Insurance Carriers Lose Fight to Limit Payment of Doctors

Insurance Carriers Lose Fight to Limit Payment of Doctors

When an Emergency Room doctor performs an operation that saves a life in New Jersey due to a work accident, the doctor usually ends up fighting an insurance carrier over how much is a reasonable fee for his or her professional services. In a published decision, an Appellate Division Three-Judge Panel just rebuked arguments made by the Insurance Council of New Jersey, whose members are 16 Insurance Companies who do business in New Jersey, by holding that doctors have six years to file a claim in the New Jersey Workers Compensation Court for unpaid or partially paid medical bills rather than two years as advocated by the Insurance Council of New Jersey and the insurance companies involved in the appeal.

The 2012 Amendment

In 2012, the New Jersey State Legislature amended the Workers Compensation law to provide that disputes over unpaid medical bills matters involving work accidents had to be filed in the Workers Compensation Court.  The amendment to the law codified case law which had stated that medical bills related to Workers Compensation should be resolved in the Workers Compensation Court rather than the Superior Court of New Jersey.

Time Periods to File Claims

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NJ Supreme Court Takes Up Volunteer Firefighter’s Case for Benefits

NJ Supreme Court Takes Up Volunteer Firefighter’s Case for Benefits

 In New Jersey, Volunteer Firefighters have a special section outlining their entitlement to Workers Compensation Benefits from the town they serve.  The special section for Volunteer Firefighters was enacted by the Legislature to make sure that a volunteer firefighter, who is performing a laudable job receives temporary disability benefits, medical bills paid and permanency benefits if they are injured on the job.  Volunteer Firefighters are deemed to be at work during their travel to the firehouse or site of a fire. With some exceptions, a worker isn’t covered under the Workers Compensation Law while commuting to work.  It makes good public policy to provide coverage to Volunteer Firefighters because their service saves townships throughout New Jersey a lot of money by eliminating the need for a full time fire service and Volunteer Firefighters also save lives and property a benefit to the communities they serve. 

Supreme Court Accepts Appeal

The New Jersey Supreme Court accepted an appeal from a decision by a three judge panel in the Appellate Division which upheld the decision of a Workers Compensation Judge not to award temporary disability benefits to an injured volunteer firefighter.  The Workers Compensation Statute provides temporary disability benefits to volunteer firefighters.  It even provides temporary disability benefits at the maximum rate allowed for the year of the accident.  So why was the temporary disability benefit denied.  The Workers Compensation Judge found that the Volunteer Firefighter did not have a “wage loss” because the Volunteer Firefighter, at the time of the accident, was not employed.  The Firefighter had stopped working to take care of her ailing father.  The Appellate Division agreed with the decision stating that without a “wage loss” there could be no temporary disability benefits.

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Patients Exposed to HIV & Hepatitis at NJ Surgical Center

Patients Exposed to HIV & Hepatitis at NJ Surgical Center

When Mahogany Clifton had a work accident and injured her shoulder, she never thought that she would be at an attorney’s office talking about a lawsuit against the surgical center her doctor chose to do a routine shoulder surgery to fix a shoulder tear.  Mahogany Clifton, however, was one of the persons at a Press Conference who was potentially exposed to the HIV and the Hepatitis virus at the HealthPlus Surgery Center in Saddlebrook NJ. To be clear, Mahogany Clifton has not yet undergone blood testing for HIV or Hepatitis, but her anxiety over the potential for either infection showed in her face at the Press Conference.

Department of Health Inspection & Immediate Closure

The Department of Health of New Jersey shut down the Health Plus Surgical Center located at 190 Midland Avenue, Saddle Brook on September 7, 2018, after an inspection on that day found unacceptable sterilization practices, poor drug storage methods, and an outdated infection control plan among other violations.  One particular egregious sterilization violation was the improper use of drug vials for more than one patient which could spread a virus if the vial is contaminated and then used for another patient. Another was the improper use of sterilization oven by overcrowding and not allowing the instruments to cool (part of the sterilization procedure) which would result in surgical instruments not being sterilized.

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Fireworks Legal in New Jersey? False News

Fireworks Legal in New Jersey? False News

Fireworks Coming Soon

Fireworks Coming Soon

In 2017, ex-Governor Chris Christie signed a law passed by the New Jersey Legislature allowing for the sale, possession, storage, and use of certain sparklers and other non-exploding, non-aerial fireworks by persons 16 years of age or older.  Several local stores and fireworks vendors have started to sell fireworks in New Jersey.  (more…)