving spouse shall receive payments for the “entire period of survivorship or until such surviving spouse shall remarry.” See N.J.S.A. 34:15-13(j).

In the case of children as dependents, the plain language of N.J.S.A. 34:15-13 tells us that us that they are entitled to payments up until the age of 18, unless they are physically or mentally deficient which would allow them to collect on the “full compensation period of 450 weeks.” See N.J.S.A. 34:15-13(i). The plain meaning of this statue leads one to interpret the language as limiting disabled dependents to 450 weeks of compensation following the death of the petitioner, unless they are a surviving spouse.

In the case of Apperman v. Visiting Nurse Ass’n of Westfield, a father and son challenged this interpretation of the statute by arguing that a disabled dependent is entitled to benefits for the entirety of his life. Continue reading Can an Incapacitated New Jersey Beneficiary Receive Dependency Benefits for Life?