NJ Adopts New Workers' Compensation Rules Aimed at Reform
Update on Cases and Regulations
New Administrative Regulations
The State of New Jersey recently adopted new Administrative Rules, which appear to be the most sweeping reform of the NJ Workers' Compensation system in the last 17 tears. The rules address substantive and procedural aspects that may result in a detrimental effect on the rights of many litigants. The Rules were adopted on March 3, 1997, with the support of business and the insurance company lobbying teams.
- more specific pleading is now required
- more delays in the processing of claims have been imposed
- increased difficulty in obtaining exposure information from the employer
- no commutations of awards will be permitted in total or dependency claims
- the time to file a discrimination action has been reduced to 180 days
Since many of the rules promulgated appear to be contrary to the spirit and intent of the New Jersey Workers' Compensation Act, it would not be surprising if the Courts, as well as the NJ Legislature, review the proposals and modify them to conform with the philosophy that workers' compensation is social remedial legislation and a type of social insurance for the injured worker. The Rules were adopted on March 3, 1997, and for the most part, took effect immediately.
Intoxicated Worker Awarded Workers' Compensation Benefits
An employee fell from a narrow, eighteen-foot-high scaffold in the course of assembling a sheet metal roof. Even though there was evidence admitted at the trial that he had consumed a gallon and a half of hard alcohol, drank two beers that day, and had a grossly elevated blood alcohol level of .29%, the accident was held compensable.
The court reasoned that the accident was also caused by the risk of work in addition to alcohol consumption. The accident was partially caused while the worker was attempting to fasten a defective assembly apparatus to the bridge of the scaffold. Therefore alcohol consumption was not the sole cause of the accident. Warner v. Vanco Manufacturing, Inc. (App. Div. 1997)
Employee Harassed By State Police Awarded Benefits
Where there is a specific traumatic event caused by the employer's actions, the petitioner's psychiatric disability is said to be causally related to the employment. An employee was accused of searching through the desk of another employee, and a criminal investigation concerning the theft of an expensive bracelet from the other employee's desk was instituted. The injured worker suffered depression, high blood pressure and post-traumatic stress disorder due to being falsely imprisoned and harassed by the New Jersey State Police detectives. She accused the detectives of yelling at her and insisting that she was lying. The employee became very emotional, began to cry, and became nauseous during the investigation. She was threatened by the State Police with an arrest warrant and informed that she could go to jail for 5-7 years. The employee was denied a request to call her sister or her cousin on the telephone. Detectives detained her for over 2 ½ hours in the basement of the Justice Complex. Approximately 3 weeks after the investigation, she was advised that she was no longer a suspect in the theft of the bracelet. Prettman v. State of New Jersey (App.Div.1997).
Examining Physicians Have A Duty To Exercise Reasonable Professional Care
While the court did not intend to impose upon the examining physician the same duty owed to the traditional patient, the examiner will be subject to third-party liability if the professional fails to diagnose a condition for which the claimant presents symptoms and complaints. A forty-year-old individual was unable to continue to work because of vision problems. The claimant claimed he could not drive a car because of decreased vision. The claimant appeared at a physician's office for an examination for Social Security Disability Benefits at the direction of the reviewing agency. The examining physician noted the petitioner's complaint of poor vision and administered eye chart tests, and concluded that the claimant was in fairly good health, although his eyesight could be better. The claimant's problems continued, and he saw an ophthalmologist who referred him for MRI studies. Diagnostic tests revealed a large brain tumor in the optic chasm, which was the cause of his visual difficulties. Surgical tumor excision was required, and follow-up radiation treatments were conducted. The Social Security Administration finally awarded disability benefits and the claimant was permitted to proceed against the examining physician for professional negligence. Ranier v. Frieman (App.Div.1996).
Teachers' Summer Benefits Limited - Seasonal Employment
A worker who is not expected to work for the school district over the summer recess and who has already received his or her full salary was not permitted to collect temporary disability benefits over the summer recess. The court held that the workers' compensation benefits were to be paid with the same intent as sick leave benefits according to N.J.S.A. 18A:30-2. Outland v. Monmouth-Ocean Education (App. Div. 1996) [Note: Reversed on appeal Outland v. MONMOUTH-OCEAN EDUC. SERV., 713 A. 2d 460 - NJ: Supreme Court 1998].